Mirena

Before taking this medicine

Mirena must not be used if you: • Are pregnant or think you may be pregnant. • Have an abnormality of the uterus, including fibroids, that changes the shape of the uterine cavity. • Have active pelvic inflammatory disease (PID), or a history of PID unless you have since had a pregnancy within the uterus. • Have had an infection of the uterine lining after childbirth or an infected abortion within the past 3 months. • Have known or suspected cancer of the uterus or cervix. • Have or have previously had breast cancer or another cancer sensitive to progestins, or are suspected of having one. • Have unexplained uterine bleeding. • Have an untreated active infection of the cervix, vagina or other lower genital tract, including bacterial vaginosis, until the infection is controlled. • Have acute liver disease or a liver tumour. • Have a condition that increases your susceptibility to pelvic infections. • Have another intrauterine device (IUD) still in place. • Are allergic to any component of Mirena. Mirena must not be used as emergency contraception. The risk of PID should be considered before use. Mirena can perforate the uterus, reducing contraceptive protection and sometimes requiring surgery. This risk is higher during breastfeeding and may be higher after childbirth or if the uterus is fixed in a backward-tilted position. Serious group A streptococcal infection has been reported after insertion; strict sterile technique is essential. Mirena may come out partly or completely without being noticed, resulting in loss of contraceptive protection. Persistent enlarged ovarian follicles or ovarian cysts need medical assessment. Bleeding may become irregular, and periods may stop. If pregnancy occurs with Mirena in place, seek medical care promptly; the label advises removal by a healthcare professional. Risks include ectopic pregnancy, loss of fertility, pregnancy loss, life-threatening infection associated with miscarriage, and premature labour and delivery.