implant jadelle

8/9/2019 Implant Jadelle

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JADELLE

JADELLEis the registered trademark of Leiras Oy for two-rod subdermal

levonorgestrel implants. orplantis the registered trademark of !he"opulation #oun$il for subdermal levonorgestrel implants.


2/22

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%hat is JADELLE

!wo &ilasti$7rods $ontaining

'( mg of levonorgestrel )L*+

whi$h are inserted ,ust under

the skin )subdermal+ of awomans upper arm.


3/22

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JADELLE /e$hanisms of A$tion

&uppress ovulation

De$rease tubal motility

#hange endometrium

!hi$ken $ervi$al mu$us


4/22


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JADELLE #ontra$eptive 9enefits

! :ighly effe$tive )2.2(0;3pregnan$ies per 022 women during the

first year of use+

!


6/22

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JADELLE #ontra$eptive 9enefits

continued

! @mmediate return of fertility on removal

! ew side effe$ts

! #lient needs to return to $lini$ only if problems

! o supplies needed by $lient

! #an be provided by trained nonphysi$ian )nurse or midwife+

! #ontain no estrogen


7/22

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JADELLE on$ontra$eptive 9enefits

! De$reases e$topi$ pregnan$y

! /ay de$rease menstrual $ramps

! /ay de$rease menstrual bleeding

! /ay improve anemia

! "rote$ts against endometrial $an$er

! De$reases benign breast disease

! "rote$ts against some $auses of "@D


8/22

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JADELLE Limitations

! #auses $hanges in menstrual bleeding pattern )irregular

bleeding8spotting+ in most women

!


9/22

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JADELLE Limitations continued

! %oman $annot stop whenever she wants )provider dependent+

! Effe$tiveness may be lowered when $ertain drugs for epilepsy

)phenytoin and barbiturates+ or tuber$ulosis )rifampin+ aretaken

! #ost-effe$tiveness dependent on length of use

! Does not prote$t against &!Ds )e.g.; :9B; :@B8A@D&+


10/22

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%ho #an Cse JADELLE

%omen

$ Of any reprodu$tive age

$ Of any parity in$luding nulliparous women$ %ho want highly effe$tive; long-term prote$tion against

pregnan$y

$ %ho are breastfeeding ) 6 weeks postpartum+

$ %ho are postpartum and not breastfeeding

$ %ho are postabortion


11/22

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%ho #an Cse JADELLEcontinued

%omen

$ %ith desired family sie who do not want voluntary

steriliation

$ %ith histories of e$topi$ pregnan$y

$ %ho have blood pressure = 0728002; blood $lotting

problems of si$kle $ell disease

$ %ith moderate to severe menstrual $ramping

$ %ho smoke )any age; any amount+$ %ho prefer not to or should not use estrogen

$ %ho $annot remember to take a pill every day


12/22

12Source %:O 0116.

JADELLE %ho &hould ot Cse

)%:O #lass 5+

JADELLEshould not be used if woman

$ @s pregnant )known or suspe$ted+

$ :as une>plained vaginal bleeding )only if serious problemsuspe$ted+

$ :as breast $an$er


13/22

13Source %:O 0116.

JADELLE #onditions


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JADELLE #onditions o Longer


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%hen to @nsert JADELLE

! Anytime during the menstrual $y$le when you $an be

reasonably sure the $lient is not pregnant

! Days 0B' of the menstrual $y$le

! "ostpartum

$ after 6 months if using la$tational amenorrhea method

)LA/+

$ after 6 weeks if breastfeeding but not using LA/

$ immediately or within 6 weeks if not breastfeeding

! "ostabortion )immediately or within the first ' days+


16/22

16&our$e !iet,en; #ronin and /$@ntosh 0113.

JADELLE @nfe$tion "revention


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JADELLE !en /ost re?uently


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&ide Effe$ts /anagement

@rregular or heavy

bleeding

#he$k for gyne$ologi$ problem

#ounseling and reassuran$e #O#s;

&A@Ds or oral estrogens

:eada$he onnar$oti$ analgesi$s

%eight $hange Diet history; advi$e and e>er$ise

9reast tenderness &upport bra

9reast dis$harge De$reased nipple stimulation

A$ne Diet; $leansers and topi$al

antibioti$s

JADELLE !reatment of #ommon &ide

Effe$ts


19/22

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JADELLEvs. orplant #omparison of


20/22

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JADELLE #lient @nstru$tions

! eep in$ision area dry for 57 hours.

! eep pressure bandage on for 57 hours and leave 9and-Aid7

on until in$ision heals )4F( days+.

! 9ruising; swelling and tenderness at insertion site are

$ommon.

!


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JADELLE *eneral @nformation

! #ontra$eptive effe$tiveness begins '3 hours after insertion

and stops soon after removal.

! #hanges in menstrual bleeding patterns are $ommon.

! #ertain drugs may redu$e effe$tiveness of implants. !ell your

provider if you start any new drugs.

!


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JADELLE %arning &igns

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