Levonorgestrel (Generic Levonelle)

Levonorgestrel is an emergency contraceptive pill containing the active ingredient levonorgestrel, a synthetic version of the natural hormone progesterone.

Levonorgestrel delays the ovulation process (the release of an egg from the ovaries) which can stop sperm from reaching and fertilising any eggs, in turn helping to prevent pregnancy.

You can take levonorgestrel to prevent pregnancy within 72 hours (3 days) of unprotected sex.

Levonorgestrel works by preventing pregnancy in 3 ways:

• preventing ovulation – stopping your ovaries from releasing an egg
• preventing fertilisation – stopping sperm from fertilising an egg that has already been released
• preventing fertilised eggs growing – stopping a fertilised egg attaching in the womb

Levonorgestrel prevents pregnancy, but it is not an abortion pill: it does not end a pregnancy once an egg has been fertilised and implanted.

Does Levonorgestrel work if you’ve already ovulated?

No, Levonorgestrel is only effective if you take it before ovulation (when you release an egg from your ovary). You should take levonorgestrel as soon as possible, ideally in the first 12 to 24 hours, and within 3 days of having unprotected sex.

How quickly does Levonorgestrel work?

Levonorgestrel starts working straight away. Within a couple of hours after taking levonorgestrel, it will have been absorbed into the bloodstream after which it begins to affect the ovaries and the lining of the uterus (womb). It is effective for up to 3 days (72 hours) of having unprotected sex.

You take levonorgestrel by swallowing 1 tablet whole with water. You should take it:

• as soon as possible
• ideally within the first 12 to 24 hours after unprotected sex
• no later than after 72 hours (3 days)

You can take levonorgestrel at any point in your menstrual cycle

If you use a regular method of oral contraception (such as the combined pill or mini pill), continue to take this at your usual time. You should also use a barrier method of contraception (such as condoms or a diaphragm) for at least 7 days or until your next period.

Levonorgestrel is for emergency use only. You should not use it as a regular method of contraception.

After you have taken levonorgestrel, you can speak to a doctor for advice about a reliable method of contraception that will be suitable for you.

How often can I use Levonorgestrel?

You can use levonorgestrel more than once in your menstrual cycle but this can cause irregular periods and make levonorgestrel less effective. There is no limit to how many times you can use levonorgestrel but it should only be used in emergency circumstances.

If you find yourself using levonorgestrel more than once in a menstrual cycle, you should consider taking regular contraception such as the contraceptive pill or other non-hormonal alternatives.

Should I keep taking my contraceptive pill after taking Levonorgestrel?

You should continue taking your contraceptive pill as normal, at the usual time, after taking levonorgestrel.

What should I do if I vomit after taking Levonorgestrel?

If you are sick (vomit) within 3 hours of taking levonorgestrel, take another tablet straight away, as the tablet may not work if you are sick. This is a normal side effect that happens to around 1% of people who take the morning after pill, and usually isn’t a cause for concern.

The only way to know if levonorgestrel has worked is to wait for your next period. It might be a little late and this is normal. Take a pregnancy test if your period is more than 5 days late.

Early detection pregnancy tests can be taken when your period is delayed by 1 day, but if the result is negative you should repeat the test after a week.

Levonorgestrel is effective in preventing pregnancy in most cases when taken correctly.

When taken after unprotected sex, Levonorgestrel:

• is up to 99% effective when taken as soon as possible (within 12 to 24 hours of unprotected sex)
• prevents around 84% of expected pregnancies if taken within 72 hours

Levonorgestrel is not as effective as other, regular methods of contraception. You should use an additional method of contraception to prevent pregnancy.

Levonorgestrel may be less effective the higher your body weight or body mass index (BMI) is. You can still take levonorgestrel if you have a high body weight or BMI, but you may need to take more than 1 tablet. You should speak to your pharmacist if you feel your BMI might affect the effectiveness of levonorgestrel.

Levonorgestrel is an over-the-counter medication and is available in most UK pharmacies. You can also buy levonorgestrel safely and easily online. It’s important to only request levonorgestrel online from trusted online services like ZAVA, that are monitored and regulated to ensure you receive safe and genuine medication.

Always make sure you buy medication from a reputable website when buying online. A good way to check is to see if they are registered with the Care Quality Commission. This will ensure the medication is genuine and has been checked by a medical professional that it is safe and suitable for you to take.

Getting levonorgestrel online from ZAVA is quick and convenient, with no need for a face-to-face appointment:

1. Complete a short online medical questionnaire – share details about your health so our doctors can ensure levonorgestrel is right for you.
2. Order and pay online – sign in or create your ZAVA account, select levonorgestrel, and securely make your payment.
3. Doctor review and approval – a UK-licensed doctor will check your health information and approve your request if levonorgestrel is safe and appropriate for you.
4. Fast and discreet delivery – if approved, levonorgestrel will be delivered discreetly to your home or a local post office for collection.

Can you get levonorgestrel on the NHS?

Yes. You can get levonorgestrel on the NHS from your GP or local family planning or sexual health clinic for free.

Can you get levonorgestrel over the counter?

Yes, you can buy Levonorgestrel over the counter from pharmacies. Your pharmacist will ask you some questions about your health before selling you levonorgestrel. This is to make sure the medication is suitable and safe for you to take.

Some patients experience side effects after taking levonorgestrel. These are usually mild, and not everyone gets them.

Levonorgestrel can affect your period (menstrual) cycle. This means the next date you ovulate may be earlier or later than usual.

Very common side effects of levonorgestrel include:

• nausea (feeling sick)
• irregular bleeding until your next period
• lower abdominal pain
• tiredness
• headache

Other common side effects of levonorgestrel:

• breast tenderness
• diarrhoea
• dizziness
• changes to your period – your next period may be earlier or later, or you may have some irregular bleeding or spotting

If your period is more than 5 days late or if it is unusually light or heavy, speak to your doctor.

Find more information about side effects when taking levonorgestrel in your patient information leaflet.

If you are concerned about any side effects, speak to your doctor. You can also report any side effects through the MHRA (Medicines and Healthcare products Regulatory Agency) Yellow Card Reporting Scheme.

Each tablet contains 1.5 mg of the active ingredient levonorgestrel.

The other ingredients are:

• lactose monohydrate
• maize starch
• povidone K30
• silica (colloidal anhydrous)
• magnesium stearate

You can take levonorgestrel if you have had unprotected sex in the past 72 hours and want to prevent pregnancy.

Levonorgestrel is for emergency use only and it is not suitable for use as a regular contraceptive.

Levonorgestrel should not be taken by women or girls before they have had their first period.

You should not take levonorgestrel if you have:

• an allergy to levonorgestrel or any of its other ingredients
• a disease of your small bowel, such as Crohn’s disease
• severe liver problems
• had an ectopic pregnancy (where the baby develops outside the womb, usually in the fallopian tubes)
• had inflammation of the fallopian tubes (salpingitis)

If you have previously had an ectopic pregnancy or inflammation of the fallopian tubes, you have a higher risk of having a new ectopic pregnancy.

Can I take levonorgestrel while breastfeeding?

Yes, you can take levonorgestrel if you are breastfeeding. However, the active ingredient can get into the breast milk, so you should take levonorgestrel straight after finishing a feed. Then you should avoid breastfeeding for at least the next 8 hours, and use a breast pump to drain your milk. This will reduce the amount of levonorgestrel that your baby is exposed to.

When taken together, some medicines may make Levonorgestrel less effective. This includes:

• barbiturates and some other medicines used to treat epilepsy, for example primidone, phenytoin and carbamazepine
• tuberculosis treatment, for example rifampicin and rifabutin
• treatment for HIV, for example ritonavir and efavirenz
• fungal infection treatments, such as griseofulvin
• herbal remedies containing St John’s Wort

You should let your doctor know about any medicines you are taking (or have taken in the last 4 weeks) before taking Levonorgestrel. Your doctor may recommend that you take 2 doses of levonorgestrel, or that a copper IUD (intrauterine device) may be suitable as an emergency contraceptive instead.

Levonorgestrel may make some medicines less or more effective. This includes ciclosporin, which is used to suppress the immune system. Speak to your doctor for advice.