Levonorgestrel is a long-acting birth control intrauterine device (IUD). This medicine is used to prevent pregnancy.
This medicine is also used to treat menorrhagia (heavy menstrual bleeding).
Levonorgestrel is contained inside a T-shaped IUD. This device will be fitted and inserted through your vagina and cervix inside the uterus (also known as the womb) by your doctor or a healthcare professional.
Prior to fitting and insertion, your doctor or health care professional will examine you. They will also inform you of the right time to be given the device. If you have any concerns regarding its use, ask your doctor or healthcare professional.
During the insertion, you may feel a slight discomfort. Inform your doctor or healthcare professional of any pain that you feel.
Each Levonorgestrel IUD may be left in place for a specified number of years (3 or 5 years, depending on the brand used). The device can be removed at any time by your doctor but no later than the specified span of use (3 or 5 years) from the date of insertion. Remember to see your doctor on the date of device removal.
Alert your doctor if you have the following conditions:
- current, suspected, or history of sex hormone-sensitive cancers e.g. breast, uterine, cervical, or endometrial cancer
- unexplained bleeding from the womb or vagina
- current or history of blood clot disorders
- untreated lower genital infection
- a high risk or with a history of infection of the reproductive organs (pelvic inflammatory disease)
- condition of the uterus that changes the shape of the uterine cavity e.g. large fibroid tumours
- infection from an abortion (within the last 3 months)
- liver disease e.g. liver tumours
- you have an unremoved intrauterine device
as Levonorgestrel may not be suitable for you.
Do not use this medicine if you are pregnant. If you become pregnant while being treated with Levonorgestrel, alert your doctor immediately. This medicine may cause harm to your unborn child.
Inform your doctor if you have the following conditions:
- with risk or history of ectopic pregnancy (pregnancy that occurs outside of the womb)
- history of ovarian cyst (fluid-filled sacs or pockets)
- slow heart rate
- high blood pressure
- seizure or fits
- depression
- severe headache
- migraine (severe throbbing or pulsating sensation usually affecting one side of the head that is often accompanied by nausea, vomiting, and sensitivity to light and sound
- obesity
Let your doctor know if you are breastfeeding.
Levonorgestrel does not reduce your risk of getting HIV infection or any other sexually transmitted diseases. Ensure that you use proper precautions to avoid getting these diseases.
If you are going to have an operation or certain laboratory tests (e.g. test for cholesterol levels or blood sugar tolerance), inform your doctor that you are using this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy tests must be done before treatment to know if this medicine is suited for you to use.
- Routine tests (e.g. sugar levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure during treatment.
- Regular monitoring of signs and symptoms of infection and formation of blood clots may also be needed.
Levonorgestrel may cause any of the following side effects: headache, dizziness, nausea, vomiting, diarrhoea, tiredness, nervousness, pimple, back pain, excessive hair growth, hair loss, increased appetite, breast pain.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs and symptoms of pregnancy outside the womb such as light vaginal bleeding, lower abdominal pain
- displacement of the device (inability to feel the threads)
- severe pain or fever shortly after insertion of the device
- pain, swelling and tenderness in your leg accompanied by redness and warmth
- signs and symptoms of pelvic inflammatory disease such as pain in the lower abdomen, fever, unusual discharge with a bad odour from your vagina, bleeding between periods
- changes in menstrual bleeding patterns
- rashes, swelling of the face, eyes or mouth
- changes in the nipple, lumps in the breast, dimpling of the skin
- difficulty in sleeping, lack of energy, change in mood
- seizure or fits
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- rifampicin (medicine to treat TB [lung infection known as tuberculosis])
- medicines for seizures (fits) e.g. phenytoin, carbamazepine, primidone
- medicines for HIV infection e.g. ritonavir, efavirenz, atazanavir, nelfinavir
- medicines to treat fungal infection e.g. griseofulvin, voriconazole, ketoconazole, itraconazole
- certain antibiotics e.g. erythromycin, clarithromycin
- medicines for high blood pressure or heart disease e.g. diltiazem, verapamil
- ciclosporin (medicine used in organ transplant or certain immune disorders)
- St. John's Wort (herbal medicine)
This list does not include all medicines that may interact with Levonorgestrel.
Always notify your doctor and pharmacist if you are taking or using any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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