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Overview: Paragard is an intrauterine device (IUD), a form of birth control, that is inserted into the uterus to prevent pregnancy for up to 10 years. Common side effects include low red blood cell levels, back pain, painful periods, and changes in menstrual bleeding. Serious side effects are rare but can include infections or uterus problems. 

Uses

What is Paragard used for?

Paragard is a copper-containing intrauterine device (IUD) that is inserted into the uterus and is commonly used to prevent pregnancy for up to 10 years. 

Paragard may also be used for other conditions as determined by your health care provider.

How does Paragard work (mechanism of action)?

Paragard works by slowly releasing copper into the uterus. It prevents pregnancy by affecting how sperm move and stopping them from fertilizing an egg. It may also prevent a fertilized egg from attaching to the uterus. 

How is Paragard supplied (dosage forms)?

Brands and other names

  • Paragard
  • Paragard T 380A

Dosage forms and strengths

Paragard is available as an intrauterine device (IUD) that is inserted by a health care provider.

How should I store Paragard?

Paragard is usually inserted by a health care provider during an office visit. You will not store it at home.

Side Effects

What are the most common side effects of Paragard?

The most common side effects of Paragard are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Low red cell blood levels (anemia)
  • Back pain 
  • Painful periods
  • Pain during sex
  • Expulsion of the device (see below)
  • Changes in menstrual bleeding (see below)
  • Pain and cramping
  • Vaginal discharge or irritation

There may be other side effects of Paragard that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Paragard?

While less common, the most serious side effects of Paragard are described below, along with what to do if they happen.

Severe Allergic Reactions. Paragard may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Severe Infection. Paragard can increase your risk of a severe infection or sepsis within the first few days after the device is inserted. Call your health care provider right away if you have severe pain or fever.

Uterus Problems. Paragard may go into the wall of the uterus (become embedded) or go through the wall of the uterus (perforation). This increases your risk of pregnancy. It also increases the risk of infection and damage to other organs. The risk of perforation is higher if you are breastfeeding while using Paragard. Tell your health care provider right away if you cannot feel the threads of the device inside your vagina or if you have pain or bleeding that gets worse after Paragard is inserted. 

Expulsion. Paragard may come out of the uterus by itself, which is called expulsion. The risk of expulsion may be higher if Paragard is placed right after you deliver a baby. If Paragard comes out, you will be at higher risk of pregnancy. Tell your health care provider right away if you cannot feel the threads of Paragard inside your vagina or if you have pain or bleeding that gets worse after Paragard is inserted.

Changes in Menstrual Bleeding. Paragard can cause your period to become longer and heavier. It can also cause frequent spotting or light bleeding between periods. Call your health care provider right away if bleeding remains heavier or longer than usual or if you continue to have spotting. 

Pelvic Inflammatory Disease. Paragard can increase the risk of pelvic inflammatory disease (PID), which is an infection that can affect the uterus, ovaries, or fallopian tubes. Bacteria that cause pelvic inflammatory disease can get into your body when Paragard is inserted. Call your health care provider right away if you have any of the following symptoms of PID.

  • Pain in your lower belly or pelvis
  • Heavy vaginal discharge that is discolored and has a bad smell
  • Heavy bleeding during your period or bleeding between periods
  • Pain or bleeding during sex
  • Chills or fever
  • Pain when your pee or problems peeing
  • Sores on your genitals

Pregnancy Problems. If you become pregnant while using Paragard, you may be at higher risk of miscarriage, infection, and early labor or delivery. You may also be at higher risk of that pregnancy being  outside the uterus (ectopic pregnancy). With ectopic pregnancy, as the fertilized egg grows, it can burst (rupture) and cause life-threatening bleeding and death. Call your health care provider right away if you think you might be pregnant or have any of the following symptoms. 

  • Pain in your lower stomach or vomiting
  • Sharp belly cramps 
  • Unusual vaginal bleeding or discharge
  • Pain on one side of your body
  • Dizziness or weakness
  • Pain in your shoulder, neck, or rectum
  • Fever, chills, or flu-like symptoms

Warnings & Precautions

Who should not use Paragard?

Allergies to Ingredients. People who are allergic to any of the following should not use Paragard.

  • Paragard
  • Copper
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Paragard.

Pregnancy. Do not use Paragard if you are pregnant or think you might be pregnant. If you become pregnant, contact your health care provider right away. See the Pregnancy section for more details.

Uterus Problems. Paragard should not be used if you have bleeding from the uterus for an unknown reason, or if you have problems that change the shape of your uterus, such as fibroids. Paragard may not work as well if you have these conditions.

Pelvic or Genital Infections. Paragard should not be used if you are at high risk of pelvic inflammatory disease (PID), which is an infection that can affect the uterus, ovaries, or fallopian tubes. It should also not be used if you have recently had an infection of the uterus after a pregnancy or abortion, or if you currently have an infection of the uterus, ovaries, fallopian tubes, cervix, or vagina. The infection should be treated before using Paragard.

Cancer. Paragard should not be used if you have or think you may have uterine or cervical cancer.

Wilson’s Disease. Paragard should not be used if you have a genetic disorder where copper builds up in the body, called Wilson’s disease. Paragard can make this condition worse.

Another Intrauterine Device (IUD). Paragard should not be used if you already have an intrauterine device (IUD) inside your uterus. The other device must be removed before Paragard can be placed.

What should I know about Paragard before using it?

Paragard is an intrauterine device (IUD) that is inserted into the uterus by your health care provider at a medical facility. It will be removed or replaced after 10 years, but it can be removed at any time.

Paragard does not protect you from HIV, AIDS, or other sexually transmitted diseases (STDs). 

Tell your health care provider right away if you have intense pain, cramping, bleeding, or dizziness after Paragard is inserted. It may need to be removed or replaced.

Check that Paragard is in place by feeling the threads inside the vagina at least once a month. Talk with your health care provider if you have questions about how to do this. 

If you think Paragard has fallen out of your uterus (expulsion) or is out of place, call your health care provider right away and use backup birth control (such as condoms or spermicide) until Paragard can be replaced. 

Be extra careful when changing tampons or menstrual cups so that you do not accidentally pull the Paragard threads. Call your health care provider right away if you think you have pulled Paragard out of place. 

Make sure to keep all follow-up appointments with your health care provider. They will use these appointments to check that Paragard is in the right position. 

You may need special X-rays or other imaging to check whether Paragard is in place, or to help find the device when it is time to take it out. Depending on the exact position of the device, removal may be difficult and may require surgery. Talk to your health care provider if you have questions.

Tell all your health care providers that you have Paragard in place. In some cases, it may not be safe to get an MRI (magnetic resonance imaging) or to have certain procedures that use high levels of radiofrequency (RF) energy (diathermy). 

What should I tell my health care provider before using Paragard?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Paragard is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following.

  • Dizziness or fainting (syncope)
  • Slow heart rate (bradycardia)
  • Seizures
  • Recently had a baby 
  • HIV, AIDS, or another sexually transmitted disease (STD)
  • Multiple sexual partners or your partner has multiple sexual partners
  • Immune system problems
  • Substance use disorder (specifically injectable drugs)
  • Anemia
  • Unexplained vaginal bleeding
  • Conditions that affect the shape of your uterus, such as fibroids

Pregnancy. Do not use Paragard during pregnancy. Using Paragard while you are pregnant may cause complications during pregnancy. If you become pregnant or think you might be pregnant while using Paragard, contact your health care provider right away.

Breastfeeding. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should use Paragard while breastfeeding.

How can I get more information about Paragard?

For more information about Paragard, you can visit the drugmaker’s website at www.paragard.com or call 877-727-2427.

Interactions

Does Paragard interact with foods or drinks?

There are no known interactions between Paragard and foods or drinks.

It is unknown if drinking alcohol will affect Paragard.

Does Paragard interact with other medicines (drug interactions)?

There are no known interactions between Paragard and other medicines. Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Paragard?

If you or someone else has used too much Paragard, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Paragard?

Paragard is inserted by a health care provider and left in place for up to 10 years. If it has been in place for too long or has come out of place, avoid sexual intercourse or use backup birth control (such as condoms or spermicide) and contact your health care provider right away.