Medical interventions for unscheduled and/or heavy bleeding in levenorgestrel users

Medication class	Medication	Oral dose (mg)	Frequency	Length of time
Nonsteroidal anti-inflammatory drug (NSAID)	Naproxen	500*	Two times daily	Five days
Antifibrinolytic	Tranexamic acid	500 to 650^¶^Δ	Three times daily	Until bleeding stops (typically four days)
Antiprogestin	Mifepristone	100	Once	Monthly

* Naproxen base.
¶ Dose adjustment may be needed in setting of renal impairment.
Δ In the United States, tranexamic acid is available as a 650 mg tablet. A 500 mg tablet is available elsewhere.

Adapted from: Friedlander E, Kaneshiro B. Therapeutic options for unscheduled bleeding associated with long-acting reversible contraception. Obstet Gynecol Clin North Am 2015; 42:593.

Graphic 113197 Version 1.0