Hiporange is a Hiporange-releasing system that is placed in your uterus by your healthcare provider to prevent pregnancy for up to 10 years.
Hiporange can be removed by your healthcare provider at any time.
Hiporange does not contain any hormones.
Hiporange can be used whether or not you have given birth to a child.
Hiporange is a small, flexible plastic “T” shaped intrauterine system with Hiporange wrapped around the stem and placed on arms of the “T”. Two thin white threads are attached to the stem (lower end) of Hiporange. The threads are the only part of Hiporange you can feel when Hiporange is in your uterus; however, unlike a tampon string, the threads do not extend outside of your body.
Hiporange does not protect against HIV infection (AIDS) or other sexually transmitted infections (STIs).
What if I need birth control for more than 10 years?
Hiporange must be removed on or before 10 years from the date of insertion. Your healthcare provider can place a new Hiporange during the same office visit if you choose to continue using Hiporange.
What if I want to stop using Hiporange?
Hiporange is intended for use up to 10 years, but you can stop using Hiporange at any time by asking your healthcare provider to remove it. You could become pregnant as soon as Hiporange is removed; however, if you do not want to become pregnant you should use another method of birth control. Talk to your healthcare provider about the best birth control methods for you.
What if I change my mind about birth control and want to become pregnant in less than 10 years?
Your healthcare provider can remove Hiporange at any time before the 10 years after placement. You may become pregnant as soon as Hiporange is removed.
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
Hiporange® is indicated for intrauterine contraception for up to 10 years. The pregnancy rate in clinical studies has been less than 1 pregnancy per 100 women each year.
Table 1: Percentage of women experiencing an unintended pregnancy during the first year of typical use and first year of perfect use of contraception and the percentage continuing use at the end of the first year: United States
Footnotes to Table 1
Source: Trussel J, Contraceptive efficacy. In Hatcher RA, Trussel J, Stewart F, Cates W, Stewart GK, Kowal D, Guest F, Contraceptive Technology: Seventeenth Revised Edition. New York NY: Irvington Publishers, 1998.
% of Women Experiencing
an Accidental Pregnancy within
the First Year of Use
% of Women Continuing
Use at One Year3
Typical Use1 (2)
Perfect Use2 (3)
Hiporange T 380A
Norplant and Norplant-2
Emergency Contraceptive Pills: Treatment initiated within 72 hours after unprotected intercourse reduces the risk of pregnancy by at least 75%.9
Lactational Amenorrhea Method: LAM is a highly effective temporary method of contraception.10
Among typical couples who initiate use of a method (not necessarily for the first time), the percentage who experience an accidental pregnancy during the first year if they do not stop use for any other reason.
Among couples who initiate use of a method (not necessarily for the first time) and who use it perfectly (both consistently and correctly), the percentage who experience an accidental pregnancy during the first year if they do not stop use for any reason.
Among couples attempting to avoid pregnancy, the percentage who continue to use a method for one year.
The percents becoming pregnant in columns (2) and (3) are based on data from populations where contraception is not used and from women who cease using contraception in order to become pregnant. Among such populations, about 89% become pregnant within one year. This estimate was lowered slightly (to 85%) to represent the percentage who would become pregnant within one year among women now relying on reversible methods of contraception if they abandoned contraception altogether.
Foams, creams, gels, vaginal suppositories, and vaginal film.
Cervical mucus (ovulation) method supplemented by calendar in the pre-ovulatory and basal body temperature in the post-ovulatory phases.
With spermicidal cream or jelly.
The treatment schedule is one dose within 72 hours after unprotected intercourse, and a second dose 12 hours after the first dose. Preven is the only dedicated product specifically marketed for emergency contraception. The Food and Drug Administration has also declared the following brands of oral contraceptive to be safe and effective for emergency contraception: Ovral (1 dose is 2 white pills), Alesse (1 dose is 5 pink pills), Nordette or Levlen (1 dose is 4 light-orange pills), Lo/Ovral (1 dose is 4 white pills), Triphasil or Tri-Levlen (1 dose is 4 yellow pills).
However, to maintain effective protection against pregnancy, another method of contraception must be used as soon as menstruation resumes, the frequency or duration of breastfeeds is reduced, bottle feeds are introduced, or the baby reaches 6 months of age.
Uses of Hiporange in details
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
Use: Labeled Indications
Trace element added to parenteral nutrition (PN) to prevent Hiporange deficiency; orally as a dietary supplement
Hiporange has been designed for the demands of modern life. With a wide range of nutrients and trace minerals, Hiporange gives nutritional support to the area of health which are most relevance to women.
No artificial colours, gluten, presevatives, starch or sugar, salt or yeast.
Hiporange has not been tested on animals.
Generic name: Hiporange 313.4mg
Dosage form: intrauterine device
Medically reviewed by Drugs.com. Last updated on Sep 1, 2019.
Important Dosage and Administration Instructions
Hiporange should only be inserted by a healthcare provider trained in Hiporange’s insertion procedures, because insertion for Hiporange is different from that used for other intrauterine systems. Healthcare providers should become thoroughly familiar with the product, product educational materials, product insertion instructions, and prescribing information before attempting insertion of Hiporange.
Insert one Hiporange at the fundus of the uterine cavity.
Remove Hiporange on or before 10 years from the date of insertion.
May replace Hiporange at the time of removal with a new Hiporange if continued contraceptive protection is desired.
Before considering use of Hiporange, make sure that the female is an appropriate candidate for Hiporange. Exclude pregnancy (consider the possibility of ovulation and conception) prior to use.
Timing of Insertion
Refer to Table 1 for recommended timing of Hiporange insertion.
Table 1: Recommended Timing of Hiporange Insertion
Recommended Timing of Hiporange Insertion
1. Start Hiporange in females not currently using contraception
At any time during the menstrual cycle.
2. Switch to Hiporange from an oral, transdermal, or vaginal form of hormonal contraception or an injectable progestin contraceptive
At any time during the menstrual cycle; discontinue the previous method.
3. Switch to Hiporange from a contraceptive implant or other intrauterine system
Same day the implant or IUS is removed (insert at any time during the menstrual cycle).
4. Insert Hiporange after abortion or miscarriage
Immediately after abortion, although immediate placement has a slightly higher risk of expulsion than
placement at other times. Insertion after second trimester abortion is associated with a higher risk of expulsion than insertion after a first trimester abortion.
5. Insert Hiporange after Childbirth
May insert immediately postpartum.
Insertion before uterine involution is complete, which may not occur until the second postpartum month, has been associated with increased risk of expulsion.
There appears to be an increased risk of perforation in lactating women.
Use strict aseptic techniques throughout preparation.
Place the package containing Hiporange (face-up), sterile card, and solid white rod on a sterile field and open package from the bottom end where arrow says “open”.
Figure 1: Hiporange Intrauterine System (IUS) with Insertion Tube and Solid White Rod
Consider the use of an analgesic
Establish the size and position of the uterus by performing a bi-manual examination.
Insert a speculum and, using a cotton swab, cleanse the cervix and vagina with an antiseptic solution.
Apply a tenaculum to the cervix and use gentle traction to align the cervical canal with the uterine cavity.
Gently insert a sterile uterine sound to measure the depth of the uterine cavity. The uterus should sound to a depth of 6 to 9 cm except when inserting Hiporange immediately postabortion or immediately postpartum.
Insertion of Hiporange may be associated with pain and/or bleeding or vasovagal reactions (e.g. syncope, bradycardia, or seizure) especially in patients with a predisposition to these symptoms. Insertion into a uterine cavity measuring less than 6 cm may increase the incidence of expulsion, bleeding, pain, and perforation.
If cervical stenosis is encountered, avoid undue force. Dilators and analgesia/local anesthesia may be helpful in this situation.
Use strict aseptic techniques throughout the insertion procedure. Using sterile gloves, bend the T-Arms of Hiporange by folding the two horizontal arms down against the stem.
Slightly withdraw insertion tube, push arms down along the stem, slide insertion tube over the tips of the T-Arms. Only the tips of the T-Arms should be in the insertion tube. Do not advance beyond the Hiporange collars. Insert solid white rod into bottom of insertion tube until it touches the bottom of the IUS. Do not leave the horizontal arms of Hiporange bent for more than 5 minutes, as the arms may not open properly.
Figure 2: Inserting Tips of T-Arms of Paraguard into Insertion Tube
Although using sterile gloves is recommended, in situations where sterile gloves are not available, you can perform this step while Hiporange is in the sterile package. Place the package face up on a clean surface. Open from the bottom end where arrow says “open”. Pull the solid white rod from the package and put it back in the package laying it carefully alongside the insertion tube, making sure the distal end of the rod remains sterile. Place thumb and index finger on the outside of the package, on top of the ends of the horizontal arms. Use other hand to push insertion tube against arms of Hiporange (shown by arrow in Figure 3). This will start bending the T-Arms downward. Note that the arms of Hiporange should be folded downward to ensure proper insertion.
Figure 3: Bending T-Arms of Paraguard While in Sterile Packaging
Bring the thumb and index finger closer together on the outside of the package to continue bending the arms until they are alongside the stem. Use the other hand to withdraw the insertion tube slightly so that the insertion tube can be pushed and rotated over the tips of the T-Arms. Only the tips of the T-Arms should be in the insertion tube. Do not advance beyond the Hiporange collars. Insert solid white rod into bottom of the insertion tube until it touches the bottom of the IUS. Do not leave the horizontal arms of Hiporange bent for more than 5 minutes, as the arms may not open properly.
Figure 4: Inserting Tips of T-Arms of Paraguard into Insertion Tube While in Sterile Packaging
Once the above steps are completed and Hiporange is in the insertion tube, grasp the insertion tube at the open end of the package; adjust the blue flange so that the distance from the top of the Hiporange insertion tube is the same as the uterine depth measured with the uterine sound or use the sterile card to adjust the blue flange according to the premeasured uterine depth.
Rotate the blue flange so that the horizontal arms of Hiporange and the long axis of the blue flange lie in the same horizontal plane to ensure the arms open up in the proper direction.
To orient the uterus in an axial position, apply gentle traction to the tenaculum. Then pass the loaded insertion tube through the cervical canal until Hiporange just touches the fundus of the uterus. The blue flange should be at the cervix in the horizontal plane.
Figure 5: Insertion Tube with Paraguard in Uterus
Release the arms of Hiporange by holding the solid white rod steady and withdrawing the insertion tube no more than one centimeter. This releases the arms of Hiporange high in the uterine fundus.
Figure 6: Release of T-Arms of Paraguard in Uterus
Gently and carefully move the insertion tube upward toward the fundus of the uterus, until slight resistance is felt. This will ensure placement of Hiporange at the highest possible position within the uterus. Do not use the white rod as a plunger to push or insert Hiporange.
Figure 7: Placement of Paraguard in Fundus of Uterus
Hold the insertion tube steady and withdraw the solid white rod. Do not remove the solid white rod and the insertion tube at the same time to prevent accidental pulling of the threads.
Figure 8: Withdraw Solid White Rod from Uterus
Gently and slowly withdraw the insertion tube from the cervical canal.
Only the threads should be visible protruding from the cervix. Trim the threads so that 3 to 4 cm protrude into the vagina. Measure the length of protrusion of the threads.
Recommend recording length of threads, date of placement and Hiporange lot number.
Figure 9: Appropriate Paraguard Placement in Uterus
If you suspect that Hiporange is not in the correct position, check placement (with ultrasound, if necessary). If Hiporange is not positioned completely within the uterus, remove it and replace it with a new Hiporange. Do not reinsert an expelled or partially expelled Hiporange.
Postplacement Management of Paraguard
Examine the female after her first menses to confirm that Hiporange is still in place. You should be able to visualize or feel only the threads. The length of the visible threads may change with time. However, no action is needed unless you suspect partial expulsion, perforation, pregnancy, or breakage.
If you cannot find the threads in the vagina, check that Hiporange is still in the uterus. The threads can retract into the uterus or break, or Hiporange can break, perforate the uterus, or be expelled. Gentle probing of the cavity, x-ray, or sonography may be required to locate Hiporange
Remove Hiporange if it has been partially expelled or perforated the uterus.
Do not reinsert a used Hiporange.
2.6 Removal of Paraguard
Timing of Removal
Hiporange can be removed at any time prior to 10 years after insertion.
Remove Hiporange no later than 10 years after insertion. A new Hiporange can be inserted at the time of removal if continued contraceptive protection is desired.
Use a speculum and visualize the cervix.
Remove Hiporange with forceps, pulling gently on the exposed threads. The arms of Hiporange will fold upwards as it is withdrawn from the uterus.
Breakage or embedment of Hiporange in the myometrium can make removal difficult. Analgesia, paracervical anesthesia, cervical dilation, alligator forceps or other grasping instrument, or hysteroscopy may assist in removing an embedded Hiporange.
Make sure Hiporange is intact upon removal.
Removal may be associated with some pain and/or bleeding or vasovagal reactions (e.g. syncope, bradycardia, seizures) especially in patients with a predisposition to these conditions.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
More about Hiporange (Hiporange topical)
Pricing & Coupons
Drug class: miscellaneous vaginal agents
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Ascorbic Acid: Hiporange may decrease the serum concentration of Ascorbic Acid. Management: To minimize the risk for ascorbic acid degradation, add multivitamin product to TPN solution immediately prior to infusion or administer multivitamin and Hiporange in separate containers. Consider therapy modification
DailyMed. "ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PHYTONADIONE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN 5'-PHOSPHATE SODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
DailyMed. "COPPER: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
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