<!DOCTYPE DOCUMENT SYSTEM "icon.dtd" []>

<DOCUMENT author="perl program" datec=020199 title="leaflet" book="ABPI" edition="1996-97" section="company">
<PB n=1>
<CB n=1>
<DIV type=0>

<HEAD weight="bold" >
Norplant Levonorgestrel
</HEAD>

<DIV type=1>

<HEAD weight="bold" >
Before you start
</HEAD>


<BLOCK>
Please read this leaflet carefully before you decide about using Norplant. It provides you with a summary of the information available on Norplant. If you have any questions or are not sure about anything please ask your doctor or clinic.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
What is Norplant?
</HEAD>


<BLOCK>
Norplant consists of six small, thin capsules each containing 38 mg of levonorgestrel, a hormone used in many contraceptive pills. The capsules are made of medical grade elastomer (Silastic Type 372 and medical adhesive Type A).
</BLOCK>


<BLOCK>
The capsules are placed just under the skin by a trained doctor or nurses where they slowly release the hormone over a period of up to five years or until the capsules are removed.
</BLOCK>


<BLOCK>
Norplant is an effective, long-term and reversible method of contraception.
</BLOCK>


<BLOCK>
Product licence holder: Roussel Laboratories Ltd Denham, Uxbridge, UB9 5HP.
</BLOCK>


<BLOCK>
Manufacturer: Leiras Oy, Turku, Finland.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
How does Norplant prevent pregnancy?
</HEAD>


<BLOCK>
Norplant acts as a contraceptive by thickening the cervical mucus so that sperm cannot get through to any eggs and also by preventing the regular release of eggs. When Norplant is removed you will return to your usual level of fertility.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
Before using Norplant
</HEAD>


<BLOCK>
Norplant is a long-term, hormonal method of contraception that can be used by most women. However, some women should not use Norplant. You must tell your doctor if:
</BLOCK>


<LIST type="bulleted">

<ITEM>

<BLOCK>
you are pregnant or suspect that you are pregnant.
</BLOCK>

</ITEM>


<ITEM>

<BLOCK>
you have or have had a stroke, heart-attack, high
</BLOCK>

</ITEM>


<ITEM>

<BLOCK>
blood pressure or very high lipid/cholesterol levels. - you have liver trouble.
</BLOCK>

</ITEM>


<ITEM>

<BLOCK>
you have undiagnosed vaginal bleeding. - you are allergic to levonorgestrel.
</BLOCK>

</ITEM>


<ITEM>

<BLOCK>
you have had breast cancer.
</BLOCK>

</ITEM>


<ITEM>

<BLOCK>
you have had an unusual outcome to a recent pregnancy, (eg trophoblastic disease).
</BLOCK>

</ITEM>

</LIST>



</DIV>
<DIV type=1>

<HEAD weight="bold" >
Warning
</HEAD>


<BLOCK>
Some women will have to be especially careful when using Norplant. You should tell your doctor if:
</BLOCK>


<LIST type="bulleted">

<ITEM>

<BLOCK>
any member of your family has had a stroke, heart attack, high blood pressure or very high lipid/cholesterol levels.
</BLOCK>

</ITEM>


<ITEM>

<BLOCK>
you suffer from or have suffered from migraine.
</BLOCK>

</ITEM>


<ITEM>

<BLOCK>
you are overweight.
</BLOCK>

</ITEM>


<ITEM>

<BLOCK>
you are breastfeeding.
</BLOCK>

</ITEM>


<ITEM>

<BLOCK>
you suffer from or have suffered from depression.
</BLOCK>

</ITEM>

</LIST>



<BLOCK>
You may still be able to use Norplant, even if you have had some of these conditions. Your doctor or clinic will advise you.
</BLOCK>


<BLOCK>
The doctor or nurse who inserts or removes Norplant for you should have completed the required training programme. If your own doctor has not been trained, they should be able to refer you to one who has been.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
Are you taking any other medicines?
</HEAD>


<BLOCK>
It is important to tell your doctor about all the medicines you are taking, including any you have bought without a prescription.
</BLOCK>


<BLOCK>
Some medicines used to treat epilepsy, tuberculosis or fungal infections, for example, may interfere with the action of Norplant. Your doctor will be able to alter your treatment if this is necessary. If appropriate, you may be advised to use additional contraception for a short time.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
What is involved?
</HEAD>


<BLOCK>
The six capsules have to be inserted in your upper arm by a trained doctor or nurse. This will be on your left arm if you are right-handed and on your right arm <CB n=2> if you are left-handed. As this will need a small cut to be made into the skin, a local anaesthetic will be used. Some discolouration, bruising and swelling may be present for a few days, but these should not interfere with your normal activities. Do not bump the site. Keep it dry and covered with a small bandage for three days.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
How quickly does Norplant work?
</HEAD>


<BLOCK>
It depends on when your Norplant is inserted. If you are having periods as usual and you are not taking any other type of hormonal contraception like the Pill, Norplant should be inserted preferably on the first day of bleeding of your next period. You will then be protected from pregnancy immediately.
</BLOCK>


<BLOCK>
If this is not convenient, insertion can take place up to 5 days after the start of your period. However, if Norplant is inserted later than day one of your period an additional non-hormonal (barrier) method of contraception (e.g. condoms) must be used for 7 days after insertion. Ask your doctor to explain this to you.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
Follow-up
</HEAD>


<BLOCK>
Your doctor may want to check the site of your Norplant after a short period of time. You will need regular check-ups while on Norplant. Your doctor or clinic will advise you how frequently your visits should be.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
Can I have Norplant after a miscarriage or abortion?
</HEAD>


<BLOCK>
After abortion Norplant may be inserted immediately but if this is not done within 5 days, an additional non-hormonal (barrier) method of contraceptive (e.g. condoms) should be used for 7 days after insertion. There are no specific instructions for insertion in women following miscarriage.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
What about Norplant after having a baby?
</HEAD>


<BLOCK>
Norplant can be used after childbirth and it makes no difference whether you are breast feeding or not. Norplant can be inserted on the 21st day after your baby is born. This will provide contraceptive cover straight away. If you leave it later than day 21 you should use an additional non-hormonal (barrier) method of contraception for seven days.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
Can I change my mind?
</HEAD>


<BLOCK>
Norplant can be removed at any time during the five years. Contact your doctor or clinic and they will arrange it for you. However, as Norplant lies under the skin, please do not attempt under any circumstances to remove it yourself.
</BLOCK>


<BLOCK>
Norplant can be removed at any stage of the menstrual cycle. If you do not want to become pregnant and you are not having another Norplant inserted you 
<EMPH slant = "italic">
must use another form of contraception straight away
</EMPH>
.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
How is Norplant taken out?
</HEAD>


<BLOCK>
Norplant is removed by making a small cut in the skin at more or less the same place as they were put in. Again a local anaesthetic will be used.
</BLOCK>


<BLOCK>
Removal of your Norplant capsules will take slightly longer than it took to insert them, usually 20-30 minutes. Occasionally (in about 5% of cases), one or more of the capsules may be difficult to remove. If it is not possible to remove all six capsules at once, you may be asked to return to the doctor to remove the remaining capsules after the area has healed, about 4-6 weeks later.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
After five years
</HEAD>


<BLOCK>
If you want to carry on using Norplant, ask your doctor or clinic to make an appointment for you about a month before the final date for removal. When the first set of capsules are removed, a new set can then be inserted. It is important not to go over the five years without using some form of contraception because your usual level of fertility may return very quickly after this time.
</BLOCK>


</DIV>
<DIV type=1>

<HEAD weight="bold" >
What if I want a baby?
</HEAD>


<BLOCK>
Your usual level of fertility will return very quickly after Norplant is removed. However, it will help if you wait until you have had one normal period before you <PB n=2>
</BLOCK>


<BLOCK>
With this type of hormonal contraception there is a
</BLOCK>

</DIV>

</DIV>

</DOCUMENT>
