Prescribe levonorgestrel-releasing IUS by brand, GPs advised

Levonorgestrel-releasing intrauterine systems (IUS) should be prescribed by brand, according to new advice issued by the MHRA.

Insertion and removal of any intra-uterine device may be associated with pain, bleeding and in some cases perforation of the uterus. | iSTOCK
Insertion and removal of any intra-uterine device may be associated with pain, bleeding and in some cases perforation of the uterus. | iSTOCK

Three IUS containing levonorgestrel are currently available in the UK. Because of the differences in indications, durations of use, and insertion techniques of these products, they should always be prescribed by brand name.

IUS containing 52mg levonorgestrel

Levosert is a levonorgestrel IUS launched in the UK in 2015. Although it contains 52mg levonorgestrel, identical to Mirena, the two IUS have different indications, durations of use and introducers.

Further information
MHRA Drug Safety Update
View Mirena drug record
View Levosert drug record
View Jaydess drug record

Key differences:

  • Mirena is licensed for 5 years of contraceptive use, whereas Levosert is licensed for 3 years' use

  • Mirena is licensed for 4 years' use for endometrial protection as part of an HRT regimen (Levosert is not licensed for this indication)

  • The two IUS have different insertion techniques; Levosert requires a two-handed technique

  • The Mirena introducer has a diameter of 4.4mm, compared with 4.8mm for the Levosert introducer.

The release rates and serum levels of levonorgestrel provided by Mirena and Levosert are similar: initially 20 microgram daily, falling to 12 microgram daily after 3 years. 

IUS containing 13.5mg levonorgestrel

Jaydess is a smaller, lower-strength version of Mirena that contains 13.5mg levonorgestrel. It is licensed for 3 years' use for contraception only.

 

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