mph Bangladesh


Levonorgestrel

(lee voe nor jes' trel)

(Also known as l-norgestrel or D-norgestrel)

PCI  :Contraindicated in pregnancy

LCaution when used during lactation:Caution when used during lactation

Molecule Info

 |See TERMINOLOGY & ABBREVIATIONS |
Indication & Dosage

Contraception
Adult: Monotherapy: 30 or 37.5 mcg orally daily. Monophasic combined oral contraceptive (COC): 150-250 mcg daily. Triphasic COC: 50-125 mcg daily.

Emergency contraception
Adult: 1.5 mg orally as soon as possible or within 72 hr of coitus. Alternatively, 750 mcg as soon as possible or within 72 hr of coitus followed by a 2nd dose 12 hr later. Another regimen combines levonorgestrel 500 mcg and ethinylestradiol 100 mcg; may be given within 72 hr of coitus followed by a 2nd dose 12 hr later.

Menopausal hormone replacement therapy
Adult: As progestogenic component: 75-250 mcg orally for 10-12 days of a 28-day cycle.

Subcutaneous
Contraception
Adult: Insert 6 implants (36 mg/implant) under the skin within the first 7 days of the menstrual cycle and replace at intervals of up to 5 yr.
Intrauterine
Contraception
Adult: 52 mg released at an initial rate of 20 mcg/day. System is effective for up to 5 yr.
Intrauterine
Menorrhagia
Adult: 52 mg released at an initial rate of 20 mcg/day. System is effective for up to 5 yr.
Transdermal
Menopausal hormone replacement therapy
Adult: As combined transdermal patch (releases 10 mcg/24 hr with an oestrogen): Apply once wkly for 2 wk of a 4-wk cycle. Alternatively, a patch releasing 7 or 15 mcg/24 hr with an oestrogen is applied once wkly for continuous HRT.

Administration Should be taken with food.
Contraindications Pregnancy, undiagnosed vaginal bleeding, severe arterial disease; liver adenoma, porphyria; after recent evacuation of hydatidiform mole; history of breast cancer; hepatic impairment.
Special Precautions Sex-steroid dependent cancer, past ectopic pregnancy, malabsorption syndromes, functional ovarian cysts, active liver disease, recurrent cholestatic jaundice, history of jaundice in pregnancy, CV or renal impairment, DM, asthma, epilepsy, migraine, conditions aggravated by fluid retention, depression and thromboembolism (high doses); lactation.
Adverse Drug Reactions Menstrual irregularities; nausea, vomiting, headache, dizziness, breast discomfort, gynaecomastia, depression, skin disorders, disturbance of appetite, wt changes, fluid retention, oedema, changes in libido, cholestatic jaundice, hair loss or hirsutism. Benign intracranial hypertension, thrombocytopenic purpura.
Potentially Fatal: Thrombocytopenia, stroke.
Drug Interactions

Reduced efficacy with enzyme-inducing drugs; aminoglutethimide. May inhibit ciclosporin metabolism. 

Lab Interference

May interfere with laboratory tests e.g. liver, renal, thyroid and adrenal function tests, plasma levels of binding proteins and lipid/lipoprotein fractions, and fibrinolysis and coagulation parameters. 

Pregnancy Category (US FDA)

Category X: Studies in animals or human beings have demonstrated foetal abnormalities or there is evidence of foetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant. 

Pharmacology Levonorgestrel, a nortestosterone derivative, is an active isomer of norgestrel. It is a potent inhibitor of ovulation and has androgenic activity.
Absorption: Rapid and almost complete from the GI tract (oral).
Distribution: Protein-binding: 42-68% (sex binding globulin), 30-56% (albumin). Distributed into breast milk.
Metabolism: Hepatic; converted to sulfate and glucuronide conjugates.
Excretion: Via urine and via faeces (lesser extent).
ATC Classification G03AC03 - levonorgestrel; Belongs to the class of progestogens. Used as systemic contraceptives.

Brand/Product Info


Total Products : 5     
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
EMCON Renata Limited Levonorgestrel 0.75mg Tablet 2 tabs: 45.16 MRP
I-PILL Popular Pharmaceuticals Ltd. Levonorgestrel 0.75mg Tablet 2 tabs: 45.15 MRP
NORIX Social Marketing Company Levonorgestrel 0.75mg Tablet 2 tabs: 45.16 MRP
NORPILL 1 Square Pharmaceuticals Ltd. Levonorgestrel 1.5mg Tablet 5x1's: 350.00 MRP
POSTINOR-2 Gedeon Richter/City Overseas Levonorgestrel 0.75mg Tablet 2 tabs: 80.00 MRP

Gen. MedInfo

Why is this medication prescribed?

Levonorgestrel is used to prevent pregnancy after unprotected sexual intercourse (sex without any method of birth control or with a birth control method that failed or was not used properly [e.g., a condom that slipped or broke or birth control pills that were not taken as scheduled]). Levonorgestrel should not be used to prevent pregnancy on a regular basis. This medication is to be used as an emergency contraceptive or backup in case regular birth control fails or is used incorrectly. Levonorgestrel is in a class of medications called progestins. It works by preventing the release of an egg from the ovary or preventing fertilization of the egg by sperm (male reproductive cells). It also may work by changing the lining of the uterus (womb) to prevent development of a pregnancy. Levonorgestrel may prevent pregnancy, but it will not prevent the spread of human immunodeficiency virus (HIV, the virus that causes acquired immunodeficiency syndrome [AIDS]) and other sexually transmitted diseases.

How should this medicine be used?

Levonorgestrel comes as a tablet to take by mouth. You'll need to take one tablet as soon as possible within 72 hours after unprotected sexual intercourse. Depending on choice of brands, you'll need to take one tablet as soon as possible within 72 hours after unprotected sexual intercourse and take a second dose 12 hours later. Levonorgestrel works best if it is taken as soon as possible after unprotected sexual intercourse. Follow the directions on your prescription label & manufacturers product information carefully; and ask your doctor to explain any part you do not understand. Take levonorgestrel exactly as directed.

In strictly regulated market, Levonorgestrel is available as a nonprescription medication for women 17 years of age and older, and by prescription only for women younger than 17 years of age. If you are younger than 17, you will need to talk to a doctor to get a prescription for levonorgestrel. If you are 17 years of age or older you can buy levonorgestrel at a pharmacy.

If you vomit less than 2 hours after you take a dose of levonorgestrel, call your doctor. You may need to take another dose of this medication.

Because you can become pregnant soon after treatment with levonorgestrel, you should continue using your regular method of birth control or begin using regular birth control immediately. If you use hormonal contraceptives (birth control pills, patches, rings, implants, or injections), you should also use a barrier method (condom or diaphragm with spermicide) every time you have sex during the same menstrual cycle as you took levonorgestrel.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor for more information.

What special precautions should I follow?

Before taking levonorgestrel,
  • tell your doctor if you are allergic to levonorgestrel, any other medications, or any of the ingredients in levonorgestrel tablets.
  • tell your doctor what other prescription and nonprescription medications, vitamins, and nutritional supplements, you are taking or plan to take. Be sure to mention any of the following: barbiturates such as phenobarbital or secobarbital; bosentan; griseofulvin; certain medications used to treat human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) including amprenavir, delavirdine, efavirenz, etravirine, fosamprenavir, nelfinavir, nevirapine, ritonavir, and saquinavir; certain medications for seizures such as carbamazepine (Tegretol), felbamate, oxcarbazepine (Trileptal), phenytoin, and topiramate; and rifampin (Rimactane). Levonorgestrel may not work as well or may be more likely to cause side effects if it is taken with these medications.
  • tell your doctor what herbal products you are taking, especially St. John's wort.
  • tell your doctor if you have or have ever had any medical conditions.
  • tell your doctor if you are pregnant. Do not take levonorgestrel if you are already pregnant. Levonorgestrel will not end a pregnancy that has already begun.
  • tell your doctor if you are breast-feeding.
  • you should know that after you take levonorgestrel, it is normal for your next menstrual period to begin up to a week earlier or later than expected. If your next menstrual period is delayed for longer than 1 week after the expected date, call your doctor. You may be pregnant and your doctor will probably tell you to have a pregnancy test.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What side effects can this medication cause?

Levonorgestrel may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
  • heavier or lighter than usual menstrual bleeding

  • spotting or bleeding between menstrual periods

  • nausea

  • vomiting

  • diarrhea

  • tiredness

    n
  • headache

  • dizziness

  • breast pain or tenderness

Some side effects can be serious. If you experience the following symptom, call your doctor immediately:
  • severe lower abdominal pain (3 to 5 weeks after taking levonorgestrel)

Levonorgestrel may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to this medicine.

Do not let anyone else use your medication. If you still have symptoms and need further treatment, consult your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

 Ref: MedlinePlus, U.S. Natl. Library of Medicine


This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.

You may be also interested in,

Simple Breath Test Might Diagnose Heart Failure An experimental breath test, designed to quickly identify patients suffering from heart failure simply by analyzing the contents of a...
Osteoporosis drug stops Breast cancer growth   News & Events News & Events     HIGHLIGHTS Osteoporosis drug stops growth of breast cancer...
Generic drug safety info loophole FDA plans to close generic drug safety info loophole The US Food and Drug Administration has announced plans to speed up the dissemination of...
Large trials unpublished   News & Events News & Events   HIGHLIGHTS Almost 1 in 3 of large clinical trials unpublished after...
TB activists boo Indian minister News & Events News & Events   HIGHLIGHTS TB activists at world conference boo Indian minister off...
Key bone marrow protein identified News & Events News & Events   HIGHLIGHTS Key bone marrow protein identified as potential new leukemia...