Generic Name and Formulations:
Levonorgestrel 19.5mg; intrauterine system.
Indications for KYLEENA:
Prevention of pregnancy for up to 5yrs.
See full labeling. Insert into uterine cavity as directed. Reexamine and evaluate 4–6wks after insertion; then yearly or more if needed. Remove or replace after 5yrs.
Pre-menarche: not recommended.
Pregnancy. Post-coital contraception. Congenital or acquired uterine anomaly including fibroids. Acute or history of pelvic inflammatory disease (PID) unless there has been a subsequent intrauterine pregnancy. Postpartum endometritis or infected abortion in past 3 months. Uterine or cervical neoplasia. Breast or other progestin-sensitive cancer. Uterine bleeding of unknown etiology. Untreated acute cervicitis or vaginitis. Active liver disease or tumor. Conditions associated with increased susceptibility to pelvic infections. Retained IUD.
Evaluate for ectopic pregnancy. Risk of spontaneous abortion, miscarriage, sepsis, premature labor or delivery, congenital anomalies: remove if pregnant. Consider risks of PID before using. Remove if endometritis or PID recurs or if acute pelvic infection is severe or unresponsive to treatment. Bleeding pattern alterations: exclude endometrial pathology prior to insertion in women with persistent or uncharacteristic bleeding. Risk of perforation, expulsion and ovarian cysts. Increased risk of perforation in lactating women or if inserted in women with fixed retroverted or not completely involuted uteri or during postpartum period; delay insertion a minimum of 6wks, until involution is complete after delivery or a second trimester abortion. Consider removal if coagulopathy, migraine, transient cerebral ischemia, severe headache, marked increase in BP, severe arterial disease, uterine/cervical malignancy, jaundice, or symptomatic actinomycosis occurs. May be scanned with MRI under specific conditions. Nursing mothers.
Caution with anticoagulants; consider removal. May be antagonized by CYP3A4 inducers. May be potentiated by CYP3A4 inhibitors.
Vulvovaginitis, ovarian cyst, abdominal/pelvic pain, headache/migraine, acne/seborrhea, dysmenorrhea/uterine spasm, breast pain/breast discomfort, increased bleeding; ectopic pregnancy, intrauterine pregnancy, sepsis, PID, perforation, expulsion.
Sign Up for Free e-newsletters
Psychiatry Advisor Articles
- Adjunctive Therapies for Bipolar Disorder Show Promise, Need More Evidence
- Predicting Treatment-Emergent Mania to Tailor Pharmacotherapy in Bipolar Disorder
- Abnormalities of Cortical Thickness in Bipolar Disorder With Auditory Hallucinations
- Prevalence of ADHD Relatively Stable Over Time Despite Increase in Diagnoses
- Prevalence of Major Depressive Disorder Remains High In US Population
- The Way to the Head May Be Through the Gut: Probiotics for Depression
- Suicide-Screening Toolkit Can Help Identify Youths at High Risk for Suicide
- Agoraphobia: An Evolving Understanding of Definitions and Treatment
- Parental Pressure to Diet Linked With Long-term Harm in Adolescents
- Does Access to Medical Cannabis Reduce Risk for Opioid Abuse?
- Evidence of Methylphenidate Abuse: Characterizing Patterns of Use in Pediatric and Adult Populations
- Intranasal Oxytocin Reduces Negative Effects, Improves Cognitive Function in Schizophrenia
- Most Patients Comfortable With Clinicians Asking About Sexual Orientation
- Peer-to-Peer Depression Awareness Program May Be Beneficial
- Examining Rates of Long-term Opioid Use in Youth With Psychiatric Disorders