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Kyleena vs. Mirena: Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Kyleena and Mirena are two brand-name medications used for birth control or to treat heavy bleeding. Both medications are approved by the United States Food and Drug Administration (FDA) and contain a progestin called levonorgestrel (LNG).

Unlike traditional birth control pills that are taken by mouth, Kyleena and Mirena are both intrauterine devices (IUDs). A hormonal IUD is a tiny device that is inserted into your uterus by your healthcare provider and releases the hormone LNG slowly over time. The way these IUDs work is not entirely understood, but it’s suggested that LNG prevents ovulation and changes the cervical mucus and endometrial lining to prevent pregnancy.

One Kyleena or Mirena IUD can be used for up to five years. Bayer HealthCare Pharmaceuticals, Inc. makes both products. (Bayer also makes an IUD called Skyla.)

Although both of these medications are IUDs that contain LNG, Kyleena and Mirena have some differences. Continue reading to learn all about Kyleena and Mirena.

What are the main differences between Kyleena and Mirena?

Kyleena and Mirena are both hormonal IUDs that contain a progestin called levonorgestrel (LNG). Both medications are available in brand name only. Kyleena (kyleena coupons) contains a lower dose of LNG, as you can see in the information below.

Kyleena is also distinguished from other intrauterine devices by a blue-colored removal thread and the visibility of a silver ring on ultrasound. Your healthcare provider must insert Kyleena or Mirena (mirena coupons). The IUD can stay in your body for five years. At that point, your healthcare provider must remove it. If you wish to continue using an IUD, a new IUD can be put in as soon as the previous one is removed.

Main differences between Kyleena and Mirena
Kyleena Mirena
Drug class Progestins Progestins
Brand/generic status Brand Brand
What is the generic name? Levonorgestrel (LNG) intrauterine device (IUD) or levonorgestrel-releasing intrauterine system Levonorgestrel (LNG) intrauterine device (IUD) or levonorgestrel-releasing intrauterine system
What form(s) does the drug come in? Intrauterine device (IUD) Intrauterine device (IUD)
What is the standard dosage? Total dose of 19.5 mg LNG is released at a rate of about 17.5 mcg/day after 24 days. This rate decreases to about 9.8 mcg/day after one year and 7.4 mcg/day after five years. Kyleena must be removed by the end of the fifth year. The healthcare provider can insert a new device when Kyleena is removed if the patient desires continued treatment. Total dose of 52 mg LNG is released at a rate of about 20 mcg/day. This rate decreases progressively to about 10 mcg/day after five years. The healthcare provider can insert a new device when Mirena is removed if the patient desires continued treatment.
How long is the typical treatment? Up to 5 years; a new device may be inserted immediately after the previous device is removed. Up to 5 years; a new device may be inserted immediately after the previous device is removed.
Who typically uses the medication? Women over 18 years old Women over 18 years old

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Conditions treated by Kyleena and Mirena

Kyleena and Mirena are both indicated to prevent pregnancy for up to five years. Mirena (What is Mirena?) is also indicated for the treatment of heavy menstrual bleeding. Kyleena (What is Kyleena?) does not have this indication, but some doctors may prescribe it off-label to help with heavy periods.

Condition Kyleena Mirena
Prevent pregnancy for up to five years Yes Yes
Treatment of heavy menstrual bleeding Off-label Yes

Is Kyleena or Mirena more effective?

Studies are not available comparing Kyleena to Mirena. Looking at each drug individually, Kyleena’s information states that the Kyleena IUD is over 99% effective at preventing pregnancy for each year of use. Over five years, it is 98.5% effective.

Mirena states similar information—it is over 99% effective at preventing pregnancy for each year of use, as well as over 99% effective over the five years.

Each IUD works as an effective method of contraception. They are appropriate for long-term use, up to five years for one IUD. Also, unlike birth control pills, you don’t have to remember to take it every day. (You just check for the threads once a month.)

These IUDs are also reversible contraception, meaning that when the IUD is removed, you can get pregnant. Most patients are able to get pregnant within 12 months after IUD removal. Only your healthcare provider can determine which medication is better for you, taking into account your medical history.

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Coverage and cost comparison of Kyleena vs. Mirena

Because your healthcare provider administers Kyleena or Mirena in the office, he or she will provide the device. You will not typically visit a pharmacy for Kyleena or Mirena. Therefore, your healthcare provider will submit Kyleena or Mirena to your medical insurance.

The out-of-pocket price of one Kyleena IUD is approximately $2,000. You can ask your healthcare provider if they will accept a SingleCare coupon, bringing the price down to about $960.

The out-of-pocket price of a Mirena IUD is about $1,400. You can ask your healthcare provider if you can use your SingleCare coupon, reducing the cost to less than $1,000.

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  Kyleena Mirena
Typically covered by insurance? Medical Medical
Typically covered by Medicare Part D? N/A N/A
Standard dosage One device One device
Typical Medicare copay N/A N/A
SingleCare cost $960+ $960+

Common side effects of Kyleena vs. Mirena

Because Kyleena and Mirena contain the same active ingredient, levonorgestrel, side effects are very similar. The most common side effects of Kyleena and Mirena include vaginal inflammation, abdominal pain, menstrual cramps, nausea, acne, breast discomfort, and changes in menstrual bleeding patterns. Device expulsion occurred in a small percentage of patients in clinical trials.

This is not a full list of side effects. Other adverse effects may occur. Consult your healthcare provider for a complete list of side effects.

  Kyleena Mirena
Side effect Applicable? Frequency Applicable? Frequency
Vulvovaginitis (vaginal inflammation) Yes 24% Yes 10.5%
Ovarian cyst Yes 22% Yes 7.5%
Abdominal or pelvic pain Yes 21% Yes 22.6%
Headache or migraine Yes 15% Yes 16.3%
Back pain No Yes 7.9%
Acne Yes 15% Yes 6.8%
Dysmenorrhea (menstrual cramping)/uterine spasm Yes 10% Yes 6.4%
Amenorrhea (no period) Yes Varies by length of treatment Yes Varies by length of treatment
Breast pain/discomfort Yes 10% Yes 8.5%
Increased bleeding Yes 8% Yes 12%
Genital discharge Yes 4.5% Yes 14.9%
Device expulsion Yes 3.5% Yes <5%
Nausea Yes 4.7% Yes <5%
Depression Yes 4.4% Yes 6.4%

Source: DailyMed (Kyleena), DailyMed (Mirena)

Drug interactions of Kyleena vs. Mirena

Drug interaction studies have not been conducted with Kyleena or Mirena, which both contain LNG. However, drugs that induce enzymes that process LNG may decrease LNG levels, making the IUD less effective. On the other hand, drugs that inhibit enzymes that process LNG may increase LNG levels, causing more side effects. Due to the local effect of the medication (the drug is released into the uterine cavity), the drug interactions may not be clinically relevant. Ask your healthcare provider if there are any drug interactions with medicines you take.

The manufacturer of both Kyleena and Mirena recommends that any drug prescribed along with one of these IUDs should be checked for potential drug interactions with LNG.

This is not a full list of drug interactions. Consult your healthcare provider for medical advice.

Drug Drug class Kyleena Mirena
Carbamazepine
Efavirenz
Felbamate
Griseofulvin
Nevirapine
Oxcarbazepine
Phenobarbital
Phenytoin
Rifabutin
Rifampin
St. John’s wort
Topiramate
Drugs that can decrease the level of LNG Yes (potential) Yes (potential)
Itraconazole
Ketoconazole
Drugs that can increase the level of LNG Yes (potential) Yes (potential)

Warnings of Kyleena and Mirena

Because both Kyleena and Mirena contain the same ingredient, levonorgestrel, warnings are the same.

  • Kyleena or Mirena should not be used in patients:
    • Who are pregnant or suspected to be pregnant
    • With uterine problems, such as fibroids
    • Who have acute pelvic inflammatory disease (PID), a history of PID, or who are susceptible to pelvic infections
    • With uterine or cervical neoplasia (growth)
    • Who have breast cancer or other progestin-sensitive cancer (or a history)
    • With uterine bleeding of unknown cause
    • Who have untreated cervical or vaginal infections (until the infection is controlled)
    • With liver disease or tumor
    • Who currently have an IUD inserted
    • Who are hypersensitive to the ingredients
  • Kyleena or Mirena should not be used as emergency contraception.
  • The patient should be evaluated four to six weeks after IUD insertion.
  • Kyleena or Mirena should be removed if pregnancy occurs. There is an increased risk of ectopic pregnancy, which could lead to pregnancy loss, fertility loss, septic abortion (including death), and premature labor and delivery.
  • The healthcare provider must use strict aseptic technique to prevent infection upon IUD insertion.
  • The healthcare provider should consider the risks of pelvic inflammatory disease.
  • Uterine perforation may occur, which can decrease the IUD’s effectiveness and/or require surgery. There is an increased risk in postpartum and breastfeeding women.
  • Partial or complete expulsion may occur (it may be unnoticed), which leads to loss of efficacy.
  • Kyleena or Mirena may alter bleeding patterns, possibly causing irregularity and/or amenorrhea.
  • Ovarian cysts may occur. Evaluate enlarged ovarian follicles or ovarian cysts.
  • Kyleena can be scanned in MRI under certain conditions. If you need an MRI, notify your healthcare provider and radiology/hospital staff that you have an IUD.
  • IUDs do not protect against HIV/AIDS or other sexually transmitted diseases.
  • Contact your healthcare provider immediately if you experience:
    • A stroke or heart attack
    • Migraine headaches
    • Unexplained fever
    • Signs of liver problems (yellow skin or eyes)
    • Pregnancy or suspected pregnancy
    • Pelvic or abdominal pain
    • Pain during intercourse
    • An HIV positive test (in yourself or your partner)
    • Exposure to sexually transmitted infections
    • Unusual vaginal discharge
    • Genital sores
    • Severe or long-lasting bleeding
    • Inability to feel the IUD threads

Frequently asked questions about Kyleena vs. Mirena

What is Kyleena?

Kyleena is a birth control method used to prevent pregnancy, which contains a progestin called levonorgestrel. It is an intrauterine device (IUD).

What is Mirena?

Mirena is also an IUD that contains levonorgestrel. It is indicated for the prevention of pregnancy as well as to treat heavy menstrual bleeding.

Are Kyleena and Mirena the same?

Both Kyleena and Mirena are IUDs that contain levonorgestrel and can be used for up to five years. The dose of hormones (levonorgestrel) is different. Mirena contains a higher amount of hormone than Kyleena. Side effects are similar. Other hormonal IUDs include Skyla and Liletta.

You may have also heard of the Paragard IUD. Paragard is different from Kyleena and Mirena because it is a copper IUD and does not contain hormones.

Is Kyleena or Mirena better?

Both Kyleena and Mirena are very effective, over 99% effective in preventing pregnancy for each year of use. Kyleena is 98.5% effective after five years, and Mirena is over 99% effective after five years. Your healthcare provider can help you determine if Kyleena or Mirena is better for you.

Can I use Kyleena or Mirena while pregnant?

Call your healthcare provider right away if you have a Kyleena or Mirena device and think that you may be pregnant. The IUD can cause an ectopic pregnancy (pregnancy outside of the uterus), a severe medical emergency. If you have a device inserted and get pregnant, and the pregnancy is in the uterus, severe infection, miscarriage, premature delivery, and even death could occur. Your healthcare provider may try to remove the IUD, which may cause a miscarriage. It is unknown if LNG IUDs can cause long-term effects on the fetus if the IUD stays in place during a pregnancy. Your healthcare professional can direct you on the safest course of action.

Can I use Kyleena or Mirena with alcohol?

Kyleena or Mirena do not have an interaction with alcohol. An IUD may actually be a preferred method of birth control for a patient who drinks alcohol.

Is Kyleena less painful than Mirena?

IUD insertion (either Kyleena or Mirena) may cause some pain, bleeding, dizziness, and discomfort. You should feel better within about 30 minutes after placement. If you do not feel better by this time, your healthcare provider will need to examine you to ensure the device was placed correctly. Kyleena is slightly smaller in size than Mirena, so some patients tolerate insertion better.

Which IUD is the best?

IUDs are a popular and effective method of contraception. Your healthcare provider can help you sort through birth control options and determine if an IUD is right for you, and if so, which one is best, taking into account your medical history.

Does Kyleena cause facial hair?

Kyleena may cause acne or greasy skin. The manufacturer’s information does not list facial hair as a side effect. Consult your healthcare provider for more details.

Does Kyleena stop periods?

Kyleena can cause irregular bleeding. Some patients may even have increased bleeding at first. Some patients have spotting as well, or lighter periods. Some patients have amenorrhea (the absence of periods). In clinical trials, about 12% of patients on Kyleena had amenorrhea after one year. After three years, about 20% had amenorrhea, and after five years, about 23% had amenorrhea.