1 What is Liletta?

Brand: Liletta, Mirena, Skyla

Generic: Levonorgestrel intrauterine system

Liletta is a plastic device which releases levonorgestrel hormone.

It is a female hormone (a type of progestin) which changes uterine lining, thus preventing attachment of fertilized egg to the uterus. It thickens cervical mucosal, making it harder for sperm to reach the egg.

This device is placed inside uterus (womb). Liletta and Skyla can prevent pregnancy for up to 3 years while Mirena can prevent pregnancy for 5 years. It can also treat heavy menstrual bleeding. Mirena is meant for use in a woman who has had at least one child. Skyla or Liletta can be used whether you have children or not.

It is available only under doctor’s prescription. It is available in the form of insert extended release.

2 What to Know Before Using

Your doctor will inform you of what you need to know before using Liletta.

Before starting, your doctor should be informed about following conditions:

Allergy: Tell your doctor if you have any allergies to food, preservatives, dyes and animals or any previous allergic reaction which occurred while using this drug before.

Pregnancy: Levonorgestrel is category X drug. It is proven teratogenic drug. Make sure you are not pregnant before using it as it causes severe harmful effects on fetus development.

This device can cause severe infection, miscarriage, premature birth, or death of the mother if left in place during pregnancy. Tell your doctor right away if you become pregnant while using it.

Breastfeeding: There are no adequate studies which prove that Levonorgestrel alters breast milk compositions, but one should wait until the baby is at least 6 weeks old before using it.

Drug Interactions: Levonorgestrel interacts with many drugs. It should not be used with several drugs.

Your doctor should be informed of any other medicine which you are taking as he may want to change the dosage or drug.

Some of these drugs are Antifungals, warfarin, valproic acid, lamotrigine, corticosteroid, tranexamic acid.
One should avoid its use in several conditions.

Make sure you inform your doctor of conditions such as:

  • Allergy to silica, silver, barium, iron oxide and silicon.
  • Abnormal vaginal bleeding.
  • Endometriosis.
  • Untreated or uncontrolled pelvic infection (vaginal, cervical uterine, or bladder).
  • Uterine fibroid tumors or other conditions that affect the shape of the uterus.
  • Past or present breast cancer, known or suspected cervical or uterine cancer.
  • Liver disease or liver tumor (benign or malignant).
  • A recent abnormal Pap smear that has not yet been diagnosed or treated.
  • A disease or condition that weakens your immune system, such as AIDS, leukemia, or IV drug abuse.

You may need special tests to safely use a levonorgestrel intrauterine device if you have:

3 Proper Usage

To use Liletta properly, you must follow all instructions given by your doctor.

Levonorgestrel intrauterine system is a T-shaped device. It is inserted through the vagina into the uterus (womb) by a doctor. It is usually inserted within 7 days of menstrual bleeding.

You may feel dizziness or pain during insertion. If the condition persists longer than 30 minutes, inform your doctor.

After each menstrual period, make sure you can still feel the removal strings. Wash your hands with soap and water, and insert your clean fingers into the vagina.

You should be able to feel the strings at the opening of your cervix. Call your doctor at once if you cannot feel the strings, or if you think the device has slipped lower in your uterus or out of your uterus.

A sudden increase in menstrual flow may be a sign that the device has slipped out of place. It will not interfere with sexual intercourse or wear tampons.

Your doctor may want to see you within 4 to 12 weeks of IUD placement. You will also need regular annual pelvic exams and Pap smears. Replace Liletta and Skyla every 3 years and Mirena every 5 years.

4 Precautions to Take

Before using Liletta, there are some precautions you must take.

Call your doctor immediately if you think you are pregnant while you are using this medicine.

Levonorgestrel increases the risk of ectopic pregnancy. Go to the doctor immediately if you experience severe lower abdominal pain 3 to 5 weeks after using it.

You may have an ectopic pregnancy (pregnancy outside the uterus). It is a life-threatening condition, may cause difficulty in getting pregnant in future.

Levonorgestrel has a higher risk of slipping away during the first year of its use. If it slipped, there is no protection against pregnancy.

During first few months, you may experience cramping and blood spotting. These symptoms go away with some time.

Levonorgestrel increases the risk of pelvic inflammatory disease (PID). PID is an infection of fallopian tubes, uterus, cervix, and vagina. PID causes difficulty in getting pregnant in future.

Signs of PID are:

  • Pain in your lower abdomen.
  • Fever
  • An unusual discharge with a bad odor from your vagina.
  • Pain and/or bleeding when you have sex.
  • Burning sensation when you urinate.
  • Bleeding between periods.
  • Levonorgestrel intrauterine system may change blood sugar levels. It also reduces signs of low blood sugar such as rapid pulse rate.
  • Before any medical procedures like MRI, CT scan, inform your doctor that you are using it.

5 Potential Side Effects

Make sure you meet with your doctor in using Liletta to avoid unwanted potential side effects.

All medicines have some side effects. Some people may experience none or minor side effects. Consult with your doctor if they become problematic or frequent.

Most common are:

  • Pelvic pain, vaginal itching or infection, irregular menstrual periods, changes in bleeding patterns or flow.
  • Stomach pain, nausea, vomiting, bloating.
  • Breast tenderness, acne, changes in hair growth, loss of interest in sex.

Less common are:

  • Ectopic pregnancy.
  • It can perforate (form a hole) in the uterus, or can move outside uterus causing scarring, infection of the uterus and other organs.
  • Dyspareunia (pain during intercourse).
  • Heavy or ongoing vaginal bleeding, vaginal sores, vaginal discharge that is watery, foul-smelling discharge, or otherwise unusual.
  • A severe migraine headache.

This is not a complete list of side effects, other may also occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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