levonorgestrel


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Related to levonorgestrel: progestin

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.”

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)

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.

levonorgestrel

/le·vo·nor·ges·trel/ (-nor-jes´trel) the levorotatory form of norgestrel; used as an oral or subdermal contraceptive.

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.

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.

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.
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or purchases) iloprost, Aflibercept, Levonorgestrel, Sorafenib and radio 223 (dichloride).
Melgar noted that levonorgestrel was previously banned in the country supposedly for causing abortion.
In women younger than 35 years who have sexual intercourse 6 or fewer times per month, correct and consistent use of pericoital levonorgestrel 1.
intrauterine levonorgestrel administered (group A) and norethisterone administered (group B).
57) with a levonorgestrel IUD, compared with a control group of women with a BMI of less than 35, Lynne Saito-Tom, MD, of the University of Hawaii at Manoa, Honolulu, reported at the annual clinical and scientific meeting of the American College of Obstetricians and Gynecologists.
It said it had data on 400 unwanted pregnancies in women taking levonorgestrel since it was first licensed in the 1970s.
Nagrani R, Bowen-Simkins P, Barrington JW Can the levonorgestrel intrauterine system replace surgical treatment for the management of menorrhagia?
While the company does not expect to list the newly issued patent in the US FDA's Orange Book in connection with its lead product candidate, Twirla (ethinyl estradiol and levonorgestrel transdermal system), the patent is relevant to its progestin-only patch R&D programme.
Research published in 2011 sparked vigorous debate--and some regulatory changes--when it reported that levonorgestrel EC pills may be ineffective for women who weigh at least 154 pounds, and that ulipristal acetate EC pills may be ineffective for women who weigh 194 pounds or more.
Approximately 29% of CPRD patients and 26% of QResearch patients used oral contraceptives, most commonly levonorgestrel.
A diferencia del tradicional DIU de cobre, este sistema intrauterino con levonorgestrel ofrece una proteccion del 99.
Fallon had been taking a Pill with a progestogen hormone called levonorgestrel, which the study says is among the lowest risk as a second-generation Pill, but it is still two-and-a-half times more likely to cause clots than not taking any oral contraceptives.