Drug Guide
Copper
Classification
Therapeutic: Contraceptive device, Intrauterine contraceptive (IUC)
Pharmacological: Copper-releasing intrauterine device (IUD)
FDA Approved Indications
- Prevention of pregnancy via intrauterine contraception
Mechanism of Action
Copper IUDs release copper ions into the uterine cavity, which sperm are toxic to and which impair fertilization. Copper also causes an inflammatory response that is hostile to sperm and ova.
Dosage and Administration
Adult: Insertion of the copper IUD into the uterine cavity by a trained healthcare provider.
Pediatric: Not applicable, used in adults for contraception.
Geriatric: Not applicable.
Renal Impairment: Not applicable.
Hepatic Impairment: Not applicable.
Pharmacokinetics
Absorption: Copper ions are released locally within the uterine cavity.
Distribution: Localized in the uterine tissue; minimal systemic absorption.
Metabolism: Not metabolized; copper ions are released gradually from the device.
Excretion: Copper is excreted via bile and feces, minimal systemic absorption.
Half Life: Not applicable; device acts locally over its lifespan.
Contraindications
- Current pelvic inflammatory disease
- Abnormal uterine bleeding or distorted uterine cavity
- History of pelvic TB or current gynecologic cancer
- Known hypersensitivity to copper
Precautions
- Use with caution in women with Wilson's disease or copper allergy; check for uterine anomalies or fibroids that obstruct placement.
Adverse Reactions - Common
- Menstrual irregularities, heavier bleeding, or cramping (Common)
- Expulsion of the device (Rare)
Adverse Reactions - Serious
- Perforation of the uterine wall during insertion (Rare)
- Infection (Rare)
- Ectopic pregnancy if pregnancy occurs (Rare)
Drug-Drug Interactions
- None significant—local device, minimal systemic effects.
Drug-Food Interactions
- None
Drug-Herb Interactions
- None
Nursing Implications
Assessment: Assess uterine size, position, and overall reproductive health before insertion.
Diagnoses:
- Risk for infection
- Risk for abnormal uterine bleeding
Implementation: Ensure aseptic technique during insertion; educate patient about expected side effects.
Evaluation: Monitor for expulsion, infection, or abnormal bleeding during follow-up.
Patient/Family Teaching
- Explain how the device works and its effectiveness.
- Inform about possible side effects like irregular bleeding, cramping.
- Advise on signs of complications such as severe pain, heavy bleeding, or signs of infection.
- Emphasize the importance of follow-up appointments for device check.
Special Considerations
Black Box Warnings:
- None
Genetic Factors: None known.
Lab Test Interference: Copper IUDs may interfere with certain copper or metal-sensitive medical tests, but generally do not affect routine labs.
Overdose Management
Signs/Symptoms: Not applicable—device use is not an overdose scenario.
Treatment: Remove the device if complications occur; treat symptoms accordingly.
Storage and Handling
Storage: Keep in a dry, room-temperature environment.
Stability: Stable under normal storage conditions for the duration specified by manufacturer.