levonorgestrel

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levonorgestrel

 [le″vo-nor-jes´trel]
the levorotatory form of norgestrel; used in contraception, either in combination with an estrogen component as an oral contraceptive or alone as a subdermal implant (see Norplant). It is also used alone as an oral emergency postcoital contraceptive, popularly called a “morning-after pill.”
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

levonorgestrel

Levonelle (UK), Mirena, Plan B One-Step

Pharmacologic class: Contraceptive, intrauterine device (Mirena); oral contraceptive, progestin-only pill (Plan B)

Therapeutic class: Contraceptive

Pregnancy risk category X (Mirena), NR (Plan B)

Mirena-

Plan B -

Action

Unclear. Mirena may enhance local contraceptive efficacy by thickening the cervical mucus (which prevents passage of sperm into uterus), inhibiting sperm capacitation or survival, and altering the endometrium. Plan B is thought to prevent ovulation or fertilization.

Availability

Intrauterine system (Mirena): 52 mg levonorgestrel

Tablets (Plan B): 1.5 mg

Indications and dosages

Intrauterine contraception for up to 5 years; heavy menstrual bleeding for women who choose to use intrauterine contraception

Adults: One intrauterine system (Mirena) inserted into uterus for up to 5 years

Emergency contraception to prevent pregnancy

Adults: 1.5 mg (Plan B) P.O. as soon as possible within 72 hours after unprotected intercourse

Contraindications

Mirena-

• Hypersensitivity to drug or its components

• Known or suspected pregnancy

• Congenital or acquired uterine anomaly

• Acute pelvic inflammatory disease (PID) or history of PID (unless patient had subsequent intrauterine pregnancy)

• Postpartum endometritis or infected abortion within past 3 months

• Known or suspected uterine or cervical neoplasia or unresolved abnormal Papanicolaou (Pap) test

• Untreated acute cervicitis or vaginitis

• Acute hepatic disease or hepatic tumor (benign or malignant)

• Genital bleeding of unknown cause

• Conditions associated with increased risk of infection

• Genital actinomycosis

• Previously inserted intrauterine device that has not been removed

• Known or suspected breast cancer

• History of ectopic pregnancy or conditions that predispose to it

Plan B -

• Hypersensitivity to drug or its components

• Known or suspected pregnancy

• Undiagnosed abnormal genital bleeding

Precautions

Use Mirena cautiously in:

• diabetes mellitus

• breastfeeding patients.

Use Plan B cautiously in:

• coagulopathy

• diabetes mellitus

• patients receiving anticoagulants concurrently.

Administration

• Know that Mirena should be inserted under aseptic conditions by health care professional familiar with procedure.

• Verify that patient isn't pregnant before Mirena insertion.

• Know that Plan B should be given as soon as possible within 72 hours of unprotected sexual intercourse. Drug isn't suitable as long-term contraceptive.

Adverse reactions

CNS: headache (Mirena, Plan B), fatigue, dizziness (Plan B), severe headache, migraine, nervousness, depression (Mirena)

CV: hypertension (Mirena)

EENT: sinusitis (Mirena)

GI: nausea, vomiting, abdominal pain (Mirena, Plan B), diarrhea (Plan B), intestinal perforation or obstruction (Mirena)

GU: breast tenderness (Mirena, Plan B); lighter or heavier menstrual bleeding (Plan B); breast pain; increased progesterone levels; ovarian cysts; dysmenorrhea; amenorrhea; spotting; erratic or prolonged menstrual bleeding; pelvic infection; vaginitis; cervicitis; dyspareunia; leukorrhea; decreased libido; abnormal Pap smear; expulsion, embedment in myometrium, adhesions, cervical or ureteral perforation (Mirena)

Hematologic: anemia (Mirena)

Hepatic: jaundice (Mirena)

Musculoskeletal: back pain (Mirena)

Respiratory: upper respiratory tract infection (Mirena)

Skin: skin disorder, acne, eczema, hair loss (Mirena)

Other: water retention, weight gain, sepsis (Mirena)

Interactions

Drug-drug. Hepatic enzyme-inducing drugs (such as barbiturates, carbamazepine, phenytoin, rifampin): decreased Plan B efficacy

Drug-diagnostic tests. Glucose: altered level (Mirena)

Patient monitoring

• Monitor blood pressure.

• Watch for adverse reactions, especially changes in menstrual bleeding.

• Monitor blood glucose level in diabetic patients.

• Check liver function tests frequently.

Patient teaching

• Tell patient taking either product that drug does not prevent HIV or other sexually transmitted diseases.

• Teach patient using Mirena how to check (after menstrual period) to make sure thread still protrudes from cervix. Caution her not to pull on thread, because this could cause displacement.

Instruct patient using Mirena to immediately report fever, chills, unusual vaginal discharge, or abdominal or pelvic pain or tenderness.

• Explain that for maximum efficacy, patient should take Plan B as soon as possible after unprotected sex.

• Inform patient that Plan B isn't intended for routine contraception and doesn't terminate existing pregnancy.

• Tell patient to report adverse reactions.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

levonorgestrel

(lē′və-nôr-jĕs′trəl)
n.
The levorotatory form of the progestin norgestrel, used for emergency contraception, and, in combination with estrogen, in oral contraceptives and in hormone replacement therapy.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

Norplant

An implantable contraceptive system that prevents pregnancy by inhibiting ovulation and thickening the cervical mucus.
 
Adverse effects
Dysmenorrhea, headache, nervousness, nausea, vertigo, increased size of ovaries and fallopian tubes, dermatitis, acne, weight gain, breast tenderness, hirsutism.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.

levonorgestrel

A PROGESTOGEN drug used in oral contraceptives. The drug is on the WHO official list. Brand names of the progestogen-only product are Microval, Mirena, Norgeston and Norplant. It is also formulated with ETHINYLOESTRADIOL (ethinylestradiol) as an oral contraceptive under such brand names as Eugynon 30, Eugynon 30, Microgynon 30, Microgynon 30 ED, Ovran, Ovranette, Schering PC4 and Trinordiol.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
"Ulipristal has been shown to be more effective than levonorgestrel," says Deborah; EllaOne can be taken up to five days after sex to prevent pregnancy, while Levonelle can be taken up to three.
Levonelle, which is intended to prevent pregnancy in the event of unprotected sex, contains high levels of levonorgestrel, a synthetic derivative of the sex hormone progesterone.
There are those of us who would argue that even the current UK public sector price of Levonelle is scandalously high--given the minimal R&D commitment and costs incurred when Schering Health Care Ltd (now BayerScheringPharma) acquired the product from Gideon Richter in Hungary.
The Irish Sunday Mirror has now forwarded the Levonelle brand pill which we received to the Irish Medicines Board for safe disposal.
The morning after pill -sold under the name Levonelle prevents an embryo implanting in the womb.
RE the furore over Boots Chemist and the emergency contraceptive pill, Levonelle, also know as emergency contraception and the morning-after pill, in reality not a true contraceptive.
Levonelle and ellaOne are pills and there is also the option of having an emergency IUD fitted.
The most commonly used brand in the UK, Levonelle, is more effective the earlier it is used.
The research was carried out by Bayer Schering Pharma, which makes the emergency contraceptive pill Levonelle One Step.
HT's launch of the UK's first snoring farm for their client Essential Health products was chosen as Best PR Campaign, ahead of the launch of GlaxoSmithKleine's NiQuitin CQ Lozenge and Schering Health Care's contraceptive pill Levonelle.
It comes as official figures reveal that more than a million women have taken the morning- after pill Levonelle.