Composition: Levonorgestrel 750µg.
Presentation: White tablets.
Action: Thought to work mainly by preventing ovulation and fertilisation. May also cause endometrial changes.
Indications: Emergency contraceptive for use within 72 hours of unprotected intercourse. Contraindications: If menstrual bleeding is overdue, if the last menstrual period was abnormal in timing or character or if pregnancy is suspected for any other reason, pregnancy should be excluded (by pregnancy testing or pelvic examination) before treatment is given. The World Health Organisation (medical eligibility criteria) advises that the only absolute contraindications to high dose progestogen-only contraception are unexplained vaginal bleeding, current breast cancer, pregnancy or hypersensitivity to any of the ingredients of the preparation.
Dosage and administration: One tablet should be taken as soon as possible (and not later than 72 hours) after unprotected intercourse, followed by one additional tablet 12 hours after the first dose. If the patient vomits within two hours of taking the tablets, she should return to her doctor or clinic where an additional tablet may be given. Levonelle-2 may be given at any time during the menstrual cycle unless menstrual bleeding is overdue.
Limited data are available in young women aged 14 and over.
Overdosage: May cause nausea and withdrawal bleeding. No specific antidotes and treatment should be symptomatic.
Precautions: See SPC for relative contraindications. In individual cases the risk-benefit ratio should be assessed by the practitioner in discussion with the patient. Women who present for repeated courses should be advised to consider long-term methods of contraception.
Vomiting, severe diarrhoea or other causes of malabsorption, such as Crohn's disease, might impair the efficacy of Levonelle-2. Consideration should be given to the taking of more tablets.
Drug interactions: As for other oral contraceptives. See SPC.
Side effects: Nausea occurs in about 25 per cent of women taking Levonelle-2 and vomiting occurs in about 5 per cent. Other side effects are breast tenderness, headache, dizziness and fatigue. Bleeding patterns may be temporarily disturbed. Some women may experience bleeding or spotting and some may experience early or delayed onset of menses (pregnancy should be excluded if the next menstrual period is more than seven days late).
Net price: £5 for pack of 2 tablets.
Supplier: Schering Health Care Ltd, The Brow, Burgess Hill, West Sussex RH15 9NE. Tel 01444 232323, fax 01444 244171.
Legal class: POM.