ParaGard^® is a T-shaped piece of soft, flexible plastic wrapped with copper. Attached to the stem of the T are two white threads. ParaGard^® and its components do not contain latex.

Yes. Millions of women use contraceptives like ParaGard^®.¹ In the United States, women have used the ParaGard^® T 380A intrauterine copper contraceptive since 1988.

ParaGard^® prevents pregnancy primarily by stopping sperm from reaching and fertilizing the egg.² ParaGard^® may also prevent the egg from attaching (implanting) in the uterus. ParaGard^® does not alter your body's natural menstrual cycle.

ParaGard^® offers protection from pregnancy immediately upon insertion.

For a step-by-step look at the ParaGard^® insertion process, click here. To order this free instructional DVD, click here.

Unlike other birth control methods, ParaGard^® works continuously without you ever having to think about taking a pill, changing a patch, or replacing a ring. ParaGard^® is over 99% effective for as long as you want—1 year, 5 years, even up to 10 years.

ParaGard^® may be a good choice if you

• Are looking for a highly effective contraceptive option
• Do not want to use hormones
• Should not use hormones due to medical conditions³
• Want contraception that is convenient and easy to use
• Want a contraceptive that allows for rapid return to fertility^4-6
• Want the flexibility of short- or long-term use (up to 10 years)
• Are thinking about having your tubes tied, or your partner is thinking about having a vasectomy

ParaGard^® is not for everyone. We will discuss whether you have any conditions that may prevent you from being an appropriate candidate for ParaGard^®.

ParaGard^® can be a good alternative to more permanent options, such as having your tubes tied (called tubal ligation) or your partner getting a vasectomy. While these permanent methods and ParaGard^® are both effective for long periods of time, the contraceptive effect of ParaGard^® can be easily reversed
at any time.^4-6

For the first few months, you may have heavier and longer periods with cramping; some women have spotting between periods. After 2 to 3 months, these side effects usually lessen as your body adjusts to ParaGard^®. However, if your menstrual flow is severe or prolonged, give us a call. You should also call right away if you miss a period, since you might be pregnant.

Typically, you should not be able
to feel ParaGard^®.

Eligibility for ParaGard^® coverage should be determined on a patient-specific basis. To assist you with this process, we've created the ParaGard^® Reimbursement Checklist. You and your staff can use this checklist as a guide when speaking to your patient's insurance company to remind you to ask all the important questions about reimbursement. After completing the checklist, you may find it helpful to file it in your patient's chart for future reference.

To download the ParaGard^® Reimbursement Checklist in
PDF format, click here.

She may be, depending on your full medical evaluation. But a history of pelvic inflammatory disease (PID) is not a contraindication for use of ParaGard^®. However, acute PID or current behavior suggesting high risk for PID
are contraindications.

No, ParaGard^® is not reusable. Even if ParaGard^® is only partly expelled, it must
be removed. A new ParaGard^® may then
be inserted if the patient requests it and
has no contraindications.

To find out details on our return and replacement policy, please call the ParaGard^® Information Line at
1-877-ParaGard (727-2427).

You can insert ParaGard^® immediately after delivery, although the risk of expulsion may
be higher than at other times. However, if
you do not insert ParaGard^® immediately postpartum, insertion should be delayed
to the second postpartum month. This is because insertion during the first postpartum month (except for immediately after delivery) has been associated with increased risk
of perforation.

Discontinuation rates due to menstrual problems for both products are low.
A clinical comparison of a hormonal IUC (levonorgestrel 20 µg/d) and a nonhormonal IUC (TCu 380Ag) demonstrated that¹

• Amenorrhea accounted for the majority of discontinuations in the
  LNg 20 group, and menorrhagia accounted for the majority among Copper TCu 380Ag users
• There were nearly 50% fewer discontinuations due to overall menstrual problems with the TCu 380Ag IUC than with the LNg 20
• Amenorrhea accounted for 72% of all discontinuations due to menstrual-related problems among
  LNg 20 users
• The discontinuation rate due to menorrhagia among TCu 380Ag users was half the discontinuation rate due to amenorrhea among
  LNg 20 users

This study was not sponsored by Duramed Pharmaceuticals, Inc.; the ParaGard^® T 380A IUC and the Mirena^®(a,b) (levonorgestrel-releasing intrauterine system) 20 µg/d were not used in this study. The difference between the copper IUC studied and ParaGard^® is the silver core in the copper wire. Two variants of the LNg 20 were studied, one with 60 mg of levonorgestrel (7-year use) and one with 46 mg (5-year use). Mirena^® is loaded with 52 mg of levonorgestrel.² Additional menstrual problems including spotting, metrorrhagia, and dysmenorrhea were not significantly different between the 2 groups.

• Mirena^® (levonorgestrel-releasing intrauterine system) 20 µg/d
• Mirena^® is a registered trademark of Bayer HealthCare Pharmaceuticals Inc.

The ParaGard^® label supports use in a
broad range of patients and there is no "Recommended Patient Profile." For example, ParaGard^® may be used in women regardless of parity. ParaGard^® may also be used in women with a history of pelvic inflammatory disease (PID); however, acute PID or current behavior suggesting high risk for PID are contraindications. Other contraindications for ParaGard^® include pregnancy, or suspicion of pregnancy; postpregnancy or postabortion uterine infection in the past 3 months; cancer of the uterus or cervix; infection in the cervix; allergy to any component; or Wilson's disease.

Click here to read more about appropriate candidates for ParaGard^®.

Yes, ParaGard^® may be used for as long or as little as your patients need or want—
from 1 year up to 10 years.

For a step-by-step look at the ParaGard^® insertion process, click here. To order this free instructional DVD, click here.

There are a variety of methods used by health insurance entities to determine payment amounts for products and services. Payment levels for ParaGard^® are based on the contractual arrangement between the plan and the healthcare provider. Payment amounts for the insertion procedure, if it is covered, are generally based on an existing fee schedule. You may elect to verify payment amounts with the insurance plan during the reimbursement process.

Copper is naturally present in your body. In otherwise healthy women, the copper in ParaGard^® doesn't raise the overall level of copper already present in your body.⁷

If you are allergic to copper, however, or if you have a rare condition called Wilson's disease, which is related to copper intolerance, you shouldn't use ParaGard^®.

Many private insurance plans cover ParaGard^® and may also cover the healthcare provider services associated with the use of ParaGard^®. However, it's important to research coverage for each patient, because policies and guidelines can vary by payer and by plan. While most private payers do not require prior authorization for ParaGard^®, it is important to verify each plan's documentation requirements as part of the reimbursement process.

Your partner should not be able to feel ParaGard^® during sex. However, if he does, please call us so that we can check the position of ParaGard^® and the length of the threads.

Yes. You can use ParaGard^® to prevent pregnancy for up to 10 years. In fact, the long-term safety and effectiveness of IUCs have been confirmed in a number of clinical studies.^4,6,8

Yes. ParaGard^® is hormone-free. In fact, the American College of Obstetricians and Gynecologists recommends it as a
choice for nursing mothers.⁹

We place ParaGard^® into your uterus during a regular office visit. After that, there are no daily or weekly routines—you simply check ParaGard^® yourself once a month. We show you how to check for the small threads attached to it and provide you with the ParaGard^® Patient Package Insert containing written instructions.

As ParaGard^® is put in place, you may feel mild or moderate cramping. You may also feel a pinching sensation. Some women feel faint, nauseated, or dizzy for a
few minutes.

The entire process takes just a few minutes during a routine office visit. Afterward, depending on how you feel, you can go right back to your normal routine, or we may ask you to lie down for
a few minutes.

No. ParaGard^® is effective for up to 10 years, but you have the flexibility to change your mind anytime. You can use it for 1 year, 3 years, 5 years—however long you need for up to 10 years. When you are ready to try to get pregnant, we can remove it for you during a routine
office visit.

Simply schedule an appointment with us to have ParaGard^® removed. Once ParaGard^® is removed, its contraceptive effect is reversed. In fact, among women who had a copper IUC removed to become pregnant, nearly 30% conceived by 1 month.⁶

ParaGard^® has a one-time initial unit cost. If you plan to use birth control for at least 2 years, ParaGard^® is one of the most cost-effective options available.¹⁰ (Please note that the one-time unit cost does not include the costs for insertion, removal, or taxes).

ParaGard^® is eligible for coverage under many health insurance plans. We can call your provider to see if they cover it. If you do not have, or choose not to use, insurance coverage for purchasing the ParaGard^® unit, the ParaGard^® Patient Payment Program lets you pay for the ParaGard^® unit with 12 monthly payments. We can provide you with all
the details.

You may contact our office if you have further questions, or you may call the ParaGard^® Info Line at
1.877.ParaGard (727.2427).

Please call the ParaGard^® Information Line at 1-877-ParaGard (727-2427) and ask for Medical Affairs.

For pricing on ParaGard^®, please call
the ParaGard^® Information Line at
1-877-ParaGard (727-2427).

If your patients plan to use contraception for at least 2 years, ParaGard^® is one of the most cost-effective options available. ⁴ It offers your patients efficacy for up to 10 years, with an initial one-time-only cost. For your patients' convenience, there are different ways they may pay for the ParaGard^® unit. For example, those who do not have, or choose not to use, insurance may use the ParaGard^® Patient Payment Plan, which permits 12 monthly payments instead of the full payment up front (taxes and costs associated with the insertion or removal of ParaGard^® are the responsibility of the patient).

Establishing your ParaGard^® Direct
Web account is quick and easy!

1. Go to www.paragarddirect.com
2. Click on "New Account Sign Up" located under Log In
3. Proceed to the "Existing ParaGard^® Direct Customer" section and complete the required fields to create a Web account
4. Click "Submit" and begin ordering ParaGard^® online!*

After you set up an online account, your
home page will be customized to reflect your specific account, maximizing ease of use
and convenience for you and your staff.

If you have any questions, please call Customer Service at
1-877-ParaGard (727-2427).

^*First-time online users—please allow up to 24 hours for initial online account setup. If you have not yet established a ParaGard*Direct Account (whether you order by phone or fax), please allow 48 hours for online account setup.

When a patient is adjusting to a new contraceptive, whether a nonhormonal method such as ParaGard^® or a hormonal method such as Mirena^® or the Pill, she may experience menstrual changes during her first few cycles.^2,3 Although the most common side effects of ParaGard^® are heavier and longer periods and spotting between periods, for most women these changes typically subside after 2 to 3 months postinsertion.
If a patient with ParaGard^® continues to experience heavy or longer periods or spotting between periods 2 to 3 months postinsertion, she should contact your
office for evaluation.

The most common HCPCS code used for ParaGard^® is J7300, but this may vary in some states or with some plans. Appropriate codes for ParaGard^® should always be confirmed with each
insurance plan as part of the reimbursement process.

More than 20 states currently have legislation in place requiring insurance plans to provide coverage for contraceptive drugs and devices. When state contraceptive legislation is in place, most insurance plans include coverage for ParaGard^®; however, some self-funded employer groups that fund their own insurance plans may not be required to provide contraceptive coverage, even if state legislation is in place. Because of the variances in state legislation and insurance plan coverage, it is necessary to research each patient's specific plan.

If ParaGard^® is not a covered benefit under a patient's insurance plan,
you might elect to contact the insurance plan directly to determine why coverage does not exist and consider initiating an appeal. At times, lack of coverage may be an employer decision. In these cases,
it may be helpful for your patient to contact her human resources or benefits department directly to request coverage for ParaGard^®.

Yes, for patients who do not have or choose not to use insurance coverage for purchasing the ParaGard^® unit, the ParaGard^® Patient Payment Plan lets women make 12 monthly installments via credit card or a one-time payment in full. Under this plan, patients may receive a full refund for the ParaGard^® unit within the first 150 days after placement if they are not satisfied; taxes and costs associated with insertion or removal of ParaGard^® are not covered under the plan or the refund.

To download the ParaGard^®
Patient Payment Plan Tear Sheet in PDF format, click here.

To assist patients in need, Duramed Pharmaceuticals, Inc., offers the ParaGard^® Patient Assistance Program. Under this plan, patients who meet certain eligibility criteria can receive a ParaGard^® unit free of charge; taxes and costs associated with insertion or removal of ParaGard^® are not covered through this program. Click here to download a brochure with key details about the program and information on how patient qualification is determined.

Your ParaGard^® Sales Representative can provide educational and counseling materials for your office staff and your patients. These specialized sales consultants can also offer educational tools about the ParaGard^®
insertion procedure.

To request that a Duramed Sales Representative contact you, click here.