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GENERIC NAME: Levonorgestrel
BRAND NAME: Levonelle One Step
How does it work?
Levonelle one step is commonly known as 'the morning after pill'. It is used to reduce the chances of becoming pregnant after unprotected sexual intercourse. Levonelle one step tablets contain the active ingredient levonorgestrel, which is a synthetic derivative of the naturally occurring female sex hormone, progesterone.
It is not fully understood how this medicine prevents pregnancy. It is thought to work by preventing ovulation and fertilisation and also by altering the lining of the womb, depending on which stage of the menstrual cycle the woman is at.
In a woman's normal menstrual cycle, an egg matures and is released from the ovaries (ovulation). The ovary then produces progesterone, which prevents the release of further eggs. Levonorgestrel, tricks the body processes into thinking that ovulation has already occurred, as it provides high levels of synthetic progesterone. This prevents the release of eggs from the ovaries.
Levonorgestrel also increases the thickness of the natural mucus at the neck of the womb (cervix), making it more difficult for sperm to cross from the vagina into the womb. By preventing sperm entering the womb, successful fertilisation of any egg that is there is less likely.
Levonorgestrel is also thought to alter the lining of the womb, preventing it from being prepared for a fertilised egg. This means that if an egg is released from the ovaries and is fertilised, it cannot implant into the womb and therefore pregnancy is avoided.
The whole process from fertilisation to implantation in the womb can take up to three days, so the morning after pill can only stop a pregnancy for up to 72 hours after unprotected sex. The sooner it is taken after unprotected sex, the more effective it will be.
There is one tablet to be taken. Previously, the morning after pill consisted of two tablets that had to be taken twelve hours apart. Studies have since shown these tablets were equally effective if they were taken together. Levonelle one step contains one double strength tablet. It has been phased in to replace the old Levonelle product that contained two tablets. With Levonelle one step there is no second tablet to remember to take twelve hours after the first. The new double strength tablet should be taken as soon as possible, preferably within 12 hours and no later than 72 hours, after unprotected sex.
It is estimated that 85 per cent of pregnancies will be prevented if this morning-after pill is taken within 72 hours of unprotected sex. The tablet is more effective at preventing pregnancy the earlier it is taken, so it is important to take it as soon as possible after unprotected sex, rather than delay to the third day.
What is it used for?
- Emergency contraception within 72 hours of unprotected sex.
Use with caution in:
- Crohn's disease
- Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.
Not to be used in:
- Pregnancy
- Women who had unprotected sex more than 72 hours previously, or whose menstrual period is late.
- This medicine is not recommended for women with severely decreased liver function.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
This medicine should not be taken by women who are pregnant. If you think you could be pregnant, if your period is late, or if your last period was more than five days late or unusually light or heavy, you should tell your pharmacist, as you may already be pregnant. Taking this medicine if you are already pregnant will not stop the pregnancy.
Emergency contraception does not prevent a pregnancy in every instance. If this medicine doesn't work to prevent a pregnancy, limited data suggest that it does not have adverse effects on a pregnancy that develops in your womb. However, as there is a possibility that a pregnancy will be ectopic after taking the morning after pill, you should consult your doctor immediately if you think you could be pregnant. Ask your doctor, pharmacist or family planning clinic for more information.
Small amounts of this medicine pass into breast milk. If you need to take this medicine while you are breastfeeding this is not thought to be harmful to the nursing baby, but you can minimise your baby's exposure to the medicine by taking the dose immediately after giving a feed. By the time the next feed is due the amount of medicine in the breast milk will then be reduced.
Side effects:
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Nausea
- Vaginal bleeding after taking the tablet (not related to your normal period)
- Abdominal pain
- Fatigue
- Early or delayed start of next menstrual period
- Menstrual spotting or irregular bleeding
- Headache
- Diarrhoea
- Dizziness
- Breast tenderness
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
The morning after pill may be less effective if you are taking any of the following medicines, because these medicines speed up the breakdown of levonorgestrel by the liver:
antiepileptic medicines such as carbamazepine, oxcarbazepine, phenytoin, phenobarbital, topiramate or primidone barbiturates griseofulvin nevirapine protease inhibitors for HIV infection such as ritonavir rifamycin antibiotics such as rifabutin or rifampicin the herbal remedy St John's wort (Hypericum perforatum).
If you are taking any of these medicines regularly, you may be advised to take two doses of this medicine, one tablet immediately and another twelve hours later (ie a total dose of 3mg). This is an unlicensed use of the medicine. An alternative would be to have a coil fitted as emergency contraception, as this is not affected by the medicines you are taking. You should discuss these options with your doctor, pharmacist or family planning clinic.
This medicine may increase the blood level of ciclosporin (an immunosuppressant).
This medicine may decrease the blood level of the antiepileptic medicine lamotrigine.
Warning!
Levonelle one step cannot be sold from pharmacies to girls under 16 years of age except in exceptional circumstances. Girls under 16 who need the morning after pill are advised to consult a doctor, family planning clinic or casualty department at a hospital. Some minor injuries departments at hospitals also provide the morning after pill.
Your pharmacist will ask about your last period and when you last had sex in order to make sure this medicine is suitable for you.
This medicine can be used at any point during your menstrual cycle, apart from if your period is late. If your period is late, or your last period was more than five days late or unusually light or heavy, you should tell your pharmacist, as you may already be pregnant and this medicine will not work.
This tablet should be taken as soon as possible, preferably within 12 hours and no later than 72 hours after unprotected sex (see above). If you are sick within three hours of taking the tablet, another one should be taken immediately. You should consult your doctor, pharmacist, family planning clinic or casualty department for advice and to obtain another tablet.
This medicine might make your next period earlier or later than expected by a few days. If your next period after taking this medicine is more than seven days late, or is abnormal in any way, you should consult your doctor for a pregnancy test.
The morning after pill does not provide continued contraception to prevent pregnancy after you have taken it. It is recommended that after taking it, you use a barrier method of contraception such as a condom or cap, until your next period comes. This is also recommended even if you are also taking the pill. You should talk ask your doctor, pharmacist or family planning clinic for advice about regular methods of contraception.
This medicine should only be used as an emergency measure. It is not recommended for repeated use, as it is possible that it can disrupt your menstrual cycle.
This medicine will not always prevent a pregnancy. If you do become pregnant after taking this medicine there is a possibility that the pregnancy will be ectopic (ie occuring in the fallopian tubes rather than the womb). For this reason, you should consult your doctor if you experience any sudden or abnormal abdominal pain after taking this medicine, and if your next period is shorter or lighter than your normal period.
Emergency contraception does not protect you from sexually transmitted infections. | |
