Mirena® (Levonorgestrel intrauterine system): A successful novel drug delivery option in contraception

Rose, Susan; Chaudhari, A.; Peterson, C. Matthew

doi:10.1016/j.addr.2009.04.022

Cited by 36 publications

(24 citation statements)

References 34 publications

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“…Twenty-three articles were potentially eligible, and the full-text version for each of those articles was retrieved. Fifteen of these were excluded because of (1) duplicated studies, 2 (2) nonrandomization, 1 (3) ineligible interventions, 4 (4) ineligible duration, 1 and (5) ineligible outcomes. 6 One study was classified as waiting for assessment because of unclear information regarding the study design.…”

Section: Study Selectionmentioning

confidence: 99%

“…1 It has subsequently been used as an alternative to progestogen in perimenopausal and postmenopausal women receiving estrogen therapy (ET). LNG-IUS provides high intrauterine but low systemic levels of levonorgestrel.…”

mentioning

confidence: 99%

“…LNG-IUS provides high intrauterine but low systemic levels of levonorgestrel. 1 In women using LNG-IUS, the endometrium remains in a nonproliferative, atrophic state. 1 The risk of endometrial cancer, stimulated by unopposed ET in perimenopausal and postmenopausal women who have a uterus, is decreased by supplementing the patient with progestogen.…”

mentioning

confidence: 99%

“…1 In women using LNG-IUS, the endometrium remains in a nonproliferative, atrophic state. 1 The risk of endometrial cancer, stimulated by unopposed ET in perimenopausal and postmenopausal women who have a uterus, is decreased by supplementing the patient with progestogen. 2<7 In recent years, a body of evidence has emerged suggesting that the addition of systemic progestogen as part of hormone therapy (HT) may be associated with adverse effects in other organs, particularly an increased risk of cardiovascular diseases 8<11 and breast cancer.…”

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confidence: 99%

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Effects of the levonorgestrel-releasing intrauterine system plus estrogen therapy in perimenopausal and postmenopausal women

et al. 2011

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Section: Study Selectionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Effects of the levonorgestrel-releasing intrauterine system plus estrogen therapy in perimenopausal and postmenopausal women

et al. 2011

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“…Since topical microdose progestin contraception is achieved largely through local effects [45], the pharmacokinetic profile of LNG concentration in the cervical tissue are a potentially more important predictor of eventual device performance. Figure 8D depicts LNG concentrations in cervical tissues collected at day 28 or day 90.…”

Section: Resultsmentioning

confidence: 99%

Engineering a Segmented Dual-Reservoir Polyurethane Intravaginal Ring for Simultaneous Prevention of HIV Transmission and Unwanted Pregnancy

et al. 2014

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The HIV/AIDS pandemic and its impact on women prompt the investigation of prevention strategies to interrupt sexual transmission of HIV. Long-acting drug delivery systems that simultaneously protect womenfrom sexual transmission of HIV and unwanted pregnancy could be important tools in combating the pandemic. We describe the design, in silico, in vitro and in vivo evaluation of a dual-reservoir intravaginal ring that delivers the HIV-1 reverse transcriptase inhibitor tenofovir and the contraceptive levonorgestrel for 90 days. Two polyether urethanes with two different hard segment volume fractions were used to make coaxial extruded reservoir segments with a 100 µm thick rate controlling membrane and a diameter of 5.5 mm that contain 1.3 wt% levonorgestrel. A new mechanistic diffusion model accurately described the levonorgestrel burst release in early time points and pseudo-steady state behavior at later time points. As previously described, tenofovir was formulated as a glycerol paste and filled into a hydrophilic polyurethane, hollow tube reservoir that was melt-sealed by induction welding. These tenofovir-eluting segments and 2 cm long coaxially extruded levonorgestrel eluting segments were joined by induction welding to form rings that released an average of 7.5 mg tenofovir and 21 µg levonorgestrel per day in vitro for 90 days. Levonorgestrel segments placed intravaginally in rabbits resulted in sustained, dose-dependent levels of levonorgestrel in plasma and cervical tissue for 90 days. Polyurethane caps placed between segments successfully prevented diffusion of levonorgestrel into the tenofovir-releasing segment during storage.Hydrated rings endured between 152 N and 354 N tensile load before failure during uniaxial extension testing. In summary, this system represents a significant advance in vaginal drug delivery technology, and is the first in a new class of long-acting multipurpose prevention drug delivery systems.

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Microfabricated Drug Delivery Devices: Design, Fabrication, and Applications

Zhang

Jackson

Chiao

2017

Adv Funct Materials

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Microfabrication technology has enabled the development of novel controlled-release devices that possess an integration of structural, mechanical, and perhaps electronic features, which may address challenges associated with conventional delivery systems. In this feature article, microfabricated devices are described in terms of materials, mechanical design, working principles, and fabrication methods, all of which are key features for production of multifunctional, highly effective drug delivery systems. In addition, the current status and future prospects of different types of microfabricated devices for controlled drug delivery are summarized and analyzed with an emphasis on various routes of administration including ocular, oral, transdermal, and implantable systems. It is likely that microfabrication technology will continue to offer new, alternative solutions to design advanced and sophisticated drug delivery devices that promise to significantly improve medical care.

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Mirena® (Levonorgestrel intrauterine system): A successful novel drug delivery option in contraception

Cited by 36 publications

References 34 publications

Effects of the levonorgestrel-releasing intrauterine system plus estrogen therapy in perimenopausal and postmenopausal women

Effects of the levonorgestrel-releasing intrauterine system plus estrogen therapy in perimenopausal and postmenopausal women

Engineering a Segmented Dual-Reservoir Polyurethane Intravaginal Ring for Simultaneous Prevention of HIV Transmission and Unwanted Pregnancy

Microfabricated Drug Delivery Devices: Design, Fabrication, and Applications

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