The intrauterine device (IUD) contains 52 mg of Microlevlen. Initially, Microlevlen is released at a rate of approximately 20 mcg/day. This rate decreases over time to half that amount after 5 years.
Is oral Microlevlen safe to take if I'm pregnant or breastfeeding?
- Emergency contraception pills will not work if you are already pregnant and should not be used during pregnancy.
- Microlevlen is thought to enter human milk after oral administration and should be used cautiously in nursing mothers.
What are some other side effects of Microlevlen?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.
The Plan B package instructions state that you should take 1 white pill within 72 hours after unprotected sex and 1 more white pill 12 hours later. Each dose contains 0.75 mg of Microlevlen. The two pills are identical; it does not matter which pill you take first.
However, recent research indicates that both doses can be taken at the same time up to 120 hours after unprotected sex. The pills are more effective the sooner they are taken, so take 2 Plan B pills at the same time as soon as possible after unprotected intercourse.
COMMON BRAND(S): Amethyst, Lybrel
GENERIC NAME(S): Microlevlen-Ethinyl Estrad
Do not use this medication if you smoke cigarettes/use tobacco and are over 35 years old. Smoking raises your risk of stroke, heart attack, blood clots, and high blood pressure from hormonal birth control (such as the pill, patch, ring). The risk of these serious problems increases with age and with the number of cigarettes you smoke. Do not smoke or use tobacco.
This combination hormone medication is used to prevent pregnancy. It contains 2 hormones: Microlevlen (a progestin) and ethinyl estradiol (an estrogen). It works mainly by preventing the release of an egg (ovulation) during your menstrual cycle. It also makes vaginal fluid thicker to help prevent sperm from reaching an egg (fertilization) and changes the lining of the uterus (womb) to prevent attachment of a fertilized egg.
Besides preventing pregnancy, birth control pills may make your periods more regular, decrease blood loss and painful periods, decrease your risk of ovarian cysts, and also treat acne.
Using this medication does not protect you or your partner against sexually transmitted diseases (such as HIV, gonorrhea, chlamydia).
Drug administration route
Microlevlen is used in the form of an intrauterine device (for example Mirena) both as a contraceptive and to treat menorrhagia. It is effective, but critical reviewers continue to point to the need to be alert to the possible development of pain and hypermenorrhea, and to warn patients of the possibility of expulsion or perforation (102 r ).
In a study of the long-term acceptability of Mirena, 165 women were examined during and after 6 and 36 months of use. There were changes in menstrual bleeding pattern in 161 women (98%), with cessation or transient absence of menstruation in 75 (47%) and 14 (9%) women respectively. As in many other studies, amenorrhea was considered by most women (81%) as a welcome effect. The device had no disturbing effects on the women or their partners during sexual intercourse (103 c ).
The fact that the Mirena system induces intermenstrual bleeding within the first few months after insertion is puzzling. It has been suggested that it is due to changes in vascular development, and a randomized study in 48 women using hysterectomy specimens has shown that the system has a localized effect on some vessels within the superficial endometrium. The cross-sectional diameters of the largest vascular lumina were significantly increased after treatment. However, there was no difference in the median values of vessel diameter or the vascular surface density (104 c ). This may not necessarily be the only explanation for early intermenstrual bleeding during such treatment. Other authors have concluded that intrauterine Microlevlen induces a decrease in expression of vascular endothelial growth factor but increased expression of adrenomedullin in the endometrial glands and stroma after 3 months of therapy (105 c ).
Any intrauterine device can very occasionally perforate the uterine wall and enter the peritoneal cavity. When the device releases an active pharmacological agent it is relevant to know whether this is likely to cause adhesions. An investigation in Israel looked into this issue, examining the files of all patients with an intra-peritoneal intrauterine device over a twelve-year period (106 c ). Eight such cases were identified, four of them involving a Microlevlen-containing device and four a copper intrauterine device. Laparoscopy for removal of the intrauterine device disclosed mild local peritoneal adhesions between the omentum and the pelvic organs in all cases. There was no difference between the two devices as regards the appearance of the peritoneum. These few cases suggest that the potential of the Microlevlen system to adhere to the peritoneum is low and similar to that of the copper-bearing device.
The Fibroplant system provides an alternative to Mirena; this miniature intrauterine delivery device releases Microlevlen 14 mi-crograms/day and is used for hormonal substitution therapy, contraception, and treatment in peri- and post-menopausal women (107 C ). A 1-year study of the system in a mixed population of 141 peri- and post-menopausal women, including women with heavy or post-menopausal bleeding and women needing contraception, was too small and too heterogeneous to justify firm conclusions, and most of the women were in any case also using percutaneous 17-beta-estradiol 1.5 mg/day). However, the results suggested that this regimen is well tolerated.
Which drugs or supplements interact with oral Microlevlen?
Drugs or herbal products that increase the activity certain liver enzymes that breakdown drugs may reduce blood levels of Microlevlen and the effectiveness of the morning after pill.
COMMON BRAND(S): Plan B
GENERIC NAME(S): Microlevlen
Microlevlen is used by women to prevent pregnancy after birth control failure (such as a broken condom) or unprotected sex. This medication is an emergency contraceptive and should not be used as a regular form of birth control. It is a progestin hormone that works mainly by preventing the release of an egg (ovulation) during your menstrual cycle. It also makes vaginal fluid thicker to help prevent sperm from reaching an egg (fertilization) and changes the lining of the uterus (womb) to prevent attachment of a fertilized egg.
Using this medication will not stop an existing pregnancy or protect you or your partner against sexually transmitted diseases (such as HIV, gonorrhea, chlamydia).
This medication may not work well in women over a certain weight (for example, greater than 164 pounds or 74 kilograms), or if you have used certain other medications within the past month. This effect can result in pregnancy. Talk to your doctor for more details and to see if this medication is right for you (see also Drug Interactions section).
Check the ingredients on the label even if you have used the product before. The manufacturer may have changed the ingredients. Also, products with similar names may contain different ingredients meant for different purposes. Taking the wrong product could harm you.
Before taking or using Microlevlen, tell your doctor if you:
- have had a heart attack
- have had a stroke
- were born with heart disease or have problems with your heart valves
- have problems with blood clotting or take medicine to reduce clotting
- have high blood pressure
- recently had a baby or if you are breastfeeding
- have diabetes (high blood sugar)
- use corticosteroid medications on a long-term basis
- have severe migraine headaches
Tell your doctor about all of the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.
Pharmacologic class: Contraceptive, intrauterine device (Mirena); oral contraceptive, progestin-only pill (Plan B)
Therapeutic class: Contraceptive
Pregnancy risk category X (Mirena), NR (Plan B)
Microlevlen and Pregnancy
Call your healthcare provider right away if you think you are pregnant. If you get pregnant while using this medication, you may have an ectopic pregnancy. This means that the pregnancy is not in the uterus. Unusual vaginal bleeding or abdominal pain may be a sign of ectopic pregnancy.
Ectopic pregnancy is a medical emergency that often requires surgery. Ectopic pregnancy can cause internal bleeding, infertility, and even death.
There are also risks if you get pregnant while using this medication and the pregnancy is in the uterus. Severe infection, miscarriage, premature delivery, and even death can occur with pregnancies that continue with an intrauterine device (IUD). Because of this, your healthcare provider may try to remove the IUD, even though removing it may cause a miscarriage. If the IUD cannot be removed, talk with your healthcare provider about the benefits and risks of continuing the pregnancy.
If you continue your pregnancy, see your healthcare provider regularly. Call your healthcare provider right away if you get flu-like symptoms, fever, chills, cramping, pain, bleeding, vaginal discharge, or fluid leaking from your vagina. These may be signs of infection.
It is not known if this hormone-releasing system can cause long-term effects on the fetus if it stays in place during a pregnancy.
What is Microlevlen emergency contraceptive?
Microlevlen emergency contraceptive is used to prevent pregnancy after unprotected sex or failure of other forms of birth control (such as condom breakage, or missing 2 or more birth control pills).
Microlevlen emergency contraceptive may also be used for purposes not listed in this medication guide.
The Microlevlen IUD or LNg 20‐IUD (Mirena) is a T‐shaped polyethylene device with a collar containing 52 mg of Microlevlen dispersed in polydimethylsiloxane attached to the vertical arm. This frame is also visible on x‐ray. The device releases 15 μg of Microlevlen daily in vivo.
The LNg 20‐IUD is approved for up to 5 years in the United States, but is effective for up to 7 years. It is currently the most effective form of reversible contraception available (see Table 7‐1 ). Unlike the copper IUD, the LNg 20‐IUD actually reduces dysmenorrhea and decreases menstrual blood loss. Women receiving this type of IUD should be counseled regarding the altered bleeding patterns that can occur. Significant intramenstrual bleeding and spotting may occur during the first few months of use as the endometrial lining is thinning. Most women will experience lighter, shorter menses with continued use, with 20% of women becoming amenorrheic after 12 months of use. In fact, this decrease in menstrual bleeding has allowed the LNg‐20 IUD to be used as an alternative to hysterectomy and endometrial ablation for the treatment of menorrhagia, as well as a means of protecting the endometrium with hormone replacement therapy and as an adjuvant therapy for tamoxifen users. The LNg 20‐IUD may be a particularly useful method of contraception for women with hematologic disorders or for those who are taking chronic anticoagulants.
What is oral Microlevlen, and how does it work (mechanism of action)?
- Microlevlen (Plan B) is emergency contraception (commonly called the morning after pill) that is used as backup contraception to prevent pregnancy when taken within 72 hours after unprotected sex or when birth control fails.
- Microlevlen is a progestin. Progestins are hormones used in many birth control pills. Although Microlevlen and similar emergency contraception pills contain a higher dose of Microlevlen than birth control pills, they work in a similar way to prevent pregnancy, mainly by stopping the release of an egg from the ovary. Additionally, Microlevlen also may prevent fertilization of an egg (the uniting of the sperm with the egg) or prevent the attachment (implantation) of a fertilized egg to the uterus (womb).
- Emergency contraception pills do not work in women who are already pregnant and should not be taken during pregnancy.
- The FDA approved Microlevlen in July 1999.
What Is Estradiol-Microlevlen?
Estradiol is a form of estrogen, a female sex hormone that regulates many processes in the body. Microlevlen is a form of progesterone, a female hormone important for regulating ovulation and menstruation.
Estradiol and Microlevlen is a combination medicine used to treat menopause symptoms such as hot flashes, and to prevent osteoporosis (bone loss) in menopausal women.
Estradiol and Microlevlen may also be used for purposes not listed in this medication guide.
You should not use this medicine if you have had a hysterectomy, or if you have: undiagnosed vaginal bleeding, liver disease, a bleeding disorder, if you will have major surgery, or if you have ever had a heart attack, a stroke, a blood clot, or cancer of the breast, uterus/cervix, or vagina.
Do not use if you are pregnant.
Estradiol and Microlevlen may increase your risk of developing a condition that may lead to uterine cancer. Report any unusual vaginal bleeding right away.
Using this medicine can increase your risk of blood clots, stroke, heart attack, or cancer of the breast, uterus, or ovaries. Estradiol and Microlevlen should not be used to prevent heart disease, stroke, or dementia.
You should not use this medicine if you are allergic to estradiol or Microlevlen, if you have had a hysterectomy, or if you have:
- unusual vaginal bleeding that has not been checked by a doctor;
- liver disease;
- a bleeding disorder;
- a history of heart attack, stroke, or blood clot; or
- a history of hormone-related cancer, or cancer of the breast, uterus/cervix, or vagina.
Do not use estradiol and Microlevlen if you are pregnant. Tell your doctor right away if you become pregnant during treatment.
Using this medicine can increase your risk of blood clots, stroke, or heart attack. You are even more at risk if you have high blood pressure, diabetes, high cholesterol, if you are overweight, or if you smoke.
Estradiol and Microlevlen should not be used to prevent heart disease, stroke, or dementia, because this medicine may actually increase your risk of developing these conditions.
Tell your doctor if you have ever had:
- heart disease;
- liver problems, or jaundice caused by pregnancy or taking hormones;
- hereditary angioedema (an immune system disorder);
- kidney disease;
- gallbladder disease;
- epilepsy or other seizure disorder;
- porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system);
- endometriosis or uterine fibroid tumors;
- a thyroid disorder; or
- high levels of calcium in your blood.
Using estradiol may increase your risk of cancer of the breast, uterus, or ovaries. Talk with your doctor about this risk.
Estradiol and Microlevlen can slow breast milk production. Tell your doctor if you are breast-feeding.