Insert Mirena at any time, including during the hormone-free interval of the previous method.
Switching to Mirena from an oral, transdermal or vaginal hormonal contraceptive
If Mirena is not inserted during the first seven days of the menstrual cycle, a barrier method of contraception should be used, or the patient should abstain from vaginal intercourse for seven days to prevent pregnancy.
If Mirena is inserted during the first seven days of the menstrual cycle or immediately after a first trimester abortion, back-up contraception is not needed.
Consider the possibility of ovulation and conception prior to initiation of this product.
Insert Mirena any time there is reasonable certainty that the woman is not pregnant.
Starting Mirena in women not currently using hormonal or intrauterine contraception Use strict aseptic techniques throughout the insertion procedure. Do not use if the seal of the sterile package is broken or appears compromised. Do not open the package until required for insertion. Mirena is supplied in a sterile package within an inserter that enables single-handed loading (see Figure 1). This rate decreases progressively to approximately 10 mcg/day after 5 years and 8 mcg/day after 7 years.įor contraception, remove Mirena by the end of the seventh year and replace at the time of removal with a new Mirena if continued use is desired.įor treatment of heavy menstrual bleeding, replace Mirena by the end of the fifth year if continued use is needed because data on use in this indication beyond 5 years are limited. Initially, LNG is released at a rate of approximately 20 mcg/day. Mirena contains 52 mg of levonorgestrel (LNG).
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