Mirena contraindications and warnings


Following is information on contraindications to the use of levonorgestrel in general, pregnancy & amp; Breastfeeding and children. Please note that the contraindications may vary depending on the dosage form of a drug (eg tablet, syringe, ointment).

When should levonorgestrel not be used?

Levonorgestrel must not be used in:

  • Hypersensitivity to the active substance
  • Venous obstruction (deep vein thrombosis, pulmonary embolism)
  • previous or existing diseases of the arteries or coronary arteries (stroke, myocardial infarction) or their harbingers (angina pectoris and transient circulatory disorders of the brain)
  • Diabetes mellitus with vascular changes
  • previous or existing severe liver disease if liver function has not yet returned to normal
  • Previous or existing (benign or malignant) liver cancers
  • known or suspected cancerous diseases of the genitals or of the female breast, if these are influenced by sex hormones
  • vaginal bleeding not yet determined by the doctor.

Only after careful risk-benefit assessment by the physician may the active ingredient be taken at

  • vascular
  • Diabetes and also women who have had diabetes mellitus during a previous pregnancy
  • Hypertension
  • Women with dark facial spots (Chloasma gravidarum) due to a previous pregnancy
  • with only one functional fallopian tube or with an increased risk of ectopic pregnancy (pregnancy outside the uterus)

When levonorgestrel is used in an intrauterine device (“spiral”), the following additional restrictions apply:

  • Infections of the genitals
  • Inflammation of the endometrium after birth
  • Miscarriage, associated with septicemia in the last three months
  • Inflammation of the cervix or in the so-called small pelvis
  • Malformations of the cervix or uterus
  • Evidence or suspicion of cancerous uterine or cervical disease
  • exceptional bleeding of the uterus of unknown cause
  • Diseases and conditions associated with a higher risk of infection (eg taking medication to suppress the body’s defenses).

Before starting treatment with levonorgestrel, a thorough check-up with the gynecologist must be made and pregnancy is ruled out by a doctor.

What should you watch out for during pregnancy and lactation?

The active substance must not be used during pregnancy, as developmental disorders of the unborn child can not be excluded.

During lactation, levonorgestrel can be used for contraception because it does not inhibit the formation of breast milk (unlike estrogen-progestagen combinations for contraception). However, since small amounts of the active ingredient are leaking into the milk and there is insufficient research on possible effects on the infant, the development and growth of the breast-fed child must be carefully monitored by the doctor.

After taking a high dose of levonorgestrel for contraception after unprotected sex, breastfeeding should be stopped after 12 hours.

What should be considered in children?

Levonorgestrel is not suitable for use in children.

Warnings and Precautions

  • Regular check-ups should be made with the gynecologist while taking the drug.
  • In women with diabetes mellitus, blood sugar levels should be monitored regularly, especially at the beginning of treatment.
  • Women with a tendency to dark patches of the skin (chloasma) should avoid sunbathing and tanning during exercise.
  • At the first sign of circulatory problems (shortness of breath, leg swelling, dizziness, blurred vision) the medication should be discontinued.
  • Contact lens compatibility may be impaired during the use of the drug.

Sometimes medications release allergic reactions.
If you notice any signs of allergic reaction, tell your doctor or pharmacist immediately.