The drugs should not be used together. Adverse reactions that have been reported frequently, particularly during the early months of levonorgestrel therapy, include breakthrough bleeding, spotting, menstrual irregularity, scanty bleeding, and amenorrhea. Levonorgestrel implants can cause a type of injection site reaction. In addition, there is growing concern regarding the removal of the six silicone rods that release levonorgestrel. Removal can require surgery and may be painful.
Hormonal contraceptives can cause edema or fluid retention.
Levonorgestrel should be used cautiously in patients with heart failure or renal disease. Hormonal contraceptives can cause mood lability. Patients receiving levonorgestrel can experience mental depression, anxiety, frustration, anger, or other emotional outbursts. Levonorgestrel comes as a set of six filled capsules made of a special silicone-elastic material. These implant capsules are surgically implanted under the skin and provide contraceptive protection for 5 years.