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Long-acting reversible contraception

Long-acting reversible contraception
US trade name (manufacturer) Progestin (mg)* Estrogen (micrograms)
Depo-Provera intramuscular (Pfizer) Medroxyprogesterone acetate (150 mg/mL) None
Depo-SubQ Provera 104 subcutaneous (Pfizer) Medroxyprogesterone acetate (104 mg/0.65 mL) None
Liletta 52 mg intrauterine device (Actavis) Levonorgestrel (releases 0.0186 mg/day, decreasing to approximately 0.0163 mg/day at 1 year, then decreasing to approximately 0.0143 mg/day at 2 years, and 0.0126 mg/day at 3 years) None
Mirena 52 mg intrauterine device (Bayer) Levonorgestrel (releases approximately 0.02 mg/day, decreasing progressively to 0.01 mg/day by 5 years)Δ None
Skyla 13.5 mg intrauterine device (Bayer) Levonorgestrel (releases 0.014 mg/day, decreasing to approximately 0.01 mg/day after 60 days, then decreasing to approximately 0.005 mg/day after 3 years) None
Nexplanon 68 mg subdermal implant (Organon) Etonogestrel (releases 0.06 to 0.07 mg/day in weeks 5 to 6, decreasing to approximately 0.035 to 0.045 mg/day by 1 year, then decreasing to approximately 0.03 to 0.04 mg/day by year 2, and then to 0.025 to 0.03 mg/day by end of year 3) None

* Different progestins are not equivalent on a milligram basis.

¶ Ethinyl estradiol and mestranol are not equivalent on a milligram basis; the results of some studies indicate that 30 to 35 mcg of ethinyl estradiol is equivalent to 50 mcg of mestranol.

Δ Decreases to 0.01 mg/day by 5 years. Do not leave same system in place for >5 years.

◊ Also contains radiopaque (barium sulfate 15 mg).

Adapted with special permission from The Medical Letter on Drugs and Therapeutics, September 14, 2015; Vol. 57 (1477):e133-e134. www.medicalletter.org.

Additional data from:
  1. US Food & Drug Administration Orange Book: Approved Drugs with Therapeutic Equivalence Equations. Available at: http://www.accessdata.fda.gov/scripts/cder/ob/default.cfm (Accessed on September 30, 2015).
  2. UpToDate Lexidrug. More information available at https://online.lexi.com/.
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