Levonorgestrel - dosage, use, side effects, indications

Levonorgestrel is a synthetic form of progesterone, a hormone that controls ovulation and menstrual periods. It works primarily by preventing the release of an egg during your menstrual cycle. It also makes vaginal fluid thicker to help prevent sperm from reaching an egg (fertilization), and changes the lining of the uterus (womb) to prevent attachment of a fertilized egg.

If a fertilized egg does not attach to the uterus, it is removed from the body. Besides prevention of pregnancy, Levonorgestrel is also used in the treatment of heavy menstrual bleeding, and to bring on a menstrual period in women who do not have periods due to a low level of progesterone in the body.

Levonorgestrel, a type of progestin, has a variety of indications, which means it is used to treat numerous health conditions. It is typically used as a key ingredient in various forms of contraception, including intrauterine devices (IUDs) and emergency contraceptive pills.

One of the primary indications for Levonorgestrel is as a method of contraception. It can prevent pregnancy by altering the lining of the womb so that a fertilized egg cannot implant into it. It also impedes the movement of sperm within the womb by thickening the cervical mucus. Levonorgestrel is effective at preventing pregnancy when taken as directed.

Levonorgestrel-containing IUDs, such as Mirena, are also indicated for the treatment of heavy menstrual bleeding, a condition known as menorrhagia. This treatment works by releasing small amounts of Levonorgestrel into the womb, which thins the lining of the womb, leading to lighter periods.

In addition, Levonorgestrel is utilized in hormone replacement therapy (HRT) for women going through menopause. It works by replacing the natural hormone that the body produces less of during and after menopause.

Despite its wide range of uses, it is crucial to underscore that Levonorgestrel is not intended for regular use as a contraceptive. It is considered a 'back-up' or emergency method of contraception, to be used after unprotected sex or contraceptive failure, such as a broken condom.

Despite its usefulness in preventing unwanted pregnancies, Levonorgestrel is not suitable for everyone and it has certain contraindications that must be considered before use. It's essential to discuss your medical history with your healthcare provider before starting Levonorgestrel.

Firstly, individuals who are allergic to Levonorgestrel or any other ingredients contained in the medication should refrain from using it. An allergic reaction may result in symptoms such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.

Women who are already pregnant should not use Levonorgestrel as a way to terminate the pregnancy. It's not designed to be used as an abortion pill and won't be effective in these circumstances.

Moreover, Levonorgestrel is contraindicated in women who have abnormal vaginal bleeding that hasn't been evaluated by a healthcare provider. This could be a sign of a more serious medical condition that needs to be addressed.

Levonorgestrel is not recommended for use in the following groups:

• Women with a history of ectopic pregnancy or tubal surgery
• Individuals with severe liver disease
• Women with a history of pelvic inflammatory disease (PID) unless they have had a subsequent normal pregnancy
• Individuals with known or suspected breast cancer

It's always important to discuss your personal medical history and any medications you're currently taking with your healthcare provider before starting a new medication. This allows them to make an informed decision about whether Levonorgestrel is safe for you to use.

Levonorgestrel, like any other medication, may cause a variety of side effects. Although not all of these side effects may occur, they may require medical attention if they do. Here is a non-exhaustive list of possible side effects:

• Changes in menstrual periods
• Heavy bleeding or spotting between periods
• Sudden severe headache
• Pain in the chest, groin, or leg
• Severe abdominal pain
• Eye problems such as vision changes or loss
• Severe dizziness or fainting
• Unusual or severe vaginal bleeding
• Severe nausea or vomiting
• Shortness of breath
• Yellowing eyes or skin, especially with fever or severe stomach pain (jaundice)

It's important to note that these side effects are not common. Most people who use Levonorgestrel do not experience severe side effects. However, if you notice any other effects not listed above, contact your doctor or pharmacist. It is crucial to seek immediate medical help if you have symptoms of a serious allergic reaction such as rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. However, get medical help right away if you notice any symptoms of a serious allergic reaction.

The dosage of Levonorgestrel may vary depending on the purpose of the medication. It is important to follow the instructions given by your healthcare provider or pharmacist. Never adjust the dosage on your own without medical advice.

For emergency contraception, the standard dosage of Levonorgestrel is 1.5 milligrams, taken as a single dose. This should be taken as soon as possible after unprotected intercourse, preferably within 72 hours. The effectiveness of the medication decreases with time after sexual exposure. The pill can be taken at any time of the month.

When Levonorgestrel is used as a regular contraceptive, the dosage is usually much smaller. The typical dosage is 0.1 milligrams per day, taken at the same time each day. Some women may need to start with a higher dose and then gradually decrease it over time.

Levonorgestrel is also used in intrauterine devices (IUDs). The dosage released by these devices can vary, but it is typically around 20 micrograms per day. This dosage is released directly into the uterus, which can reduce side effects and increase effectiveness.

It is important to remember that Levonorgestrel is a very powerful medication. Even small changes in the dosage can have significant effects. Always follow your healthcare provider's instructions precisely.

Levonorgestrel is primarily used in emergency contraception after unprotected sexual intercourse or failure of regular contraception. It is effective if taken within 72 hours (3 days) after unprotected intercourse. However, it is most effective if taken as soon as possible post-intercourse.

Furthermore, Levonorgestrel is also used in some types of intrauterine devices (IUDs), commonly known as 'coils'. These IUDs slowly release Levonorgestrel into the womb to prevent pregnancy. They are a long-term method of contraception and can be left in place for up to five years. This form of use is beneficial for women who cannot take estrogen-based contraceptives.

Levonorgestrel is also used in lower doses in certain combined hormonal contraceptives, including the combined oral contraceptive pill, the contraceptive patch, and the contraceptive vaginal ring. These methods are used consistently to provide ongoing contraception and also have the benefit of regulating a woman's menstrual cycle.

Another use of Levonorgestrel is to treat heavy menstrual bleeding in women who wish to use an IUD as a method of contraception. In this case, Levonorgestrel-releasing IUDs are often preferred due to their contraceptive and therapeutic benefits.

While Levonorgestrel is generally considered safe for most individuals, certain precautions must be taken when using this medication. It's crucial to discuss your medical history with your healthcare provider before starting treatment, especially if you have conditions such as abnormal vaginal bleeding, liver disease, or a history of ectopic pregnancy.

Smoking and alcohol consumption can interfere with the effectiveness of Levonorgestrel, so they should be avoided during treatment. The medication can also lead to changes in the menstrual cycle, including irregular periods, spotting, or heavier bleeding.

Levonorgestrel doesn't protect against sexually transmitted infections (STIs). Therefore, appropriate precautions should also be taken to prevent STIs when sexually active.

It's also worth noting that Levonorgestrel isn't recommended for prolonged use. If used as a regular form of contraception, other contraceptive methods are usually advised.

Lastly, Levonorgestrel may not be suitable for everyone. Women who are pregnant should not use it. Furthermore, breastfeeding women should consult their healthcare provider before starting treatment as this medication can pass into breast milk and may have undesirable effects on a nursing infant.

Interactions refer to the potential for one drug to affect the activity of another when both are used concurrently. In the context of Levonorgestrel, certain medications can affect its efficacy, leading to unexpected pregnancy. Therefore, it is crucial to be aware of these interactions.

Levonorgestrel's effectiveness can be reduced when taken with certain medicines. These include:

• Anti-seizure drugs: Such as phenobarbital, carbamazepine, oxcarbazepine, phenytoin, and primidone.
• Anti-tuberculosis drugs: Like rifampicin and rifabutin.
• HIV drugs: Efavirenz and ritonavir-based products can interfere with Levonorgestrel.
• St. John's Wort: This herbal supplement can also reduce the effectiveness of Levonorgestrel.

Furthermore, Levonorgestrel can interact with laboratory tests, potentially causing false results. It affects tests for sex hormone-binding globulin (SHBG) and thyroid function.

Moreover, Levonorgestrel can affect glucose tolerance, so if you’re diabetic and using Levonorgestrel, careful monitoring of blood glucose levels is advised.

Therefore, before starting treatment with Levonorgestrel, it is vital to inform your healthcare provider about all the medications, supplements, and herbal products you are currently using or planning to use.

The price of Levonorgestrel can vary greatly depending on the brand, the form in which it is sold (tablets, intrauterine devices, etc.), and the country in which it is purchased. Levonorgestrel is typically more affordable as a generic drug, but name brands can carry a higher price tag.

In the United States, for example, the price of a generic Levonorgestrel tablet can range from around $20 to $50 without insurance. Brand names, such as Plan B One-Step, may cost around $50 to $60 for a single tablet. Intrauterine devices containing Levonorgestrel, such as Mirena, can cost several hundred dollars, although they are intended to last for several years.

In many countries, Levonorgestrel is available over the counter without a prescription. However, in some places, you will need a prescription from a healthcare provider, which can also add to the overall cost.

It's also important to note that many health insurance plans cover some or all of the cost of Levonorgestrel. Therefore, it's advisable to check with your health insurance provider to find out what your out-of-pocket costs might be.

Lastly, there are often patient assistance programs available that can help to reduce the cost of Levonorgestrel. These programs are typically run by the manufacturers of the medication and can provide significant savings for those who qualify.

When it comes to finding substitutes for Levonorgestrel, there are a few options available on the market. However, it's critical to remember that you should not change your medication without consulting with your healthcare provider. Here are some of the potential alternatives to Levonorgestrel:

• Ethinylestradiol/Norethisterone: This is a combination pill that's often used as a substitute for Levonorgestrel. It contains two hormones: ethinylestradiol (an estrogen) and norethisterone (a progestin), which work together to prevent ovulation.
• Ethinylestradiol/Desogestrel: This combined contraceptive pill also serves as an effective alternative. It works in the same way as Ethinylestradiol/Norethisterone by preventing the ovaries from releasing an egg.
• Etonogestrel: This progestin-only contraceptive is available as an implanted device under the skin. It provides long-term contraception and is a good alternative for those who cannot take estrogen.
• Medroxyprogesterone: This progestin-only contraceptive is injected by a healthcare provider every three months. It's a useful alternative for those who have difficulty remembering to take a daily pill.

Remember, each of these substitutes comes with its own set of potential side effects and interactions. Therefore, it's essential to discuss any changes in medication with your healthcare provider.