Intra-Uterine Progestogen–Only Device

Warning

Progestogen-Only Device

Preferred list (P)

LEVOSERT®

  • Effective for 6 years when used for contraception. 

  • Has a demonstrated efficacy for 3 years for the indication of heavy menstrual bleeding. Clinical trial data to support efficacy beyond this are not available. Levosert should be removed or exchanged if heavy or bothersome menstrual bleeding returns or no later than 6 years if used clinically in line with contraceptive effectiveness.

  • Currently the most cost-effective.

  • Levonorgestrel intrauterine delivery system - initial in vivo release rate of 20.1 micrograms/day decreases to 17.5 micrograms/day during the first year and 8.6 micrograms/day during the sixth year.

  • See Summary of Products Characteristics (SPC) for full pharmacokinetic properties.

MIRENA®

  • Effective for 5 years in the indications for contraception and idiopathic menorrhagia.

  • Also licensed for protection from endometrial hyperplasia during oestrogen replacement therapy.

  • Levonorgestrel intrauterine delivery system - initial in vivo release rate of 20 micrograms/day estimated to decrease to 18 micrograms/day during year 1 and 10 micrograms/day at year 5.

  • See Summary of Products Characteristics (SPC) for full pharmacokinetic properties.

Total list (T)

KYLEENA®

  • Effective for 5 years when used for contraception.

  • Levonorgestrel intrauterine delivery system - in vivo estimated average release rate over year 1 is 12.6 micrograms/day and 9 micrograms/day over 5 years.
  • See Summary of Product Characteristics (SPC) for full pharmacokinetic properties.

BENILEXA®

  • Effective for 6 years when used for contraception.
  • Has a demonstrated efficacy for 3 years for the indication of heavy menstrual bleeding. Clinical trial data to support efficacy beyond this are not available. Benilexa should be removed or exchanged if heavy or bothersome menstrual bleeding returns or no later than 6 years if used clinically in line with contraceptive effectiveness.

  • Levonorgestrel intrauterine delivery system - initial in vivo release rate of 20.1 micrograms/day decreases to 17.5 micrograms/day during the first year and 8.6 micrograms/day during the sixth year.
  • See Summary of Product Characteristics (SPC) for full pharmacokinetic properties.

Prescribing Notes:

  • Levonorgestrel-releasing intra-uterine devices vary in licensed indication, duration of use and insertion technique—the MHRA recommends prescribing and dispensing by brand name to avoid inadvertent switching.
  • MHRA Drug Safety Update June 2015 provides advice on intra-uterine contraception uterine perforation risk factors.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.