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)

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.

Does Levonorgestrel work if you’ve already ovulated?

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, within 3 days of having unprotected sex.

How quickly does Levonorgestrel work?

Levonorgestrel takes a couple of hours to be 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 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.

How often can I use Levonorgestrel?

You can use Levonelle more than once in your menstrual cycle but this can cause irregular periods.

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 of Levonorgestrel straight away

The only way to know if levonorgestrel has worked is to wait for your next period. Take a pregnancy test if your period is more than a week late. Early detection pregnancy tests can be taken when your period is delayed by one 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, 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.

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 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.

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 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.

Can I take Levonorgestrel while breastfeeding?

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.

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.

There are other forms of emergency contraception available which may be more suitable for you. Other emergency contraceptive pills include EllaOne and Levonelle. In some cases, a copper IUD (intrauterine device) may be recommended. To discuss which type of emergency contraception may bebest for you, speak to a doctor for advice or message ZAVA today.

EllaOne

EllaOne is another type of emergency contraceptive pill. It contains the active ingredient ulipristal acetate which works by stopping the hormone progesterone from working properly and preventing your ovaries from releasing an egg. EllaOne needs to be taken within 5 days (120 hours) of having unprotected sex. One advantage of EllaOne is that you can take it later (up to 5 days) than levonorgestrel to prevent pregnancy.

Levonelle

Levonelle is the brand name for levonorgestrel and contains the same active ingredient. It works in the same way as levonorgestrel and needs to be taken within 3 days (72 hours) of having unprotected sex. Levonelle is usually more expensive than generic levonorgestrel.

Copper IUD

An intrauterine device or IUD is a small t-shaped device that is inserted into the uterus (womb) by a doctor or nurse.

The copper IUD is made of plastic and copper and works by creating a toxic environment that prevents your eggs from being fertilised or implanting in your womb. For emergency contraception, the IUD needs to be inserted within 5 days of unprotected sex or the earliest time you could have ovulated.

The IUD is the most effective method of contraception and is safe for most women. It can remain in place for up to 5 years. You can choose to have your IUD left in to protect against future pregnancies.

Where can I buy Levonorgestrel?

You can buy levonorgestrel over the counter from pharmacies or online from online doctors and pharmacies like ZAVA Online Doctor.

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.

You do not need a prescription to buy levonorgestrel, but will need a consultation with a pharmacist, or to complete an online medical questionnaire if buying online.

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?

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.

How long after taking Levonorgestrel should I do a pregnancy test?

You should do a pregnancy test if your period is more than 7 days late after taking levonorgestrel. Taking a pregnancy test too early may not be accurate and may give a false negative result (a negative result when you are pregnant).

What is the difference between Levonorgestrel and ellaOne?

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.

How long will Levonorgestrel stay in your system?

The half-life of levonorgestrel is 24 to 32 hours meaning it takes this amount of time for half the drug to be eliminated from your body. Levonorgestrel should be completely eliminated from your body within five days.

Can Levonorgestrel delay your period?

After taking levonorgestrel, most women have their next period at the usual time, but it may be earlier or later than usual. You may also have some spotting before your period after taking levonorgestrel. If your period is more than a week late after taking levonorgestrel, take a home pregnancy test or contact your GP or local sexual health clinic.

How do I know if Levonorgestrel has worked?

There are no outward signs to tell you whether levonorgestrel has worked or not. If levonorgestrel has worked you should get your next period at or around the usual time. Sometimes your period can be earlier or later than usual after taking levonorgestrel. If your period is more than 7 days late, take a pregnancy test or make an appointment with your GP or sexual health clinic. Taking a pregnancy test earlier than this can give a false negative result as the hormone levels in your urine will not be high enough to be accurate.

Can you drink alcohol after taking Levonorgestrel?

Drinking alcohol after taking levonorgestrel is safe and will not have any effect on how the medication works.

Can Levonorgestrel cause spotting?

Some women may experience spotting (light bleeding between periods) after taking levonorgestrel. This is due to changes in your hormone levels and is usually nothing to worry about. If you are losing a lot of blood, or the spotting continues for more than 5 days and you feel dizzy or have pain in your lower tummy, see a doctor straight away.

Is Levonorgestrel safe?

Levonorgestrel is safe for most women. Before you take levonorgestrel tell your doctor or pharmacist about any medical conditions or allergies you have. Read the patient information leaflet that comes with your medication carefully and ask your doctor or pharmacist if you have any questions.

Will Levonorgestrel affect my fertility in the future?

Taking levonorgestrel or other types of emergency contraception will not affect your ability to get pregnant in the future. You can take levonorgestrel as many times as you need to, but it shouldn’t be used as birth control long-term. If you find yourself needing to take levonorgestrel often, talk to your GP, sexual health, or family planning clinic about finding a method of birth control that is right for you.

Do you bleed after taking Levonorgestrel?

Some women experience spotting or bleeding before their next period after taking levonorgestrel. This is normally nothing to worry about and is due to the increase in your hormone levels. If your bleeding is heavy, lasts longer than 5 days or is accompanied by pain in your lower belly, see a doctor straight away.

Can Levonorgestrel cause mood swings?

Though not listed as a side effect, it has been suggested that the high dose of hormones in levonorgestrel may cause mood swings and depression as it leaves your body. This is rare and usually settles down within a couple of weeks. If you feel depressed or experience mood swings for more than 2 weeks after taking levonorgestrel, make an appointment with your GP.

Does Levonorgestrel stop sexually transmitted infections (STIs)?

Levonorgestrel does not provide any protection from sexually transmitted infections. If you have had unprotected sex, you should get tested for STIs so that you can receive the correct treatment and avoid spreading the infection to other people. You can arrange for an STI test at your GP, or if you prefer, your local sexual health or genitourinary (GUM) clinic. Testing is free and confidential, and you do not have to give your real name.

Does Levonorgestrel cause stomach pain?

Lower abdominal pain is listed as a common side effect of levonorgestrel. This is normally mild and goes away on its own within a few days. Contact your doctor immediately if your abdominal pain is severe, lasts longer than a few days or is accompanied by vaginal bleeding or dizziness. These may be signs of an ectopic pregnancy (when the baby grows outside the womb) and is a medical emergency which needs immediate treatment.

Can Levonorgestrel increase my risk of an ectopic pregnancy?

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.