Intra-Uterine Progestogen–Only Device

NHSL Medicines Guidance
NHS Lanarkshire

Progestogen-Only Device

Preferred list (P)

LEVOSERT®

  • Levosert® is effective for 8 years for contraception. See Summary of Product Characteristics (SPC) for full information.

  • 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 8 years if used clinically in line with contraceptive effectiveness.

  • Currently the most cost-effective.

MIRENA®

  • Mirena® is effective for 8 years for contraception. See Summary of Product Characteristics (SPC) for full information. 

  • Has a demonstrated efficacy for 5 years for the indication of heavy menstrual bleeding. Clinical trial data to support efficacy beyond this are not available. Mirena® should be removed or exchanged if heavy or bothersome menstrual bleeding returns or no later than 8 years if used clinically in line with contraceptive effectiveness.

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

 

Total list (T)

KYLEENA®

  • Effective for 5 years when used for contraception.

BENILEXA®

  • Benilexa® is effective for 8 years for contraception. See Summary of Product Characteristics (SPC) for full information. 

  • 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 8 years if used clinically in line with contraceptive effectiveness.

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.
  • For information on release profiles please see the Summary of Product Characteristics for each device.
  • 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.