Paragard

Generic name: Copper intrauterine device

Drug class: Miscellaneous vaginal agents

Dosage form: Intrauterine device

Root of administration: Intrauterine

Dose: Single device inserted into the uterus; effective for up to 10 years

Mechanism of action: Releases copper ions into the uterine cavity, altering the uterine and fallopian tube fluids to disrupt sperm motility and viability, preventing fertilization; may also prevent implantation of a fertilized egg

Drug usage cases:

• Primary indication: Prevention of pregnancy in females of reproductive potential for up to 10 years
• Off-label use: Emergency contraception if inserted within five days after unprotected intercourse

Drug contraindications:

• Pregnancy or suspicion of pregnancy
• Abnormalities of the uterus resulting in distortion of the uterine cavity
• Acute pelvic inflammatory disease (PID) or postpartum endometritis in the past 3 months
• Known or suspected uterine or cervical malignancy
• Uterine bleeding of unknown etiology
• Untreated acute cervicitis or vaginitis or other lower genital tract infection
• Conditions associated with increased susceptibility to pelvic infections
• Wilson’s disease
• Hypersensitivity to any component of Paragard, including copper or any of the trace elements present in the copper component
• Presence of another intrauterine system (IUS) that has not been removed

Side effects:

• Common: Heavier and longer menstrual periods, spotting between periods, cramping, backache, pain during intercourse, vaginal discharge, vaginal irritation
• Serious: Ectopic pregnancy, embedment (device becoming embedded in the uterine wall), perforation (device passing through the uterine wall), expulsion (partial or complete device expulsion from the uterus), pelvic infection, sepsis

Warnings:

• Increased risk of pelvic inflammatory disease (PID) associated with IUDs, including Paragard
• Risk of ectopic pregnancy if pregnancy occurs while using Paragard
• Potential for device expulsion, especially in the first year of use
• Risk of uterine perforation during insertion, which may require surgical removal
• Not recommended for individuals with Wilson’s disease due to copper content
• Regular follow-up with healthcare provider to ensure proper device placement and address any complications

Use during pregnancy or breastfeeding:

Paragard is contraindicated during pregnancy. If pregnancy occurs while using Paragard, there is an increased risk of ectopic pregnancy, which can be life-threatening and may result in infertility or loss of pregnancy. Paragard is not recommended for individuals with Wilson’s disease due to copper content. Paragard can be used during breastfeeding; however, it is important to consult with a healthcare provider to ensure it is appropriate for individual circumstances. After removal, fertility typically returns immediately.