Levonorgestrel

Levonorgestrel Brand Names

EContra EZ | EContra One-Step | Fallback Solo | Kyleena | LILETTA | Mirena | My Choice | My Way | Next Choice | Next Choice One Dose | Norplant | Opcicon One-Step | Plan B | Plan B One-Step | Preventeza | React | Skyla | Take Action

What is Levonorgestrel

Levonorgestrel is a synthetic progestin. Levonorgestrel is commonly used as an emergency post-coital oral contraceptive (Plan B, Plan B One-Step, and others).

A levonorgestrel implantable device (Norplant) was used historically for continuous routine contraception, but is no longer marketed.

Levonorgestrel is used for the routine prevention of pregnancy as various intrauterine devices (IUDs) such as Mirena, Skyla, Liletta, and Kyleena. Mirena is additionally used for the treatment of menorrhagia in women desiring an intrauterine device (IUD) for contraception.

The Liletta IUD is indicated for up to 6 years of use.

The Mirena, and Kyleena IUDs release a low amount of levonorgestrel continuously over a 5-year period.

The Skyla IUD is indicated for up to 3 years of use.

A 2-dose levonorgestrel-only emergency oral contraceptive regimen (e.g., Plan-B, others) is available non-prescription (OTC) for women age 17 years and older, is very effective at preventing pregnancy when ingested within 72 hours of unprotected intercourse.

The regimen causes less post-dose nausea than oral combination estrogen-progestin postcoital (Yuzpe) regimens.

Plan B One-Step (a 1 tablet, single-dose emergency oral contraceptive), is approved for non-prescription (OTC) use in all females of childbearing potential regardless of age; many other marketed products are available besides this brand.

Indications

  1. contraception
  2. endometriosis
  3. menorrhagia
  4. postcoital contraception

For routine contraception

Side Effects

  1. abdominal pain
  2. acne vulgaris
  3. alopecia
  4. amenorrhea
  5. anemia
  6. angioedema
  7. anxiety
  8. back pain
  9. bradycardia
  10. chills
  11. cholestasis
  12. depression
  13. dizziness
  14. dysmenorrhea
  15. dyspareunia
  16. ectopic pregnancy
  17. emotional lability
  18. endometritis
  19. fatigue
  20. fever
  21. fluid retention
  22. headache
  23. hepatoma
  24. hirsutism
  25. hyperglycemia
  26. hypertension
  27. infection
  28. jaundice
  29. leukorrhea
  30. libido decrease
  31. mastalgia
  32. menorrhagia
  33. menstrual irregularity
  34. migraine
  35. myocardial infarction
  36. nausea
  37. ovarian enlargement
  38. pelvic pain
  39. pulmonary embolism
  40. rash
  41. retinal thrombosis
  42. seborrhea
  43. stroke
  44. syncope
  45. thromboembolism
  46. thrombosis
  47. urticaria
  48. uterine contractions
  49. uterine perforation
  50. vaginal discharge
  51. vaginitis
  52. visual impairment
  53. vomiting
  54. weight gain

Monitoring Parameters

  • pap smear
  • pelvic exam
  • pelvic ultrasound
  • pregnancy testing

Contraindications

  • acquired immunodeficiency syndrome (AIDS)
  • anticoagulant therapy
  • Asian patients
  • bradycardia
  • breast cancer
  • breast-feeding
  • cerebrovascular disease
  • cervical cancer
  • cervicitis
  • children
  • coagulopathy
  • diabetes mellitus
  • ectopic pregnancy
  • endometritis
  • headache
  • hepatic disease
  • hepatocellular cancer
  • human immunodeficiency virus (HIV) infection
  • hypertension
  • incomplete abortion
  • infection
  • intrauterine fetal death
  • jaundice
  • leukemia
  • magnetic resonance imaging (MRI)
  • menstrual irregularity
  • migraine
  • myocardial infarction
  • obesity
  • obstetric delivery
  • ovarian cyst
  • pregnancy
  • pregnancy testing
  • renal disease
  • requires an experienced clinician
  • seizure disorder
  • sexually transmitted disease
  • stroke
  • syncope
  • thromboembolic disease
  • thrombophlebitis
  • tobacco smoking
  • uterine cancer
  • uterine leiomyomata
  • vaginal bleeding
  • vaginal discharge
  • vaginitis
  • valvular heart disease
  • visual disturbance

Interactions

  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetohexamide
  • Acitretin
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alpha-glucosidase Inhibitors
  • Amikacin
  • Aminoglycosides
  • Amobarbital
  • Amoxicillin
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amoxicillin; Clavulanic Acid
  • Ampicillin
  • Ampicillin; Sulbactam
  • Amprenavir
  • Apalutamide
  • Aprepitant, Fosaprepitant
  • Armodafinil
  • Artemether; Lumefantrine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azithromycin
  • Aztreonam
  • Bacitracin
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Bexarotene
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Boceprevir
  • Bosentan
  • Brigatinib
  • Bromocriptine
  • Butabarbital
  • Calaspargase pegol
  • Canagliflozin; Metformin
  • Carbamazepine
  • Carbapenems
  • Carbenicillin
  • Cefaclor
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  • Cefazolin
  • Cefdinir
  • Cefditoren
  • Cefepime
  • Cefiderocol
  • Cefixime
  • Cefotaxime
  • Cefotetan
  • Cefoxitin
  • Cefpodoxime
  • Cefprozil
  • Ceftaroline
  • Ceftazidime
  • Ceftazidime; Avibactam
  • Ceftibuten
  • Ceftizoxime
  • Ceftolozane; Tazobactam
  • Ceftriaxone
  • Cefuroxime
  • Cenobamate
  • Cephalexin
  • Charcoal
  • Chenodiol
  • Chloramphenicol
  • Chlorpropamide
  • Ciprofloxacin
  • Clarithromycin
  • Clindamycin
  • Clobazam
  • Cobicistat
  • Colistimethate, Colistin, Polymyxin E
  • Dabrafenib
  • Dalbavancin
  • Dapagliflozin
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Daptomycin
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Deferasirox
  • Delafloxacin
  • Demeclocycline
  • Dicloxacillin
  • Doripenem
  • Doxycycline
  • Efavirenz
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  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elagolix; Estradiol; Norethindrone acetate
  • Elvitegravir
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enasidenib
  • Encorafenib
  • Enzalutamide
  • Eravacycline
  • Ertapenem
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Eslicarbazepine
  • Felbamate
  • Fidaxomicin
  • Flibanserin
  • Fosamprenavir
  • Gemifloxacin
  • Gentamicin
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Glycylcyclines
  • Griseofulvin
  • Hydantoins
  • Idelalisib
  • Imipenem; Cilastatin
  • Imipenem; Cilastatin; Relebactam
  • Incretin Mimetics
  • Indinavir
  • Insulins
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Isotretinoin
  • Ivosidenib
  • Kanamycin
  • Lamotrigine
  • Lefamulin
  • Leflunomide
  • Lesinurad
  • Lesinurad; Allopurinol
  • Levofloxacin
  • Linagliptin
  • Linagliptin; Metformin
  • Lincomycin
  • Lincosamides
  • Linezolid
  • Lomitapide
  • Lopinavir; Ritonavir
  • Lorlatinib
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  • Meglitinides
  • Mephobarbital
  • Meropenem
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  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methohexital
  • Metronidazole
  • Mifepristone
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  • Minocycline
  • Mivacurium
  • Modafinil
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  • Morphine; Naltrexone
  • Moxifloxacin
  • Nafcillin
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  • Norfloxacin
  • Ofloxacin
  • Omadacycline
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Oritavancin
  • Oxacillin
  • Oxcarbazepine
  • Paromomycin
  • Pegaspargase
  • Penicillin G
  • Penicillin G Benzathine
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  • Penicillin V
  • Pentobarbital
  • Perampanel
  • Pexidartinib
  • Phenobarbital
  • Phentermine; Topiramate
  • Piperacillin
  • Piperacillin; Tazobactam
  • Pitolisant
  • Plazomicin
  • Polymyxin B
  • Polymyxins
  • Pramlintide
  • Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
  • Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
  • Primidone
  • Pyrimethamine; Sulfadoxine
  • Rifabutin
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  • Rifamycins
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  • Siltuximab
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  • Sitagliptin
  • St. John’s Wort, Hypericum perforatum
  • Streptogramins
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  • Succinylcholine
  • Sugammadex
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  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfasalazine
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  • Tolbutamide
  • Topiramate
  • Trimethoprim
  • Ulipristal
  • Vancomycin
  • Warfarin