LEVONORGESTREL oral

Prescription under medical supervision


Therapeutic action

– Hormonal contraceptive, progestogen

Indications

– Oral contraception

Forms and strengths

– 0.03 mg (30 micrograms) tablet

Dosage

– One tablet daily to be taken at the same time each day, on a continuous basis, including during menstruation.

– Contraception may be started at any moment of the cycle if it is reasonably certain the woman is not pregnant, including when switching from another form of contraception. Contraception will be effective as of the 3rd tablet. 
Use condoms for the first 2 days of the pack if the pill is started:
• more than 5 days after the start of menstruation; 
• more than 28 days postpartum if not breastfeeding; 
• more than 7 days after an abortion.

– If a pill is missed, it should be taken as soon as possible and usual treatment continued. The missed pill and next scheduled pill can be taken together.
If the missed pill is more than 3 hours overdue, the effectiveness of the contraceptive is reduced. Use:
• condoms for the following 2 days;
• emergency contraception if the woman has had intercourse in the 5 days preceding the missed pill.

Duration

If there are no adverse effects, as long as this method of contraception is desired.

Contra-indications, adverse effects, precautions

– Do not administer to women with breast cancer, severe or recent liver disease, unexplained vaginal bleeding, active thromboembolic disorders.
– May cause: amenorrhoea, menstrual disturbances, nausea, weight gain, breast tenderness, mood changes, acne, headache.
– Enzyme-inducing drugs (rifampicin, rifabutine, efavirenz, nevirapine, lopinavir, ritonavir, phenobarbital, phenytoin, carbamazepine, griseofulvin, etc.) reduce the effectiveness of the contraceptive. 
PregnancyCONTRA-INDICATED
Breast-feeding: no contra-indication

Remarks

– Levonorgestrel is a possible alternative when oestroprogestogens are contra-indicated or poorly tolerated. Its use requires taking pills at strictly the exact time daily, no more than 3 hours late.
Storage: below 25 °C -