Last Updated on February 19, 2017 by Dr.Derek Fhisher
Most popular brand: Plan B
Active ingredient: Levonorgestrel
Available dosage forms: 0,75 mg
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Levonorgestrel general information
In Canada, the mix of cyproterone acetate and ethinyl estradiol was approved to be used as acne treatment. Sometimes, the physician might recommend the usage of an intrauterine device (IUD) that releases levonorgestrel (a kind of progestin). Aside from the aforementioned circumstances, menorrhagia could occur on account of the usage of an intrauterine device or prolonged usage of certain drugs (blood thinners). In a few cases, the administration of oral progesterone may be recommended.
One of the health benefits linked with birth control pills could be the prevention and decrease in acne breakouts. It’s used to stop pregnancy as well as for acne management. The therapy would be contingent on the underlying cause. Similarly to headache and back pain, leg pain further is a typical symptom which can be caused on account of numerous reasons.
It’s a mix of female hormones that help with avoidance of ovulation. Now, if fertilization doesn’t occur, the amount of estrogen and progesterone drop, which causes menstruation. The pill interferes with all the normal procedure for ovulation. On the opposite hand, estrogen is necessary for proper ovulation.
If you fail to remember to take a pill one moment, refrain from taking two pills the following day. A singlephasic pill is going to have the exact same dosage through the full 21 day pack pills. In all instances, the previous 7 days don’t have any hormones and are given to maintain the practice of taking pills each and every day. The pill might also make an impact on your flow, which makes it lighter or heavier than normal.
Some men and women think that endometriosis and mirena treatment is really not a great match, on account of the fact it does increase the chance of developing benign, fluid filled ovarian cysts. High degrees of estrogen was found to boost risk of breast and endometrial cancer. Oral contraceptives are produced with a mix of progestin and estrogen. Mirena is used to take care of endometriosis symptoms by limiting the total amount of the flow of blood during menses.
So tell your physician to prescribe you the correct pills. Thus, inform your physician about any other medication which you’ve been taking. For this particular, it is advisable to talk with your doctor initially. Don’t use Alesse or another medication following the expiry date on the pack.
The very best pills for acne chance to be anti-androgenic. These pills are only taken if the rest of the acne treatments never have yielded results, or in the event the woman demands an oral contraceptive anyway. The most usual reaction exhibited by persons experiencing progesterone allergy is an inflammatory shape of the skin. On the opposite hand, it really is true there are potential side effects connected to the pill.
When starting out using any birth control pill, it is a great thought to use another type of birth control like condoms or possibly a spermicidal cream for a backup. Though many women utilize these products with no serious unwanted side effects, there isn’t any way of knowing how one will respond until the medication has been utilized for many months. It’s used as a contraceptive pill for preventing pregnancy, and in addition used for acne treatment.
Secondly, varicose veins is just another disorder that may be caused as a result of birth control pills. In the same way, hormonal changes may also occur every time a woman switches to some other pill. In which case, there’s a higher risk of an impending pregnancy. It can help reduce the total amount of estrogen within the uterus.
Active – active substance / start: levonorgestrel
Levonova; levonorgestrel; Mikrolyut; Mirena (IUD); Norplant; postinor; Eskapel.
Levonorgestrel – a means to prevent pregnancy, contraception. It has a pronounced progestogenic and antiestrogenic activity that contributes to the inhibition of early conception and prevention of pregnancy. Levonorgestrel – the most studied progestogen, which has long been successfully used in many contraceptive pills .
Active – active substance:
Levonorgestrel / Levonorgestrel.
Dosage Forms:
Tablets.
Drops.
capsules.
IUS (intrauterine device).
Levonorgestrel
Properties / Action:
Levonorgestrel has a pronounced progestogenic and antiestrogenic activity, which contributes to the inhibition of conception at an early stage and prevent pregnancy. Levonorgestrel is applicable when oral contraceptives (oral contraceptive). A distinctive feature of drug versus levonorgestrel gestagen combination – estrogen oral contraceptives (. Mikroginon trikvilar, Femoden) is that as active substances they contain only a progestogen (progestin).
For the emergency contraceptive levonorgestrel administered at a dose of 0.75 mg. In long-term daily intake in a dose of 0.03 mg of levonorgestrel has a contraceptive effect, due to a number of mechanisms, among which the leading role to the peripheral progestational effects.
Under the influence of the drug increases the viscosity of the mucus, located in the neck (cervical or cervical mucus), which makes it difficult penetration of sperm into the uterus. Levonorgestrel inhibits the proliferation of the endometrium, making it impossible for implantation of a fertilized egg. Levonorgestrel is able to exert an inhibitory effect on the release of hypothalamic releasing – factor and reduce the production of pituitary luteinizing hormone (LH) and follicle-stimulating (FSH) hormones, reduce the function of the corpus luteum. Intensity of these effects at a low dose of levonorgestrel is small but sufficient to ensure the contraceptive effect. At low doses, does not cause complete suppression of ovulation.
Intrauterine System:
IUD (Mirena) is a T – shaped plastic system (device), a vertical rod which consists of levonorgestrelsoderzhaschego container covered with a special membrane, through which continually occurs levonorgestrel diffusion controlled to 20 mg / day. Levonorgestrel
entering directly into the uterine cavity has a direct local effect on the endometrium, preventing proliferative changes therein and thereby reducing its implantation function and also increase the viscosity of cervical mucus that prevents penetration of sperm into the uterus. Levonorgestrel also has little systemic effect manifested suppression of ovulation in a certain number of cycles. Reduces the amount of menstrual bleeding, reduces the pre – and menstrual pain.
Pharmacokinetics:
The tablets, dragees:
Levonorgestrel ingestion rapidly and completely absorbed in the gastro – intestinal tract. The bioavailability of levonorgestrel is about 100%. It has a high (90%), communication with the plasma proteins. Maximum concentration in the blood was 0.5 – 2 h. Subsequently, the concentration of the drug is characterized by a biphasic decline with a half-life of 2 or 24 hours. It is metabolized in the liver. Well it distributed to organs and tissues. About 10% of the dose enters the breast milk. 60% of the drug is excreted in urine, 40% – through the intestines. Daily re-admission is not accompanied by cumulation of the active substance and its metabolites.
Intrauterine System:
Levonorgestrel is delivered directly into the uterine cavity. A small part of it is absorbed into the systemic circulation. Levonorgestrel concentration in blood plasma is stable and is 100 – 200 pg / ml (0.3 – 0.6 nmol / L).
Indications:
The prevention of pregnancy.
Tablets 0.75 mg of levonorgestrel used for emergency contraception after sex if the male condom burst or in the case of unprotected intercourse.
Drops of levonorgestrel 0.03 mg used for long-term contraception, as well as an additional method of contraception in women using non-hormonal methods of contraception and in cases where there is objective or subjective reasons, do not enable the use of progestogen – estrogen contraceptives.
idiopathic menorrhagia (for the intrauterine system).
Dosage and administration:
Tablets 0.75 mg:
0,75 mg (1 tablet) levonorgestrel taken within 72 hours (preferably immediately) after unprotected intercourse, even 1 tablet should be taken 12 hours after the first.
0.03 mg Drops:
0,03 mg (1 tablet) taken orally 1 tablet per day, for a long time, without interruption. Acceptance begin with 1 – th day of menstruation, using pellets of the corresponding day of the week of the calendar packaging. Drops take, not liquid, and washed down with a small amount of liquid. Hours not play a role, but the subsequent reception of the drug should be made in the same hour selected as the interval between the reception of pills should be close to 24 hours.
Capsules:
implanted n / a in the inner shoulder area for a period of 5 years.
intrauterine system (Mirena):
recommended to enter into the uterus 4 – 6 days of the menstrual cycle; post-abortion care – immediately, or, preferably, after the next menstruation; after uncomplicated spontaneous labor – no earlier than 6 weeks. Intrauterine system must be removed in 5 years. At the same time possible to make the introduction of a new intrauterine system.
Overdose:
In case of overdose may be increased described side effects.
Antidote not recommended gastric lavage and symptomatic treatment.
intrauterine system (Mirena):
With this method, the application can not overdose.
Contraindications:
Pregnancy, breast-feeding (optional waiver of breastfeeding);
Age of puberty;
Uterine bleeding of unknown etiology;
Infectious diseases of the genitourinary system, pelvic organs, presence of herpes infection during pregnancy of the former;
Malignant neoplasms of genitals and mammary glands, hormone-dependent tumors;
Diseases of the liver and gall bladder, jaundice in history, liver tumors, syndromes Dubin – Johnson and Rotor (hereditary benign hyperbilirubinemia);
The propensity to thromboembolism, including in disorders of cerebral circulation and other cardio – vascular diseases, thrombosis;
Sickle – cell anemia;
Otosclerosis;
Severe diabetes with vascular complications;
Hypersensitivity;
intrauterine system (Mirena):
Congenital and acquired uterine anomaly affecting the IUD is inserted.
Use during pregnancy and lactation:
During pregnancy and lactation is contraindicated levonorgestrel regimen.
Side effects:
After application of levonorgestrel may cause nausea, vomiting, headaches and abdominal pain, intermenstrual bleeding, shortening or lengthening of the cycle, oligo – and amenorrhea, dysmenorrhea, breast engorgement , mastalgia, rarely – acne, depression, changes in body weight and libido.
intrauterine system (Mirena):
Side effects usually do not require additional treatment and disappear within a few months. Perhaps the development of expulsion of the intrauterine system, perforation of the uterus, ectopic pregnancy, described the use of other intrauterine contraceptives.
Special instructions and precautions:
Tablets 0.75 mg:
The drug at a dose of 0.75 mg is only for emergency postcoital contraception !
It is recommended to use for women with a regular menstrual cycle.
Do not use the drug at a dose of 0.75 mg as a means of constant and continuous contraception. With regular sex life is recommended to use permanent methods of contraception (pills of 0.03 mg).
In the case of uterine bleeding gynecological examination is recommended.
0.03 mg Drops:
The majority of women receiving pills of levonorgestrel 0.03 mg has no influence on the menstrual cycle: menstruation occurs through regular intervals, the duration of the bleeding is normal and intensity. In some cases, there may be changes in the interval between periods and intensity of menstrual bleeding, which is a consequence of the development of a new model of the menstrual cycle. If menstrual bleeding has not occurred 6 weeks after the last menstrual period, you should carry out a survey for the presence of pregnancy and only in its absence to continue receiving levonorgestrel. After discontinuation of levonorgestrel gonadal function recovered quickly in full, allowing normal fertility.
In order to help your doctor assess the frequency of your menstrual cycle while taking levonorgestrel in a dose of 0.03 mg, fill the calendar and show it to your doctor.
During the reception the first 14 pills is recommended to use additional non-hormonal methods of contraception (except the temperature method).
On the contraceptive effect of the drug can influence: irregular intake pills, vomiting and intestinal disorders, accompanied by diarrhea, in rare cases – the individual characteristics of the metabolism and the reception of certain groups of medicines (see “Drug Interactions.”).
During the first months of administration may occur intermenstrual bleeding of varying intensity, which do not prevent the continuation of the drug.
In the case of missing reception or when taking more than 24 hours after the previous pills – the contraceptive effect of the drug is stopped. In such cases, you must continue taking pills. It should be borne in mind that the contraceptive effect in full only come to 14 – th day of daily dosing. During this period must be used hormonal contraceptive methods (except the temperature method).
The use of levonorgestrel after childbirth, abortion, the use of other hormonal contraceptives, as well as in nursing mothers is carried on doctor’s advice.
Before and every 6 months of use of levonorgestrel in a dose of 0.03 mg is recommended to undergo general medical and gynecological examination (including breast examination). In the case of when taking migraine headaches or unusually severe headaches, sudden visual and hearing impairment, signs of thrombophlebitis or thromboembolic events, a significant increase in blood pressure, hepatitis, jaundice, generalized pruritus, more frequent epileptic seizures, severe pain in the epigastric region should immediately stop taking drug and consult a doctor.
Capsules:
3 months after implantation of capsules and 1 once a year requires medical supervision. Indications for immediate removal of the capsules are a severe visual impairment, elective surgery, followed by immobilization for 6 months, the appearance of symptoms of thrombosis or embolism, acute liver disease, migraine.
intrauterine system (Mirena):
Before the introduction of the intrauterine system (Mirena) she will need to undergo a thorough general medical and gynecological examination (including breast examination) to exclude pregnancy. Furthermore, it should eliminate the disease, sexually transmitted diseases. Preventive control examinations should be carried out at least 1 time per year.
Some women in the application of the intrauterine system (Mirena) develops oligomenorrhea or amenorrhea, menorrhagia that has a therapeutic effect. After removing the intrauterine system menstrual function restored.
Design intrauterine system provides a selection of levonorgestrel at 20 mg / day. Intrauterine system is effective for 5 years. Fertility is restored in 50% of women after 6 months after removal of the contraceptive in 96% – 12 months.
Drug Interactions:
It is possible decrease in levonorgestrel contraceptive effect when combined with rifampin th, ampicillin and tetracycline om om, some antiepileptic drugs (eg carbamazepine fenition, etc…), Barbiturates, benzodiazepines.
Due to the influence of steroid hormones on glucose tolerance, when taking gestagen preparations could be adjusted dosage of antidiabetic drugs and insulin.
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