Levonorgestrel (oral contraceptive)

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Contents

[edit] BRAND NAMES

[edit] STRUCTURE

Levonorgestrel.jpg

[edit] MECHANISM OF ACTION

Unlike combination birth control pills, the minipill Levonorgestrel oral contraceptive doesn't contain estrogen. The pregnancy rate of progestogen-only pills is slightly higher than that of combined oral progestogen-estrogen combinations.

Levonorgestrel oral contraceptive thickens cervical mucus and thins the lining of the uterus (endometrium), preventing sperm from reaching the egg.

[edit] INDICATIONS

  • Contraception; The benefits of estrogen-free contraceptives are the prevention of estrogen-related side effects (nausea, edema, weight gain, mastodynia) and of cycle-dependent side effects (dysmenorrhea, pelvic pain, premenstrual syndrome, hypermenorrhea, menstrual migraine). They are primarily used for the prevention of pregnancy in women with risk factors, in whom estrogens are contraindicated. These include hypertension, thrombophilia, status post thrombosis, myocardial infarction, stroke, liver tumors, cholelithiasis and during lactation.

[edit] DOSAGE

Levonorgestrel (0.03 mg/tablet). The dosage is one tablet daily without any break, taken at the same time each day with some liquid as needed. Tablets must be taken without regard to bleeding. This means that after the first pack has been finished the next should be started without interruption.

[edit] CONTRAINDICATIONS

Levonorgestrel oral contraceptive should not be used in the presence of any of the conditions listed below. Should any of the conditions appear during the use of Microlut, the use of the preparation must be discontinued immediately.

  • Known or suspected pregnancy
  • Active venous thromboembolic disorder
  • Arterial and cardiovascular disease present or in history (e.g. myocardial infarction, cerebrovascular accident, ischemic heart disease)
  • Diabetes mellitus with vascular involvement
  • Presence or history of severe hepatic disease as long as liver function values have not returned to normal
  • Presence or history of liver tumors (benign or malignant)
  • Known or suspected sex hormone-dependent malignancies
  • Undiagnosed vaginal bleeding
  • Known hypersensitivity to any of the components of Microlut.
  • Sickle cell anemia
  • Jaundice or persistent itching during a previous pregnancy

[edit] PRECAUTIONS

[edit] INTERACTIONS

Hepatic enzyme-inducing drugs increase clearance of sex hormones and can lead to breakthrough bleeding and oral contraceptive failure. these drugs include: phenytoin, barbiturates, primidone, carbamazepine, rifampicin oxcarbazepine, St.John's wort and rifabutin); griseofulvin is also suspected. Women on treatment with hepatic enzyme-inducing drugs should temporarily use a barrier method in addition to evonorgestrel oral contraceptive, i.e. during the time of concomitant drug administration and for 28 days after their discontinuation.

[edit] PREGNANCY AND LACTATION

  • Pregnancy: The administration of Levonorgestrel oral contraceptive during pregnancy is contraindicated.
  • Lactation: Hormonal contraceptives are not recommended as the contraceptive method of first choice during lactation, but progestogen-only methods are considered to comprise the next choice category after non-hormonal methods.

[edit] SIDE EFFECTS

Common (≥ 1/100 and < 1/10):

  • Uterine/ Vaginal bleeding including Spotting; Intermenstrual bleeding of varying intensity may occur, particularly during the first few months. It is not a medical reason to stop tablet taking, as long as organic causes for such bleeding can be ruled out by means of adequate diagnostic measures.
  • Menorrhagia (an abnormally heavy and prolonged menstrual period at regular intervals)
  • Metrorrhagia (uterine bleeding at irregular intervals)
  • Amenorrhea (absence of a menstrual period): Amenorrhea may occur in some women, in most cases only for one or two menstrual periods. In rare cases bleeding may fail to occur at longer intervals. If no menstrual bleeding has occurred within 6 weeks after the last menstrual bleeding, pregnancy must be excluded before tablet taking is continued.

Rare (< 1/1000): Hypersensitivity reaction, Depressed mood , Libido decreased or increased, Headaches, Dizziness, Contact lens intolerance, Nausea, Vomiting, Skin disorder, Acne, Hirsutism, Breast tenderness, Vaginal discharge, Weight increased or decreased.

[edit] RELATED LINKS

What is the Progestogen-only Pill

[edit] BIBLIOGRAPHY

[edit] REFERENCES

Progestin only pills (Mini-pills)