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Drug vs. Drug

Choosing between Kyleena and Mirena: Which is right for you?

Kyleena and Mirena are IUDs that contain levonorgestrel. Compare the efficacy and side effects of Kyleena vs. Mirena.
Karen Berger medical writer and reviewer headshot
By | Updated on Jun. 18, 2024
Two Rx IUDs: Kyleena vs Mirena

Key takeaways

  • Kyleena and Mirena are FDA-approved intrauterine devices (IUDs) that release the hormone levonorgestrel to prevent pregnancy, with Mirena also approved to treat heavy menstrual bleeding.

  • Kyleena is designed for use up to five years, while Mirena can be used for up to eight years for preventing pregnancy and up to five years for treating heavy menstrual bleeding.

  • Both IUDs are over 99% effective at preventing pregnancy, but their efficacy, side effects, and duration of use vary due to different doses of levonorgestrel.

  • Common side effects for both Kyleena and Mirena include vaginal inflammation, abdominal pain, menstrual cramps, and changes in menstrual bleeding patterns, with device expulsion being a rare but possible risk.

In this article:

Kyleena and Mirena are two brand-name medications used for birth control. Both medications are known as intrauterine devices (IUDs), which must be inserted into the uterus by a healthcare provider. Kyleena and Mirena both contain a progestin hormone called levonorgestrel (LNG). Although both are hormonal IUDs, they have some differences. For example, Kyleena can be used to prevent pregnancy for up to 5 years, while Mirena can be used to prevent pregnancy for up to 8 years, or up to 5 years to treat heavy menstrual bleeding. Continue reading to learn more about Kyleena and Mirena, including cost, side effects, and other important information.

What are the main differences between Kyleena and Mirena?

Kyleena and Mirena are both intrauterine devices (IUDs) that contain a progestin hormone called levonorgestrel (LNG). Both are approved by the United States Food and Drug Administration (FDA). Kyleena contains a lower dose of LNG than Mirena. A hormonal IUD is a tiny T-shaped device that is inserted into your uterus by a healthcare provider. The IUD releases the hormone LNG slowly over time. The way hormonal IUDs work is not entirely understood, but it is thought that LNG prevents ovulation and changes the cervical mucus and endometrial lining to prevent pregnancy.

One Kyleena IUD can be used for up to five years to prevent pregnancy. A Mirena IUD can be used for up to eight years to prevent pregnancy, or for up to five years to treat heavy menstrual bleeding. Bayer HealthCare Pharmaceuticals, Inc. makes both products. (Bayer also makes an IUD called Skyla.)

Kyleena is also distinguished from other intrauterine devices by a blue-colored removal thread and the visibility of a silver ring on ultrasound. Your healthcare provider must insert Kyleena or Mirena in a healthcare setting like a doctor’s office or clinic. The IUD can stay in your body for five to eight years, depending on the IUD and indication for use. At that point, your healthcare provider must remove it. If you wish to continue using an IUD, a new IUD can be inserted as soon as the previous one is removed.

Main differences between Kyleena and Mirena
  Kyleena Mirena
Drug class Progestins Progestins
Brand/generic status Brand Brand
What is the generic name? Levonorgestrel (LNG) intrauterine device (IUD) or levonorgestrel-releasing intrauterine system Levonorgestrel (LNG) intrauterine device (IUD) or levonorgestrel-releasing intrauterine system
What form(s) does the drug come in? Intrauterine device (IUD) Intrauterine device (IUD)
What is the standard dosage? Total dose of 19.5 mg LNG is released at a rate of about 17.5 mcg/day after 24 days. This rate decreases progressively to about 9.8 mcg/day after one year and 7.4 mcg/day after five years. Kyleena must be removed by the end of the fifth year. The healthcare provider can insert a new device when Kyleena is removed if the patient desires continued treatment. Total dose of 52 mg LNG is released at a rate of about 21 mcg/day after 24 days. This rate decreases progressively to about 11 mcg/day after five years and 7 mcg/day after 8 years. The healthcare provider can insert a new device when Mirena is removed if the patient desires continued treatment.
How long is the typical treatment? Up to 5 years; a new device may be inserted immediately after the previous device is removed. Up to 8 years to prevent pregnancy, or up to 5 years to treat heavy menstrual bleeding; a new device may be inserted immediately after the previous device is removed.
Who typically uses the medication? Women of reproductive age  Women of reproductive age

Conditions treated by Kyleena and Mirena

Kyleena and Mirena are both indicated to prevent pregnancy. For this use, Kyleena can be used for up to five years, or Mirena can be used for up to eight years. Mirena is also indicated for the treatment of heavy menstrual bleeding for up to five years. Kyleena does not have this indication, but some doctors may prescribe it off-label (for non-FDA-approved use) to help with heavy periods. It is important to note that IUDs do not protect against HIV/AIDS or other sexually transmitted infections.

Condition Kyleena Mirena
Prevent pregnancy  Yes Yes
Treatment of heavy menstrual bleeding Off-label Yes

Is Kyleena or Mirena more effective?

Studies are not available comparing Kyleena to Mirena. Looking at each drug individually, Kyleena’s manufacturer, Bayer, states that the Kyleena IUD is over 99% effective at preventing pregnancy for each year of use. Over five years, it is 98.5% effective.

For Mirena, Bayer states similar information—it is over 99% effective at preventing pregnancy for up to eight years.

Each IUD works as an effective method of contraception. They are appropriate for long-term use. Also, unlike birth control pills, you don’t have to remember to take it every day—you just check for the threads once a month.

These IUDs are also reversible contraception, meaning that when the IUD is removed, you can get pregnant. Most patients are able to get pregnant within 12 months after IUD removal. Only your healthcare provider can determine which medication is better for you, taking into account your medical history and other individual factors.

Coverage and cost comparison of Kyleena vs. Mirena

Because your healthcare provider administers Kyleena or Mirena in the office, he or she will provide the device. You will not typically visit a pharmacy for Kyleena or Mirena. Therefore, your healthcare provider will submit Kyleena or Mirena to your medical insurance.

The out-of-pocket price of one Kyleena IUD is approximately $1,400. You can ask your healthcare provider if they will accept a SingleCare coupon, bringing the price down to about $1,100.

The out-of-pocket price of a Mirena IUD is about $1,500. You can ask your healthcare provider if you can use your SingleCare coupon, reducing the cost to approximately $1,100.

Get the SingleCare discount card

  Kyleena Mirena
Typically covered by insurance? Medical Medical
Typically covered by Medicare Part D? N/A N/A
Standard dosage One device One device
Typical Medicare copay N/A N/A
SingleCare cost $1,100 $1,100

Common side effects of Kyleena vs. Mirena

Because Kyleena and Mirena contain the same active ingredient, levonorgestrel, side effects are very similar. The most common side effects of Kyleena and Mirena include:

  • Headache 
  • Acne
  • Breast tenderness
  • Vaginal infection or inflammation
  • Nausea 
  • Weight gain 
  • Menstrual cramps
  • Irregular bleeding, including loss of periods
  • Depression 
  • Mood changes
  • Hair loss
  • Unwanted hair growth

While allergic reactions are rare, patients with hives, difficulty breathing, or swelling of the face, lips, tongue, or throat, should seek emergency medical attention. You should also get emergency medical attention if you have signs of a stroke or heart attack, such as difficulty speaking or understanding, facial drooping, sudden arm or leg weakness, or crushing pain in the chest and/or shoulder.

Serious side effects that require an immediate call to your healthcare provider include:

  • Pain during sexual intercourse
  • Vaginal pain
  • Genital sores
  • Yellowing of the skin or whites of the eyes 
  • Ovarian cysts (symptoms, if they occur, may include pelvic pain, a dull ache in the back, bloating, pain during intercourse, painful periods) 

In clinical trials, device expulsion (when the IUD becomes out of place) occurred in a small percentage of patients. If this occurs, it may go unnoticed, and the IUD will no longer work to prevent pregnancy.

This is not a full list of side effects. Other adverse effects may occur. Consult your healthcare provider for a complete list of side effects.

Source: DailyMed (Kyleena), DailyMed (Mirena)

Drug interactions of Kyleena vs. Mirena

Drug interaction studies have not been conducted with Kyleena or Mirena, which both contain LNG. However, drugs that induce enzymes that process LNG may decrease LNG levels, making the IUD less effective. On the other hand, drugs that inhibit enzymes that process LNG may increase LNG levels, causing more side effects. Due to the local effect of the medication (the drug is released into the uterine cavity), the drug interactions may not be clinically relevant. Ask your healthcare provider if there are any drug interactions with the medicines you take.

The manufacturer of both Kyleena and Mirena recommends that any drug prescribed along with one of these IUDs should be checked for potential drug interactions with LNG.

This is not a full list of drug interactions. Consult your healthcare provider for medical advice.

Warnings of Kyleena and Mirena

Because both Kyleena and Mirena contain the same ingredient, levonorgestrel, warnings are the same.

  • Kyleena or Mirena should not be used in certain patients, such as those:
    • Who are pregnant or suspected to be pregnant (an IUD must be removed if pregnancy occurs)
    • With uterine problems, such as fibroids
    • Who have acute pelvic inflammatory disease (PID), a history of PID, or who are susceptible to pelvic infections
    • With uterine or cervical neoplasia (growth)
    • Who have (or have a history of) breast cancer or other progestin-sensitive cancer 
    • With uterine bleeding of unknown cause
    • Who have untreated cervical or vaginal infections (until the infection is controlled)
    • With liver disease or tumor
    • Who currently have an IUD inserted
    • Who are allergic to progestin
  • Kyleena or Mirena should not be used as emergency contraception.
  • The patient should be evaluated four to six weeks after IUD insertion.

Frequently asked questions about Kyleena vs. Mirena

Are Kyleena and Mirena the same?

Both Kyleena and Mirena are IUDs that contain a hormone called levonorgestrel. Kyleena can be used for up to five years to prevent pregnancy. Mirena can be used for up to eight years to prevent pregnancy, or up to five years to treat heavy menstrual bleeding. The dose of hormones (levonorgestrel) is different. Mirena contains a higher amount of hormone than Kyleena. Possible side effects are similar. Other hormonal IUDs include Skyla and Liletta.

You may have also heard of the Paragard IUD. Paragard is different from Kyleena and Mirena because it is a copper IUD and does not contain hormones. Paragard can prevent pregnancy for up to 10 years.

Are the Kyleena and Mirena IUDs the same size?

Kyleena is slightly smaller than Mirena. The difference is small, so you can ask your healthcare provider if the size would make a difference for you. 

Can I use Kyleena or Mirena while pregnant?

Call your healthcare provider right away if you have a Kyleena or Mirena device and think that you may be pregnant. The IUD can cause an ectopic pregnancy (pregnancy outside of the uterus), which is a severe medical emergency. If you have a device inserted and get pregnant, and the pregnancy is in the uterus, severe infection, miscarriage, premature delivery, and even death could occur. Your healthcare provider may try to remove the IUD, which may cause a miscarriage. It is unknown if LNG IUDs can cause long-term effects on the fetus if the IUD stays in place during a pregnancy. Your healthcare professional can direct you on the safest course of action.

Can I use Kyleena or Mirena with alcohol?

Kyleena or Mirena do not have an interaction with alcohol. An IUD may actually be a preferred method of birth control for a patient who drinks alcohol.

How do the Kyleena and Mirena IUDs affect your period?

Different people may react to IUDs differently. Some women will have irregular bleeding, and some may have spotting. Some patients will not have periods at all (or will have infrequent periods) while on Kyleena or Mirena after a period of time. 

Which IUD is the best?

IUDs are a popular and effective method of contraception. Your healthcare provider can help you sort through birth control options and determine if an IUD is right for you, and if so, which one is best, taking into account your medical history and any other considerations.

Sources