Norplant system

Norplant System. The Norplant System is a long-term system for birth control (see Contraceptives). Investigation of this type of system began ia the eady 1960s, and a patent on the technology was issued ia 1966 (90). 

IMPLANT CONTRACEPTIVE SYSTEM. Levonorgestrel, a progestin, is available as an implant contraceptive system (Norplant System). Six capsules, each containing levonorgestrel, are implanted under local anestiiesia in die subdermal (below the skin) tissues of the mid-portion of die upper arm. The capsules provide contraceptive protection for 5 years but may be removed at any time at die request of the patient. See Table 52-3 for more information on ways to promote an optimal response when taking die contraceptive hormones. 

Polymeric membrane-based implantable drug delivery systems have been developed to deliver growth hormone, hormonal contraception, and leuprolide for the treatment of prostate cancer. Implanted sialic tubes loaded with lev-onorgestrel Norplant system) is used outside the United States to provide five years of sufficient sustained release of the... 

Five women using the Norplant system developed major depression, two of whom also developed obsessive-compulsive disorder and one of whom also developed agoraphobia (28). They had no prior psychiatric history but developed major depression within 1-3 months after insertion of Norplant. The depression worsened over time and in all cases resolved within 1-2 months after removal of Norplant. There was no recurrence of depression after 7-8 months in four cases available for follow-up. In addition to major depression, obsessive-compulsive disorder developed in two women and symptoms of agoraphobia developed in one woman during Norplant treatment, which resolved after removal. 

Implantable controlled release dmg deUvery systems, including Norplant and other contraceptive steroids ia siUcone-based devices, have been reviewed (91,92). 

Mirena is a relatively new intrauterine contraceptive device that releases levonorgestrel into the uterine cavity for 5 years. Use of this contraceptive device is associated with fewer systemic progestin side effects and is at least as effective as Norplant. 

A modified system, Norplant-2, requires only two instead of six rods. In 140 women using the Norplant-2 contraceptive subdermal implant system there were no accidental pregnancies over 3 years (52). Adverse effects that caused withdrawal from the study were acne, headache, and pain at the implant site. The termination rate for these medical reasons in year 3 of the study was 4.6%. The other main reason for termination was prolonged menstrual flow the 3-year cumulative termination rate for menstrual irregularities was 3.8%. 

Cardamakis E, Georgopoulos A, Fotopoulos A, Sykiotis GP, Pappas AP, Lazaris D, Tzingounis VA. Clinical experience with Norplant subdermal implant system as long-term contraception during adolescence. Eur J Contracept Reprod Health Care 2002 7(1) 36-40. 

Wysowski DK, Green L. Serious adverse events in Norplant users reported to the Food and Drug Administration s MedWatch Spontaneous Reporting System. Obstet Gynecol 1995 85(4) 538-42. 

Nondegradable subcutaneous implants as diffusion-controlled drug delivery systems, including Norplant, have been reviewed.89 99 Unlike biodegradable implants with long-term toxicological concern for metabolism of the polymer, nondegradable implants cannot avoid removal of the... 

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