Birth Control

Lunelle

What is Lunelle?

Lunelle is a monthly birth control shot. Lunelle can be injected into the arm, thigh, or rear. The shot has both synthetic estrogen and progesterone hormones. Lunelle prevents the release of an egg and thickens the cervical mucus to make it more difficult for sperm to enter the uterus. It also causes the uterine lining to become less prepared to support a fertilized egg. Lunelle is a very private form of birth control since it cannot be seen on the body and needs no home supplies. It does, however, require monthly visits to a clinic or pharmacy. Lunelle is about 99% effective as birth control. It does not protect against reproductive tract infections, including HIV/AIDS.

Lunelle was first approved for use in the U.S. in 2000, and was distributed by the Pfizer-Upjohn pharmaceutical company. However in Oct of 2003 Pfizer discontinued manufacturing Lunelle, and it is no longer available in the U.S.

Use

The first injection of Lunelle is usually taken during the first 5 days of a woman's menstrual cycle. It is recommended that each follow-up injection be taken 28-30 days after the last one. If the shot is given after 33 days, it may not be effective. If you are unable to get your next injection on time, you may want to use another method of birth control, like condoms and spermicide, to prevent pregnancy. Since Lunelle requires monthly injections, you can set up your next visit on the day that you get an injection.

Cautions

Some women may not be able to take Lunelle because of the risk of serious health problems. Women who are over 35 and smoke or who have any of the following conditions should not take Lunelle:

• History of heart attack or stroke
  
  
• Blood clots
  
  
• Unexplained vaginal bleeding
  
  
• Known or suspected cancer
  
  
• Known or suspected pregnancy
  
  
• Liver disease

Women who are under 35 and smoke, have migraines, gallbladder disease, hypertension, diabetes, epilepsy, sickle cell disease, elective surgery, a history of blood clots, liver or heart disease may not be able to take Lunelle. Your clinician or doctor can decide.

Side Effects  

The most commonly reported negative effect of Lunelle is irregular bleeding. This ranges from no bleeding at all to heavy and unpredictable bleeding.

Weight gain and fluid retention are also common side effects of Lunelle. Women can expect an average gain of 4 pounds per year, but the weight gain may be higher than 10 or 20 pounds.

The other side effects that may occur with Lunelle are raised blood pressure, breast tenderness, acne, change in appetite, nausea, headaches, nervousness, mood changes or depression, change in sexual desire, dizziness, rash, or vaginal infections.

Experiencing some of these side effects may not indicate serious problems. If you feel concerned about any of your body's reactions to Lunelle, contact the clinic for information and options.

Drug Interactions

The effectiveness of Lunelle is lowered when taken with certain medications, including antibiotics, barbiturates, anti-seizure medications, and herbal medicines with St. John's Wort. If you are taking any medications, tell your clinician. When taking medications that may interfere with Lunelle, consider adding a backup method of birth control, like condoms and spermicide. As with all drugs, it is useful to inform all your medical providers if you are using hormonal birth control.

Danger Signs  

Women who experience any of the following symptoms while taking Lunelle should call the clinic immediately:

• Abdominal pains (severe)
  
  
• Chest pain or shortness of breath
  
  
• Headaches (severe)
  
  
• Eye problems, such as blurred vision
  
  
• Severe leg or arm pain or numbness

In addition, women who experience difficulty sleeping, fatigue, severe changes in mood, unusually heavy vaginal bleeding, persistent pain, pus, or bleeding at the injection site should call the clinic.

Missed Shots

If you are unable to make your appointment for an injection, call the clinic for options and instructions. You may want to use other methods of birth control until you receive the next injection.
Future Fertility  

Women who want to become pregnant may stop using Lunelle at any time. Some women have an immediate return to fertility. Others may have to wait 60-90 days to have normal menstrual cycles.

Safety

The FDA approved Lunelle on October 5, 2000. While it currently appears to be safe and effective for short-term use, its long-term risks are not known. The weight gain connected to the use of Lunelle may be one of its negative, long-term effects. A large amount of weight gain can affect a woman's physical and mental well-being.

Availability

In most areas, Lunelle is only offered through clinics. In Washington State, women can ask their physician or clinician to call a local Fred Meyer pharmacy and approve injections for a year. Women can then receive their injections at the pharmacy instead of the clinic.

Advantages

• Private.
  
  
• Does not interrupt sex play.
  
  
• Easy to use.
  
  
• Does not harm future fertility.
  
  
• Available at clinics and pharmacies in Washington State.

Disadvantages

• Does not protect against sexually transmitted infections, including HIV/AIDS.
  
  
• Requires a prescription.
  
  
• Must be taken every month.
  
  
• Side effects include irregular bleeding and weight gain.
  
  
• Less effective when taken with some drugs.
  
  
• Long-term risks unknown.
  
  

Written by: the Feminist Women’s Health Center. Posted with permission.
Last revised: February 2005

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