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  • Generic Name: levonorgestrel-releasing intrauterine system
  • Brand Name: Liletta
  • Drug Class: Progestins
Last updated on MDtodate: 10/7/2022


The following serious or otherwise important adverse reactions are discussed elsewhere in the labeling:

  • Ectopic Pregnancy
  • Intrauterine Pregnancy
  • Group A Streptococcal Sepsis (GAS)
  • Pelvic Inflammatory Disease or Endometritis
  • Perforation
  • Expulsion
  • Ovarian Cysts
  • Bleeding Pattern Alterations

Clinical Trial Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

The data described below reflect exposure of 1,751 generally healthy 16- to 45-year-old women to LILETTA in a large, multi-center contraceptive trial conducted in the US, including 1,412 exposed for 1 year and 383 subjects who completed 3 years of use; 58% were nulliparous (mean age 25.1 ± 4.3 years) and 42% were parous (mean age 30.3 ± 6.1 years). Most women who received LILETTA were Caucasian (78.4%) or Black/African American (13.3%); 14.7% of women were of Hispanic ethnicity. The clinical trial had no upper or lower weight or BMI limit. Mean BMI of LILETTA subjects was 26.9 kg/m² (range 15.8 – 61.6 kg/m²); 25.1% had a BMI ≥ 30 kg/m², and 5.3% had a BMI ≥ 40 kg/m². The data cover more than 22,000 28-day cycles of LILETTA exposure. The frequencies of reported adverse drug reactions represent crude incidences.

The most common adverse reactions during the LILETTA clinical trial (occurring in ≥ 5% users) are shown in Table 1.

Table 1: Adverse Reactions in ≥ 5% of LILETTA Users in Phase 3 Clinical Study

System Organ Class/
Preferred Term
% LILETTA Subjects
(N = 1,751)
Vaginal infections 13.6%
Vulvovaginal infections 13.3%
Acne 12.3%
Headache or migraine 9.8%
Nausea or vomiting 7.9%
Dyspareunia 7.0%
Abdominal discomfort or pain 6.8%
Breast tenderness or pain 6.7%
Pelvic discomfort or pain 6.1%
Depression or depressed mood 5.4%
Mood changes 5.2%


In the contraceptive trial, 12.3% of LILETTA users discontinued prematurely due to an adverse reaction. The most common adverse reaction leading to discontinuation was expulsion (3.5%), bleeding complaints (a total of 1.5%). The next most common adverse reactions causing discontinuation were acne (1.3%), mood swings (1.3%), dysmenorrhea (0.6%), and uterine spasm (0.6%). Two women discontinued the clinical study due to PID and one due to endometritis.

In the clinical trial, serious adverse reactions included: suicidality and exacerbations of depression and bipolar disorder, ectopic pregnancy, ovarian cysts, and IUS perforation requiring a laparoscopic surgery.

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of other LNG-releasing IUSs. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

  • Hypersensitivity including rash, urticaria, and angioedema
  • Device Breakage



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