Comprehensive medication guide to Mirena including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0 for most patients with ACA-compliant insurance (device + insertion covered under preventive care mandate); prior authorization required by some plans; Medicaid covers Mirena at no cost-sharing; Medicare rarely covers it (under 5% of cases).
Estimated Cash Pricing
$1,200–$1,725 retail for the Mirena device alone (no generic available); with Bayer's Co-pay Savings Program, eligible commercially insured patients may pay as little as $20; insertion and office visit fees are billed separately by the provider.
Medfinder Findability Score
72/100
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Mirena is a brand-name intrauterine device (IUD) manufactured by Bayer. It contains 52 mg of levonorgestrel — a synthetic progestin hormone — that is slowly released into the uterine cavity over time. Mirena was first FDA-approved in December 2000, making it the first and longest-studied hormonal IUD on the U.S. market.
Mirena is a small, T-shaped plastic device approximately the size of a paper clip. A trained healthcare provider inserts it into the uterus during a brief in-office procedure. Once placed, it works continuously for up to 8 years for contraception, or up to 5 years for treating heavy menstrual bleeding — no daily pills, no monthly refills.
Mirena has two FDA-approved indications: (1) prevention of pregnancy for up to 8 years with over 99% efficacy, and (2) treatment of heavy menstrual bleeding (HMB/menorrhagia) for up to 5 years in women who also choose intrauterine contraception. It is the only IUD FDA-approved for the HMB indication.
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Mirena works primarily through local mechanisms in the uterus, with minimal systemic (whole-body) hormone exposure. The device releases levonorgestrel starting at approximately 21 mcg/day after insertion, decreasing to about 11 mcg/day after 5 years and 7 mcg/day after 8 years.
Primary mechanisms include: (1) Thickening cervical mucus, creating a physical barrier that prevents sperm from entering the uterus. (2) Inhibiting sperm motility and survival within the uterine environment. (3) Causing endometrial atrophy — thinning the uterine lining — which prevents implantation and reduces menstrual blood loss. Mirena may also partially suppress ovulation, especially in the first year of use.
Because Mirena's contraceptive effect is primarily local, it has far fewer drug interactions than oral hormonal contraceptives. The thin uterine lining is also what causes many Mirena users to experience lighter periods or no periods at all — a beneficial effect for women with heavy menstrual bleeding, endometriosis, or adenomyosis.
52 mg — intrauterine device (IUD)
Single T-shaped device containing 52 mg levonorgestrel; releases ~21 mcg/day initially, declining to ~7 mcg/day by year 8. Inserted by trained healthcare provider. Effective for up to 8 years (contraception) or 5 years (heavy menstrual bleeding treatment).
Mirena is not currently on the FDA's drug shortage list, and Bayer continues to manufacture and distribute it without supply disruptions. However, because Mirena is a provider-stocked medical device — not a pharmacy-dispensed medication — access challenges are common. The IUD must be ordered and stocked by an OB/GYN office, women's health clinic, or similar provider. Retail pharmacies do not carry it.
Common access barriers include insurance prior authorization delays (typically 2–4 weeks), provider appointment availability, and some clinics temporarily running low on stock between orders. Rural patients may face additional geographic barriers with fewer OB/GYN providers nearby. Urban patients typically have shorter wait times and more provider options.
To find a provider with Mirena in stock near you, use medfinder — the service contacts providers and clinics near you to find which ones have Mirena available, and sends you results by text. High-volume inserters like Planned Parenthood centers and large OB/GYN group practices tend to keep Mirena in stock most consistently.
Mirena is not a controlled substance, so no DEA license or special scheduling authority is required to prescribe it. However, because Mirena must be physically inserted into the uterus, the provider must have completed IUD insertion training. Prescribers who commonly insert Mirena include:
Telehealth providers can evaluate and prescribe Mirena, and can initiate insurance prior authorization — but the physical insertion must be completed in person at a clinic or provider's office. Telehealth platforms like Nurx and similar services can facilitate the pre-insertion consultation and prescription process.
No. Mirena (levonorgestrel-releasing intrauterine system) is not a controlled substance and is not scheduled by the DEA. It does not require any special prescribing authority beyond a standard medical license with IUD insertion training.
As a result, Mirena can be prescribed and inserted by a broad range of healthcare providers including OB/GYN physicians, certified nurse-midwives, nurse practitioners, physician assistants, and family medicine physicians — as long as they have received IUD insertion training. There are no refill restrictions or DEA reporting requirements associated with Mirena.
Common side effects, especially in the first 3–6 months:
Serious side effects (rare, <1%):
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Liletta
Also contains 52 mg levonorgestrel, effective up to 8 years. Most pharmacologically similar to Mirena. Available at lower cost at 340B program clinics (community health centers, Planned Parenthood). Made by AbbVie/Medicines360.
Kyleena
Contains 19.5 mg levonorgestrel, effective up to 5 years. Smaller device than Mirena; may be more comfortable for women who haven't given birth. Lower hormone dose; 12% of users have no period after year 1 vs. 20% with Mirena. Made by Bayer.
Skyla
Contains 13.5 mg levonorgestrel, effective up to 3 years. Smallest hormonal IUD available; best suited for adolescents or women with smaller uterus. Lowest hormone dose of all hormonal IUDs. Made by Bayer.
Paragard
Copper IUD, hormone-free, effective up to 10 years. No hormones — ideal for those who cannot or prefer not to use hormonal contraception. Can worsen heavy periods and cramping (opposite of Mirena). Also FDA-approved for emergency contraception within 5 days of unprotected sex.
Nexplanon
Etonogestrel subdermal implant (arm implant), effective up to 3 years. Small rod placed under skin of upper arm — no uterine placement required. Good for women with uterine conditions that contraindicate IUD use. Over 99% effective.
Prefer Mirena? We can find it.
Antithrombin alfa (Thrombate III)
majorPharmacodynamic antagonism — levonorgestrel (progestin) and antithrombin alfa have opposing effects on clotting. Avoid concurrent use; consider alternate contraception in patients on antithrombin alfa.
CYP3A4 inducers (rifampin, phenytoin, carbamazepine, phenobarbital, efavirenz)
minorMay theoretically reduce serum levonorgestrel levels. Contraceptive effect of Mirena is unlikely to be significantly affected due to local delivery mechanism, but clinical data are limited. Discuss risk with prescriber.
St. John's Wort (herbal supplement)
minorCYP3A4 inducer; may theoretically reduce levonorgestrel blood levels. Clinical significance for Mirena's local mechanism is low. Disclose use to provider.
Anticoagulants (warfarin, rivaroxaban, apixaban)
moderateNo direct drug-drug interaction, but IUD-related bleeding can interact with anticoagulant therapy. Initial irregular bleeding may be more pronounced. Discuss with prescribing hematologist or cardiologist.
Mirena is one of the most effective and well-studied contraceptive options available — over 99% effective for up to 8 years, with the added benefit of treating heavy menstrual bleeding. For patients who qualify and can navigate the access process, it offers years of reliable, low-maintenance contraception with minimal systemic hormone exposure.
The main challenges with Mirena in 2026 are access-related, not supply-related. Insurance prior authorization, provider appointment availability, and cost barriers are the primary hurdles — all of which can be navigated with the right resources. Under the ACA, most commercially insured and Medicaid patients can get Mirena at no out-of-pocket cost. For uninsured patients, Bayer's ARCH Patient Assistance Program provides the device at no cost to qualifying individuals.
If you're ready to get Mirena or having trouble finding a provider with it in stock, medfinder can contact providers near you and find which ones currently have Mirena available — saving you hours of calling on your own.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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