Mirena interactions: Alcohol, medications, and other factors

In some cases, factors or conditions could prevent your doctor from prescribing Mirena due to the risk of harm. These are known as contraindications. The contraindications of Mirena include:

Being pregnant or possibly pregnant

Healthcare professionals will not insert Mirena if you’re pregnant or could be pregnant.

Mirena is a type of birth control used to help prevent pregnancy. However, it’s not used for emergency contraception.

If you do become pregnant and already have Mirena, tell your doctor right away. They will help you decide whether it’s safe to continue the pregnancy.

Having breast, uterine, or cervical cancer

Healthcare professionals will not insert Mirena if you have breast, uterine, or cervical cancer.

They’ll also avoid prescribing Mirena if you’ve had breast cancer or another progestin-sensitive cancer in the past. This is because Mirena contains a hormone called levonorgestrel. This hormone may encourage these cancers to grow. It may also increase the risk of these cancers coming back.

Before having Mirena inserted, be sure to tell your doctor about any form of cancer you have or had in the past. They can recommend a different form of birth control for you.

Having a genital or pelvic infection

Healthcare professionals will not insert Mirena if you have a genital or pelvic infection.

Examples of genital and pelvic infections include:

• cervicitis
• vaginitis
• infection after an abortion in the last 3 months
• current or past pelvic inflammatory disease (unless you’ve had a routine pregnancy since the infection went away)

Healthcare professionals will also likely avoid inserting Mirena if you have a high risk of genital or pelvic infections. For example, your risk may be increased by having a weak immune system or having sex with multiple partners without a condom or other barrier method.

Before having Mirena inserted, be sure to tell your doctor about any genital or pelvic infections. They can recommend whether Mirena is a safe birth control option for you.

Having liver cancer or liver disease

Healthcare professionals will not insert Mirena if you have liver cancer or liver disease.

This is because Mirena contains a hormone called levonorgestrel. This hormone may worsen any liver problem you already have.

Before having Mirena inserted, tell your doctor if you have liver cancer or liver disease. They can recommend a different form of birth control for you.

Having certain problems with the uterus

Healthcare professionals will not insert Mirena if you have certain uterus problems.

These include having:

• uterine bleeding that doesn’t have a known cause
• a condition that affects the shape of your uterus, such as fibroids
• inflammation of the uterus lining after giving birth in the last 3 months

Before having Mirena inserted, tell your doctor if you have any problems with your uterus. They can recommend a different form of birth control for you.

Having had an allergic reaction to Mirena or any of its ingredients

If you have had an allergic reaction to Mirena or any of its ingredients, your doctor will likely not prescribe Mirena. Having the device inserted could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you have Mirena inserted, it’s important to tell your doctor if any of these contraindications apply to you. They can determine whether to prescribe Mirena.

There isn’t a known interaction between Mirena and alcohol. If you drink alcohol, your doctor can advise you on an amount that’s safe to consume while you have Mirena.

Mirena is not known to interact with other medications.

Mirena is a type of birth control called an intrauterine device (IUD). It works inside the uterus, so very little of the drug reaches the rest of the body. This means Mirena is not likely to have drug interactions.

However, it’s possible that new interactions could be recognized in the future. For example, new interactions could be suspected and reported by people who’ve received Mirena since it became available.

Before you have Mirena inserted, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Mirena interacts with supplements, herbs, or vitamins, see the “Mirena and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Mirena may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Mirena.

Mirena interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Mirena and herbs

There are no specific reports of herbs interacting with Mirena. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Mirena treatment.

Mirena and vitamins

There are no specific reports of vitamins interacting with Mirena. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Mirena.

Mirena and food

There are no specific reports of food interactions with Mirena. If you’d like to learn more about eating specific foods while you have Mirena, talk with your doctor.

Mirena and vaccines

There are no specific reports of vaccine interactions with Mirena. If you’d like to learn more about getting specific vaccines while you have Mirena, talk with your doctor.

Mirena and lab tests

There are no specific reports of lab tests interacting with Mirena. If you’d like to learn more about getting certain lab tests while you have Mirena, talk with your doctor.

MIRENA AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Mirena. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Mirena. The effects of cannabis may affect how well you stick to your Mirena treatment plan.

Note: Cannabis is illegal at a federal level. However, it is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Mirena. Before you take this drug, be sure to talk with your doctor about your health history. Mirena may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Mirena include:

• Breast, uterine, or cervical cancer. Healthcare professionals will not insert Mirena if you have breast, uterine, or cervical cancer. They’ll also avoid inserting Mirena if you have had breast cancer in the past. For details, see the “When to avoid Mirena” section above.
• Genital or pelvic infection. Healthcare professionals will not insert Mirena if you have a genital or pelvic infection. For details, see the “When to avoid Mirena” section above.
• Liver cancer or liver disease. Healthcare professionals will not insert Mirena if you have liver cancer or liver disease. For details, see the “When to avoid Mirena” section above.
• Problems with the uterus. Healthcare professionals will not insert Mirena if you have certain uterine problems. For details, see the “When to avoid Mirena” section above.
• Migraine. If you have migraine headaches or had them in the past, talk with your doctor. The drug may cause headaches or migraine episodes as a side effect, which could worsen this condition. Your doctor can recommend whether Mirena is safe for you.
• High blood pressure. Mirena can increase your blood pressure. Be sure to tell your doctor if you already have high blood pressure. They can recommend whether Mirena is a safe treatment option for you.
• Risk of blood clots or having had a stroke or heart attack in the past. Mirena may cause a stroke or blood clots. If you’ve had a stroke or heart attack in the past, talk with your doctor. Also, tell them if you already have a high risk of blood clots. They can advise you on whether Mirena is a safe treatment option.
• Pregnancy. Healthcare professionals will not insert Mirena if you’re pregnant or could be pregnant. Mirena is used to help prevent pregnancy. However, it’s not used for emergency contraception. To learn more about having Mirena while pregnant, see this article.
• Breastfeeding. Levonorgestrel (the active drug in Mirena) may pass into breast milk. However, side effects from the drug haven’t been reported in children who are breastfed. In addition, having Mirena placed into your uterus while breastfeeding may increase your risk of perforation. (With perforation, the IUD pokes through the wall of your uterus). To learn more about having Mirena while breastfeeding, see this article.
• Allergic reaction. If you’ve had an allergic reaction to Mirena or any of its ingredients, your doctor will likely not prescribe Mirena. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: To learn more about Mirena’s side effects, see this article.

Here are some frequently asked questions about Mirena and possible interactions.

Are there any drug interactions with Mirena that reduce its effectiveness?

Possibly, though it isn’t known for certain. Drug interactions with Mirena haven’t been studied in clinical trials.

Keep in mind that Mirena is a type of birth control called an intrauterine device (IUD). It works inside the uterus, so very little of the drug reaches the rest of the body. This means Mirena is not likely to have drug interactions.

That said, interactions with other drugs or supplements could be recognized in the future. For this reason, it’s important to tell your doctor and pharmacist about other medications you take. It’s also best to check with them before starting new drugs or supplements while you have Mirena.

If you’re concerned that a specific drug could make Mirena less effective, talk with your doctor. They can tell you about symptoms that may occur when Mirena is not working as well as it should. For example, you may have heavier periods than you typically do.

If you notice signs that suggest Mirena is wearing off, talk with your doctor. They may suggest you have an exam to determine whether Mirena should be adjusted or removed. You may also ask them whether a backup birth control method is needed.

You can take certain steps to help prevent interactions with Mirena. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Mirena information pamphlet and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions. (If Mirena doesn’t come with paperwork, you can ask your pharmacist to print a copy.) If you need help reading or understanding this information, ask your doctor or pharmacist.

Besides learning about interactions, you may want to find out more about Mirena. These resources might help:

• Overview of Mirena. For a general overview of Mirena, you can see this article.
• Facts about pregnancy prevention. To learn more about pregnancy prevention, see our sexual health hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.