Levonorgestrel (Intradermal)

Levonorgestrel implant is used to prevent pregnancy for up to 5 years. It works by stopping a woman's egg from fully developing each month. The egg can no longer accept a sperm and fertilization (pregnancy) is prevented.

This medicine is to be given only by or under the direct supervision of a trained healthcare professional.

It is very important that your doctor checks your progress at regular visits to ensure this medicine is working correctly and does not cause unwanted effects.

Infection at the insertion site may happen after inserting or removing the implants. It is important to tell your doctor if you feel any pain, numbness, or tingling in your upper arm.

Call your doctor right away if you think you may be pregnant while using this medicine. You may have a higher risk of an ectopic pregnancy if you become pregnant while your implants are in place. An ectopic pregnancy can be serious and life-threatening. It can also lead to problems that may make it harder for you to get pregnant in the future.

You might experience less bleeding or even stop having periods by the end of the first year. Call your doctor if you notice a change in your usual bleeding pattern after having your implants for a while, such as more bleeding or if you miss a period (especially if you were having periods while using your implants).

This device will not protect you from getting HIV/AIDS, herpes, or other sexually transmitted diseases. Inform your doctor if you or your partner start having sexual intercourse with other people, or if you or your partner test positive for a sexually transmitted disease. If this is a concern for you, discuss it with your doctor.

Contact your doctor immediately if you experience pain or tenderness in your upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellowing of your eyes or skin. These could be signs of a serious liver problem.

This medicine may cause changes in your blood sugar levels. It may also hide signs of low blood sugar, such as a rapid heartbeat. Talk to your doctor if you have these issues or notice changes in your blood or urine sugar test results.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.

Do not take other medicines unless you have discussed them with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines, herbal products (like St. John's wort), or vitamin supplements.

In deciding to use a medicine, you and your doctor need to consider the risks of taking the medicine compared to the benefits it may provide. For this medicine, consider the following:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know about any other allergies you may have, such as to foods, dyes, preservatives, or animals. For over-the-counter products, carefully read the labels or package ingredients.

Pediatric

Studies so far have not shown any specific problems in teenagers that would limit the usefulness of levonorgestrel implants in teenage females. This medicine can be used for birth control in teenage females, but it is not recommended before menstruation begins.

Geriatric

There have not been studies on how age affects the use of levonorgestrel implants in older adults. This medicine is not recommended for elderly women.

Breast Feeding

There are no adequate studies to determine the risk to infants when this medication is used during breastfeeding. Consider the potential benefits and risks before taking this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while others may be used together even if an interaction could happen. In these situations, your doctor may adjust the dose or take other precautions. It is very important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions are highlighted for their potential significance but may not be all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may choose not to prescribe this medication or change some of the other medicines you are taking.

• Tranexamic Acid

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed, your doctor may adjust the dose or frequency of one or both medicines.

• Amoxicillin
• Ampicillin
• Amprenavir
• Apalutamide
• Aprepitant
• Armodafinil
• Artemether
• Bacampicillin
• Belzutifan
• Betamethasone
• Bexarotene
• Bosentan
• Carbamazepine
• Carbenicillin
• Cefaclor
• Cefadroxil
• Cefdinir
• Cefditoren
• Cefixime
• Cefpodoxime
• Cefprozil
• Ceftazidime
• Ceftibuten
• Cefuroxime
• Cenobamate
• Ceritinib
• Clobazam
• Cloxacillin
• Colesevelam
• Cyclacillin
• Cyclosporine
• Dabrafenib
• Darunavir
• Dexamethasone
• Dicloxacillin
• Dipyrone
• Doxycycline
• Efavirenz
• Elagolix
• Elvitegravir
• Encorafenib
• Enzalutamide
• Eslicarbazepine Acetate
• Etravirine
• Fosamprenavir
• Fosaprepitant
• Fosphenytoin
• Griseofulvin
• Guar Gum
• Isotretinoin
• Ivosidenib
• Lesinurad
• Lixisenatide
• Lopinavir
• Lorlatinib
• Lumacaftor
• Mavacamten
• Meropenem
• Minocycline
• Mitapivat
• Mitotane
• Mobocertinib
• Modafinil
• Mycophenolate Mofetil
• Mycophenolic Acid
• Nafcillin
• Nelfinavir
• Nevirapine
• Octreotide
• Oxacillin
• Oxcarbazepine
• Oxytetracycline
• Penicillin G
• Penicillin G Procaine
• Penicillin V
• Phenobarbital
• Phenylbutazone
• Phenytoin
• Pitolisant
• Prednisolone
• Prednisone
• Primidone
• Red Clover
• Rifabutin
• Rifampin
• Rifapentine
• Ritonavir
• Rufinamide
• Secobarbital
• St John's Wort
• Sugammadex
• Sultamicillin
• Tazemetostat
• Telaprevir
• Telotristat Ethyl
• Tetracycline
• Theophylline
• Thioridazine
• Ticarcillin
• Tigecycline
• Tirzepatide
• Tizanidine
• Topiramate
• Ulipristal

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both may be necessary. If both are prescribed, your doctor may change the dose or frequency of one or both medicines.

• Acitretin
• Amitriptyline
• Atazanavir
• Clomipramine
• Diazepam
• Doxepin
• Imipramine
• Lamotrigine
• Licorice
• Lorazepam
• Perampanel
• Selegiline
• Tacrine
• Temazepam
• Triazolam
• Troleandomycin
• Voriconazole
• Warfarin

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around the time of eating food or certain types of food because interactions may occur. Drinking alcohol or using tobacco with certain medicines may also lead to interactions. The following interactions are highlighted for their potential significance but may not be all-inclusive.

Using this medicine with any of the following may increase the risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may adjust the dose or frequency of this medicine, or provide special instructions about food, alcohol, or tobacco use.

• Caffeine

Other Medical Problems

Other medical issues may affect how this medicine works. Be sure to tell your doctor if you have any other medical problems, especially:

• Abnormal or unusual vaginal bleeding or
• Blood clots (e.g., deep vein thrombosis, pulmonary embolism) or
• Breast cancer, known or suspected, or a history of or
• Liver disease, including tumors—Should not be used in patients with these conditions.

• Bleeding problems or
• Depression, history of or
• Diabetes or
• Heart attack, history of or
• Heart disease or
• Hyperlipidemia (high cholesterol or fats in the blood) or
• Hypertension (high blood pressure), severe or history of or
• Kidney disease or
• Migraine headaches, severe or
• Ovarian cysts or
• Stroke, history of—Use with caution. May worsen these conditions.

Along with its necessary effects, this medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they may require medical attention.

Check with your doctor or nurse right away if any of the following side effects occur:

More common

• Absent, missed, or irregular menstrual periods
• bloating
• breast pain
• clear or bloody discharge from the nipple
• dimpling of the breast skin
• increased clear or white vaginal discharge
• inverted nipple longer or heavier menstrual periods
• lump in the breast or under the arm
• pain in the pelvis
• persistent crusting or scaling of the nipple
• redness or swelling of the breast
• sore on the skin of the breast that does not heal
• stomach or pelvic discomfort, aching, or heaviness
• stopping of menstrual bleeding

Incidence not known

• Abdominal or stomach pain
• anxiety
• blurred vision
• change in vaginal discharge
• chest pain
• chills
• clay-colored stools
• confusion
• cough
• dark urine
• diarrhea
• difficulty with swallowing
• dizziness or lightheadedness
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fainting
• fast heartbeat
• fever
• headache
• hives, itching, or rash
• loss of appetite
• nausea
• pain or feeling of pressure in the pelvis
• pain, redness, or swelling in the arm or leg
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• sudden shortness of breath or troubled breathing
• sweating
• tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over affected area
• tightness in the chest
• trouble breathing
• unpleasant breath odor
• unusual tiredness or weakness
• vaginal bleeding
• vomiting of blood
• yellow eyes or skin

Some side effects may happen that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your health care professional may also have ways to help prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue, are bothersome, or if you have any questions about them:

More common

• Blemishes on the skin
• blistering, crusting, irritation, itching, or reddening of the skin
• cracked, dry, or scaly skin
• hair loss or thinning of the hair
• itching of the vagina or genital area
• pain at the insertion site
• pain during sexual intercourse
• pimples
• thick, white vaginal discharge with no odor or with a mild odor
• weight gain

Less common

• Discouragement
• feeling sad or empty
• irritability
• lack of appetite
• loss of interest or pleasure
• trouble concentrating
• trouble sleeping
• weight loss

Incidence not known

• Changes in menstrual or bleeding patterns
• white or brownish vaginal discharge

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Jadelle

Pharmacologic Class: Progestin

Jadelle® is a set of 2 hormone-releasing birth control implants that are surgically placed and removed under the skin of the upper arm by a trained healthcare provider. The implants are placed in the upper arm for up to 5 years.

The implants are usually inserted by your doctor within the first 7 days of your regular menstrual period. Your doctor also needs to do a pregnancy test before inserting the implants.

After the implants are inserted, your doctor should feel your arm to check that the implants are in the right place. If you cannot feel the implants in your arm, you will need to use a non-hormonal birth control (such as condoms, spermicide) until your doctor confirms that the implants are in place.

Your doctor will cover the insertion site with a gauze bandage. Keep it dry and avoid heavy lifting for 2 to 3 days. The gauze may be removed after 1 to 3 days.

Do not try to remove the implants by yourself. Call your doctor if you wish to remove your implants.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

This medicine comes with a patient information insert. Read and follow the instructions carefully. Ask your doctor if you have any questions.

• Can Plan B make your period late or cause bleeding?
• Can you drink alcohol after taking Plan B?
• How many times can you take Plan B?
• What's the weight limit for Plan B?
• What are my birth control options and how effective are they?
• Mirena, Kyleena, Skyla & Liletta - What's the difference?

View more FAQ