Levonorgestrel (Generic Levonelle)

Levonorgestrel is an emergency contraceptive pill. You can take Levonorgestrel to prevent pregnancy within 72 hours (3 days) of unprotected sex.

You may have been unprotected from pregnancy during sex because you:

• did not use contraception during intercourse
• missed a dose of your usual oral contraceptive pill
• are concerned that your usual contraceptive method may not have worked (for example because a condom split or a vaginal diaphragm burst)

You can take Levonorgestrel after unprotected sex to prevent pregnancy.

Swallow 1 Levonorgestrel tablet whole with water, and you should take it:

• as soon as possible
• ideally within the first 12 to 24 hours after unprotected sex, and no later than after 72 hours (3 days)
• if you are sick (vomit) within 3 hours of taking Levonorgestrel, take another tablet of Levonorgestrel straight away

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 Levonorgestrel 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.

Three weeks after taking Levonorgestrel, you should check that it has worked and that you are not pregnant. You can do this by waiting for your next period, and if it is more than 1 week late, do a pregnancy test.

Levonorgestrel works in 2 main ways:

• preventing ovulation – stopping your ovaries from releasing an egg
• preventing fertilisation – stopping sperm from fertilising an egg that has already been released

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

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, and you may need to take more than 1 tablet.

Levonorgestrel does not protect you from sexually transmitted infections(STIs). If you are concerned that you may be at risk from a sexually transmitted infection, speak to a doctor or visit a sexual health clinic.

Some women 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

Vomiting (being sick) is a common side effect of Levonorgestrel. If you are sick within 3 hours of taking Levonorgestrel, you should take another tablet straight away.

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 7 days late or if it is unusually light or unusually heavy, speak to your doctor.

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.

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

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

You can take Levonorgestrel if you are breastfeeding. The active ingredient of Levonorgestrel 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 breast. This will reduce the amount of Levonorgestrel that your baby is exposed to.

If you are already pregnant or think you might be, you should not take Levonorgestrel and should speak to your doctor. Your doctor may be able to prescribe a different type of emergency contraception.

You may be pregnant if:

• your period is more than 7 days late
• you have had unusual bleeding (light or heavy) when your period is due
• it has been more than 72 hours since you had unprotected sex and you have not had a period since
• you take a combined contraceptive pill and you have not had a period in your pill-free days

If you become pregnant after taking Levonorgestrel, you should speak to your doctor. There is no evidence that Levonorgestrel will harm a developing baby.

Levonorgestrel may increase the risk of an ectopic pregnancy, where a baby develops outside of the womb (usually in the Fallopian tubes). If you develop severe abdominal pain after taking Levonorgestrel you should speak to your doctor straight away, as it may be a sign of ectopic pregnancy.

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

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 (Hypericum perforatum)

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 cyclosporin, which is used to suppress the immune system. Speak to your doctor for advice.

You should not take Levonorgestrel if you have:

• an allergy to Levonorgestrel or any of the 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.

There are other forms of emergency contraception available which may be suitable for you. This includes EllaOne and Levonelle. In some cases, a copper IUD (Intrauterine Device) may be recommended. Speak to a doctor for advice or message ZAVA today.

Levonorgestrel and EllaOne are both oral emergency contraceptives. EllaOne contains a different active ingredient to Levonorgestrel. EllaOne contains the active ingredient ulipristal acetate, which works by delaying ovulation, and can be used up to 5 days after unprotected sex. It does not prevent the fertilisation of an egg that has already been released.