LEVONORGESTREL for emergency contraception

Therapeutic action

• Hormonal contraceptive, progestogen

Indications

• Emergency contraception after unprotected or inadequately protected intercourse (e.g. forgotten pill or condom breaking)

Forms and strengths

• 1.5 mg tablet

Dosage and duration

• One 1.5 mg tablet, whatever the day of the cycle, as soon as possible after unprotected or inadequately protected intercourse and preferably within the first 72 hours as effectiveness decreases with time. It is however recommended to administer the treatment up to 120 hours (5 days) after unprotected intercourse.

Contra-indications, adverse effects, precautions

• May cause: disturbance of next menstrual cycle, metrorrhagia, nausea, headache, dizziness.
• Re-administer treatment immediately if vomiting occurs within 2 hours of taking treatment.
• Double the dose (3 mg single dose) in women taking enzyme-inducing drugs (rifampicin, rifabutin, efavirenz, nevirapine, lopinavir, ritonavir, phenobarbital, phenytoin, carbamazepine, griseofulvin, etc.): can reduce the effectiveness of the contraceptive.
• Pregnancy: in the event of treatment failure (i.e. pregnancy develops) or if used during an undiagnosed pregnancy, there is no known harm for the foetus.
• Breast-feeding: no contra-indication

Remarks

• Emergency contraception is intended to prevent pregnancy; it cannot terminate an ongoing pregnancy.
• If hormonal contraception is started or resumed immediately after taking levonorgestrel as emergency contraception, use condoms during the first 7 days.
• There is a risk of treatment failure; carry out a pregnancy test if signs or symptoms of pregnancy (no menstruation, etc.) appear one month after taking levonorgestrel as emergency contraception.

Storage