levonorgestrel

Before using levonorgestrel, tell your doctor if you have

• high blood pressure, angina, or heart disease;

• had a stroke;

• a bleeding or blood-clotting disorder;

• liver disease;

• breast cancer, uterine, or another hormone-related cancer;

• undiagnosed, abnormal vaginal bleeding;

• a history of intracranial hypertension (increased blood pressure inside the head);

• diabetes;

• an increased level of cholesterol in your blood;

• migraines;

• asthma; or

• seizures or epilepsy.

You may not be able to use levonorgestrel or you may require special monitoring during treatment if you have any of the conditions listed above.

Levonorgestrel is in the FDA pregnancy category X. This means that levonorgestrel is known cause birth defects in an unborn baby. Hormonal changes during pregnancy can have very serious negative effects on a developing baby. The use of levonorgestrel during early pregnancy is not always harmful to a developing baby. Notify your doctor immediately if you think you might be pregnant.

The hormones in levonorgestrel pass into breast milk. Talk to your doctor before using levonorgestrel if you are breast-feeding a baby.

Use levonorgestrel exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

To use the Norplant system, your doctor or health care provider will surgically implant six capsules containing levonorgestrel under the skin of your upper arm.

Following insertion of the capsules, keep the area clean and dry and avoid heavy lifting with that arm for 2 to 3 days. The incision should be healed in about 3 days. Follow your doctor’s instructions regarding proper wound care.

Use another method of birth control for at least 7 days after insertion of the levonorgestrel capsules.

Have a complete physical examination at least once a year while using a levonorgestrel implant.

The capsules will continue to work for 5 years and should be removed by the end of the fifth year. New capsules may be inserted at that time if desired.

Since the implanted capsules continuously release a low dose of levonorgestrel, missing a dose does not occur when using this form of levonorgestrel.

If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

• possible blood clot in the lung (shortness of breath or pain in the chest);

• possible blood clot in an arm or leg (pain, redness, swelling, or numbness of an arm or leg);

• headaches with a change in pattern, severity, or length, or that are unending in nature or accompanied by changes in vision;

• high blood pressure (severe headache, flushing, blurred vision); or

• liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, severe fatigue).

• infection at the insertion site;

• pain, numbness, or tingling in the arm with the implanted capsules; or

• movement of the capsules under the skin.

Other, less serious side effects may be more likely to occur. Talk to your doctor if you experience

• breakthrough, heavy, or prolonged menstrual bleeding;

• lack of menstrual bleeding;

• pain, swelling, or bruising at the insertion site;

• headache or dizziness;

• nausea;

• breast tenderness;

• changes in weight or appetite;

• oily skin or acne; or

• changes in hair growth.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Avoid smoking cigarettes while using levonorgestrel. Smoking increases the risk of developing a heart attack, stroke, or blood clot.

Levonorgestrel does not protect you from sexually transmitted diseases—including HIV and AIDS.

Avoid smoking. Smoking increases the risk of developing a heart attack, stroke, or blood clot.

Levonorgestrel does not protect you from sexually transmitted diseases—including HIV and AIDS.

Other medications may decrease the effectiveness of levonorgestrel. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, while using levonorgestrel.

An overdose of levonorgestrel can result only if more than six capsules are implanted at once, which is unlikely to occur.