Plasma levels symptoms and conditions

I had mine taken out yesterday afternoon. So here's my scoop so far: The actual procedure was easy as pie. I felt a tiny pinch...no worse than a basic pap and that was it...they said it was out! The attitude from the staff and the doctor was a whole other story.

The nurse first of all asked what kind of side effects I had been having...I told her. (See my original posting from about a week ago if you need.) She asked if I had seen my PCP, because "Mirena couldn't cause those things." (I laughed at that point!) I tried explaining to her and educating her on these and other such sites and the reality that many of us have, as well as assuring her that I have seen several doctors and specialists and after office visits, x-rays, blood work, and multiple courses of meds, there is, in fact, nothing wrong with me. She stated, "Well, you'll need to talk to the doctor about that." So in comes the doc. He states that although I "think" I'm having these side effects...the IUD is at least serving it's purpose. I admitted that I was not pregnant, however it's not really a surprising fact seeing as how I'm now fat with bad skin and the ability to either rip your head off or cry depending on the minute you catch me! His response: "Well I don't think any of that is going to change because the Mirena isn't causing it." I truly don't believe I've been as insulted by a doctor before in my life as I was in that moment! (And I'm a nurse...I've been insulted plenty!) I asked him how he was so sure of this and he again tells me: "Because Mirena isn't systemic...it only acts on your uterus." I then questioned him about the Canadian drug study done about 10 years ago proving that you can verify effectiveness based on serum plasma levels (blood levels) within 3 hours of insertion. His response was simply this: (Oh ladies...you'll love this!) "Don't believe everything you read on the internet." He asked what I would do for birth control...and I told him that I wanted a non-hormonal form of control. He tried telling me the only options I had were the Copper IUD or permanent sterilization! At that point I looked at him and said I thought what I really needed was a new GYN, thanked him for the removal, paid my co-pay, and left that building for what I think will be the very last time.

I didn't go back to work. I went home and rested. Then I cried...just a massive cathartic release...and it felt great! I'm at the point where I am so ready to feel good again and knowing that this was the first step just brought all those emotions to the forefront. I have not yet had even so much as any spotting. Still feeling (and looking) fat and bloated with bad skin...I didn't wake up and lose 10 pounds...like I had hoped for, but I remain optimistic and continue to have faith that these symptoms will go away.

I'll continue posting occasionally and document my results. Good luck to all of us out there dealing with this.

If anyone has any access to databases that can describe the history of drug licensing in other countries and whether Merck had to amend product statements, this is worth investigating. I do know that montelukast was at least not initially licensed for seasonal allergies in the United Kingdom when the FDA granted approval in the US. As of 2006, seasonal allergies were not on the approved listed in the UK.

More to add to the files:

Safety of leukotriene antagonists
United Kingdom — The Medicines Control Agency
has published a review of adverse drug reactions to
a new class of asthma drugs, leukotriene antagonists.
Zafirlukast and moltelukast, competitive cysteinyl
leukotriene type-1 receptor antagonists, were
both marketed for the first time in 1998.
Cysteinyl leukotrienes are inflammatory mediators
and potent constrictors of bronchial smooth muscle
that attract human eosinophils and cause airway
oedema, mucus hypersecretion and reduced
mucociliary clearance. By blocking this action, leukotriene
antagonists can improve respiratory function
and lessen symptoms in patients with asthma.
The pharmacological action of leukotrienes is quite
complex and varying side effects have been
reported. Zafirlukast inhibits the hepatic cytochrome
P4502C9, and interacts with warfarin, theophyllin,
terfenadine, acetylsalicylic acid and erythromycin.
Montelukast is metabolized by hepatic cytochrome
P450CYP3A4 and co-administration of such drugs
as phenytoin, phenobarbitone and rifampicin, which
induce this enzyme, result in a marked reduction in
plasma levels.
Side-effects identified during clinical trials were
headache, abdominal pain, nausea, diarrhoea,
gastro-enteritis, influenza, pharyngitis, sinusitis,
cough, nasal congestion, dizziness, fatigue and insomnia.
Since marketing of montelukast, 173 reports
of 317 suspected adverse drug reactions
have been received in the United Kingdom. These
include oedema (50), psychiatric reactions, including
including agitation/restlessness (15), allergy, including
anaphylaxis, angioedema and urticaria (10), chest
pain (7), tremor (5), mouth dryness (5), vertigo (4)
and arthralgia (3).
Reference: Current Problems in Pharmacovigilance,
Volume 24, August 1998.
https://www.who.ch/druginformation/vol12/12-4.pdf

Been on lithium ( 800mcgs) for three months in a desperate attempt to lift a drug resistant depression. My moods are all over the place now but less severe. Feel quite drowsy the next day ( I take them at night)and am going to the toilet much more often. Plasma levels were 0.4 and I was feeling better but GP has now increased dosage.