Levonorgestrel Introduction
Levonorgestrel is a synthetic progestin (hormone) used in many forms of birth control. It is also used to treat abnormal uterine bleeding, endometriosis, and as an emergency contraceptive. It has recently been approved by the FDA as an over-the-counter medication for emergency contraception in the United States. Levonorgestrel is available in oral tablet, patch, and injection forms.
Uses For
Levonorgestrel is most commonly used for contraception and emergency contraception. It is also used to regulate menstrual periods, to treat endometriosis, and to treat symptoms of premenstrual dysphoric disorder (PMDD).
| Brand Name | Levonorgestrel |
|---|---|
| Type | |
| Weight | |
| Generic | Levonorgestrel |
| Manufacturer | |
| Available in | English বাংলা |
Mechanism of Action
Levonorgestrel works by preventing ovulation (the release of an egg from the ovary) and altering the cervical mucus to make it difficult for sperm to reach the uterus. It has a low efficacy rate if taken after ovulation has already occurred.
How Long Does it Take to Work?
Levonorgestrel will begin to work immediately once taken. When taken as emergency contraception, it is most effective if taken within 24 hours after unprotected sex, but can be taken up to 5 days after. When used as a regular form of contraception, it is most effective when taken daily.
Absorption
Levonorgestrel is absorbed rapidly and extensively when taken orally, and is completely absorbed after topical application.
Route of Elimination
Levonorgestrel is primarily metabolized by the liver. It is eliminated principally in feces with lesser amounts excreted in urine. The elimination half-life varies from 11-16 hours.
Dosage
1.5 mg Tablet: The treatment necessitates the intake of one tablet. The Levonorgestrel tablet must be taken as soon as possible, preferably within 12 hours, after the unprotected intercourse, and no longer than within 72 hours (3 days) after the intercourse. Levonorgestrel can be taken at any moment during the menstrual cycle.0.75 mg Tablet: The first Levonorgestrel tablet must be taken within 72 hours of the intercourse and the second tablet should be taken after 12 hours of the intake of the first tablet. Levonorgestrel must be taken within 48 hours of unprotected intercourse and in no way after 72 hours because the effectiveness of the medicine starts reducing after 48 hours of intercourse. Levonorgestrel can be taken at any moment during the menstrual cycle.
After using emergency contraception, it is recommended to use a local contraceptive mean (condom, spermicide, and cervical cap) until the next menstrual period resumes. The use of Levonorgestrel does not contraindicate the continuation of regular hormonal contraception. If you have used this medicine while you were using oral contraception (contraceptive pill), you should carry on taking the usual tablets until the end of the treatment. In case no menstrual period occurs in the next pill-free period following the use of Levonorgestrel a pregnancy test should be performed to rule out a pregnancy.
Levonorgestrel is available in multiple dosage forms. The recommended dose for oral contraception is 0.75 mg taken once daily. The recommended dose for emergency contraception is a single dose of 1.5 mg taken as soon as possible within 72 hours of unprotected sex. Consult your healthcare provider for the appropriate dosage for your specific condition.
Administration
Levonorgestrel is available in oral tablet, patch, and injection forms. Oral levonorgestrel should be taken with food to increase absorption.
Side Effect
Common side effects include nausea, headache, bloating, breast tenderness, and acne. Some women may experience decreased libido and depression. Rare side effects include pelvic pain, breast lumps, and vaginal bleeding.
Toxicity
Levonorgestrel is generally well tolerated. However, if overdose is suspected, seek immediate medical attention or call the Poison Help Line at 1-800-222-1222.
Precaution
Levonorgestrel may decrease the effectiveness of some medications, including barbiturates, rifampin, phenytoin, and some anticonvulsants. It may also increase the blood levels of certain anti-seizure medications. Women should not take levonorgestrel during pregnancy.
Interaction
Levonorgestrel may interact with other medications, including certain antibiotics and anticonvulsants. It is important to tell your healthcare provider about all other medications you are taking before taking levonorgestrel.
Disease Interaction
Levonorgestrel may exacerbate pre-existing conditions, including migraines, gallbladder disease, and depression. It is important to tell your healthcare provider about all of your medical conditions before taking levonorgestrel.
Drug Inetraction
Levonorgestrel may interact with certain drugs, including certain antibiotics and anticonvulsants. It is important to tell your healthcare provider about all other medications you are taking before taking levonorgestrel.
Food Interactions
Levonorgestrel is recommended to be taken with food to increase absorption. Taking it with grapefruit juice may increase the levels of levonorgestrel in the body.
Pregnancy Use
Levonorgestrel is not recommended for pregnant women. It is a pregnancy category B drug, which means that it has been studied in animals and no adverse effects were seen. However, it is important to tell your healthcare provider if you become pregnant while taking levonorgestrel.
Lactation Use
Levonorgestrel is excreted in breastmilk. Nursing mothers are advised to use alternate forms of contraception while taking levonorgestrel.
Acute Overdose
In the case of an acute overdose, seek medical help immediately. Symptoms of overdose may include severe nausea and vomiting.
Contraindication
Levonorgestrel is contraindicated in women who have a history of acute porphyria, a condition involving abnormal production of haem, and in women who are taking certain drugs, such as cyclosporine.
Directions for Use
Levonorgestrel should be taken as directed by your healthcare provider. Follow the instructions on the product label carefully. Consult your healthcare provider for any questions or concerns.
Storage Conditions
Levonorgestrel should be stored at room temperature away from light and moisture. Do not store it in the bathroom.
Volume of Distribution
Levonorgestrel has a volume of distribution of about 10 L/kg.
Half Life
Levonorgestrel has a half-life of approximately 11-16 hours.
Clearance
Levonorgestrel is cleared primarily by hepatic metabolism, with about 80% eliminated in the feces and about 20% in the urine.
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