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Aftera Review

Aftera is a levonorgestrel morning-after pill which helps to prevent pregnancy when used within 72 hours after unprotected sexual intercourse.


Indications for use

Aftera levonorgestrel pill is only used an emergency contraception and is recommended for women with a regular period.

Mechanism of action

The active substance of the drug is levonorgestrel 1.5 mg, a synthetic progesterone. The consequence of taking such a high dose is a kind of hormonal impact on the woman’s body.

We can distinguish three mechanisms of action:

  • Blockage of the release of the egg from the ovary. Such consequences of the pill reception are observed in the first phase of the period. The drug significantly reduces the synthesis of estrogens, which affect the maturation of the egg. Furthermore, the action of levonorgestrel affects and slow down endometrium;
  • In the middle of the period, the drug inhibits the synthesis of luteinizing hormone, which affects the release of the ovum from the ovary. Thus, ovulation becomes impossible;
    Drug effect on the body in the second phase reduces the synthesis of progesterone and creates unfavorable conditions for the implantation of the embryo into the uterine wall;
  • Under the influence of levonorgestrel, mucus of the cervix becomes viscous and does not pass spermatozoa. So the probability of pregnancy decreases. This effect is important only when the tablet is taken immediately after intercourse.

How to take a morning-after pill?

Aftera pill is taken orally 72 hours after an unprotected sexual act.

If vomiting occurs within 3 hours after taking a pill, the same dose of levonorgestrel should be taken again. You can use the drug on any day of your menstrual period.

Postcoital drugs are not recommended to be used more than once a month. It is recommended to use emergency contraception once every 3-6 months.

If you have a regular sex life (sexual acts at least once a week or several a month), it is recommended to choose other methods of contraception that are safe.

When to expect menstrual bleeding after taking Aftera?

Menstruation should occur in accordance with an individual calendar, however, in some cases, there may be a minor period failure. Acceleration or delay of menstruation for 2-3 days after using a morning-after pill should not cause any concern.

In some cases, minor bleeding may occur in the middle of the period due to sudden hormonal changes and premature rejection of the endometrium. After using a pill in the second half of the period, brown discharge often appears.

If you used the drug and the bleeding did not occur on time, you need to wait a few days, because the drug may a delay menstruation. When the delay lasts more than a week, you need to visit a doctor and exclude pregnancy.

Aftera and COCs

Use of a morning-after pill does not exclude the possibility of taking combined oral contraceptives. However, do not forget that you need to start using the latter from the first day of menstrual bleeding, in the opposite case, the effect will be reduced.

How effective is levonorgestrel emergency contraception?

The chances for successful termination of pregnancy depend directly on the time of taking a tablet after sexual intercourse:

  • effective in 95% of cases – if a pill is taken within 24 hours after sexual intercourse;
  • effective in 85% of cases – if a pill is taken within 25-48 hours after sexual intercourse;
  • effective in 58% of cases – if a pill is taken within 49-72 hours after sexual intercourse.

The intake of food does not affect the efficacy of levonorgestrel 1.5 mg pill. Therefore, it does not matter when a woman takes a pill – before or after meals.


Contraindications for Aftera include:

  • severe kidney failure;
  • hypersensitivity to the components of the drug;
  • pregnancy;
  • children and adolescents under 16;
  • rare diseases of hereditary type, for example, glucosogalactose malabsorption, lack of lactase, lactose intolerance.

The drug is used with caution:

  • Crohn’s disease in an anamnesis;
  • period of breastfeeding;
  • jaundice in an anamnesis;
  • diseases of the liver and biliary tract in an anamnesis.

Side effects

Since levonorgestrel 1.5 mg pill contains a high hormone dose, its use can adversely affect the health of women. There is a high probability of uterine bleeding, which can only be surgically treated. The use of emergency contraception may cause disorders of the menstrual period, hormonal imbalance and anovulation. These effects can also cause infertility. A large dose of levonorgestrel can also cause side effects:

Common side effects of Aftera:

  • nausea and vomiting, diarrhea;
  • headache, dizziness;
  • mood swings (emotional lability, panic attacks);
  • delay of menstruation;
  • allergic reactions;
  • pain in the lower abdomen, fatigue;
  • pain and engorgement of the mammary glands.


Aftera emergency contraception can interact with drugs-inducers of liver enzymes, lansoprazole, amprenavir, oxcarbazepine, topiramate, barbiturates, ampicillin, tetracycline antibiotics.

The interaction can decrease the contraceptive effect of a levonorgestrel morning-after pill.

Breastfeeding period

The active ingredient of the drug penetrates into breast milk. Its maximum concentration is achieved in three hours after taking a tablet. The half-life shows a different time: 11 to 45 hours. A woman should stop breastfeeding for 24 hours after using the contraceptive pill.

Special instructions

  • To avoid undesirable consequences and complications, Aftera levonorgestrel 1.5 pill should be used strictly according to the doctor’s prescription;
  • The drug is recommended to women with a regular menstrual period;
  • Repeated use of the drug throughout the same period should be avoided because of the risk of menstrual irregularities;
  • The use of emergency contraception as a means of regular and continuous contraception is not allowed, because it reduces the effectiveness of the drug, increases the occurrence of side effects and multiplies their severity;
  • This drug cannot replace regular contraception. It is a method of “emergency” care in cases where regular contraception “failed” (missing a birth control pill, a condom break, etc.);
  • In the case of uterine bleeding as a result of the use of levonorgestrel contraceptive, a gynecological examination is recommended;
  • If pregnancy has developed on the background of the use of a morning-after pill, or the contraceptive tablet has been taken during the existing pregnancy, it is impossible to reliably predict the consequences. The risks of negative effects on the fetus are not established;
  • Aftera drug does not adversely affect the ability to drive a vehicle and perform work that requires a high rate of reactions, both physical and mental.

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