Levonest is an oral birth control pill which contains ethinyl estradiol and levonorgestrel, that are used to prevent pregnancy.
Indications for use
Mechanism of action
Levonest is a three-phase oral combination contraceptive. The contraceptive effect is realized through several complementary mechanisms. Levonorgestrel blocks the release of the hypothalamus, suppressing the secretion of the gonadotrophic hormones by the pituitary gland, which leads to inhibition of maturation and release of the ovum ready for fertilization. The substance causes changes in the endometrium, preventing the implantation of a fertilized egg. Ethinyl estradiol increases the viscosity of the secretion of the cervix, making it impenetrable for spermatozoa.
Along with the contraceptive effect, Levonest reduces the frequency of painful menstruations and reduces their intensity, which in turn reduces one of the risk factors for the development of iron deficiency anemia.
When used correctly, the Perl index (an indicator that reflects the frequency of pregnancy in 100 women during the year of use of the contraceptive) is less than 1. When missing tablets or improperly used, the Pearl index may increase.
Dosage and mode of application
Take one tablet daily for 28 days in the following order: 6 yellow tablets, followed by 5 green tablets, followed by 10 light brown tablets, and 7 white inert tablets. Start taking the pills on the first day of your menstrual period. It is recommended to take the drug at the same time of day.The risk of cardiovascular complications increases with smoking (especially after 35 years). Before taking the drug, it is necessary to consult a gynecologist.
In some cases, Levonest tablets can cause the following side effects:
- nausea, vomiting,
- breast engorgement,
- weight gain,
- decreased libido and mood,
- coarsening of the voice,
- intermenstrual bloody discharge,
- eyelid edema,
- visual impairment,
- discomfort when wearing contact lenses.
These phenomena are temporary and disappear after cancellation the drug without any therapy.
With prolonged use, the drug may cause:
- hearing loss,
- generalized pruritus,
- calf muscle cramps,
- increased frequency of epileptic seizures (very rarely)
- decreased glucose tolerance,
- increased blood pressure,
- thrombosis and venous thromboembolism,
- skin rashes,
- a change in the nature of vaginal secretion,
- vaginal candidiasis,
- increased fatigue,
Levonest should not be used in the presence of any of the conditions listed below (present or in the anamnesis). If any of these conditions develop against the background of the contraceptive, the drug should be immediately withdrawn:
- increased sensitivity to ethinyl estradiol and levonorgestrel or any other components of the drug;
- thrombosis (venous and arterial) and thromboembolism, cerebrovascular disorders;
- states preceding thrombosis (transient ischemic attacks, angina pectoris);
- risk factors for venous or arterial thrombosis (valvular heart disease, cardiac rhythm disturbances, deep vein thrombophlebitis, cerebrovascular or coronary artery disease); uncontrolled arterial hypertension, long-term immobilization, extensive surgical intervention, operative interventions on the lower limbs, extensive injuries;
- migraine with focal neurologic symptoms;
- diabetes mellitus with vascular complications;
- pancreatitis with severe hypertriglyceridemia;
- precision failure and severe liver disease;
- liver tumors;
- exposed hormone-dependent malignant diseases (genitals or mammary glands);
- bleeding from the vagina of unknown origin;
- breastfeeding period;
- lactase deficiency, sugarase / isomaltase deficiency, fructose intolerance, lactose intolerance, glucose-galactose malabsorption.
Use with caution:
- pronounced disorders of fat metabolism (obesity, hyperlipidemia);
- otosclerosis with hearing impairment,
- idiopathic jaundice or itching during an earlier pregnancy;
- congenital hyperbilirubinemia (syndromes Gilbert, Dubin-Johnson and Rotor);
- systemic lupus erythematosus;
- hemolytic uremic syndrome;
- Crohn’s disease;
- sickle-cell anemia;
- arterial hypertension.
- Barbiturates, some anti-epileptic drugs (carbamazepine, phenytoin), sulfonamides, pyrazolone derivatives may enhance the metabolism of steroid hormones included in Levonest;
- The contraceptive effect can be reduced by antimicrobial drugs (ampicillin, rifampicin, chloramphenicol, neomycin, polymyxin B, sulfonamides, tetracyclines);
- When taking Levonest tablets, it may be necessary to correct the dosage regimen for hypoglycemic drugs and indirect anticoagulants.
Pregnancy and breastfeeding
Levonest is contraindicated for use in pregnancy and lactation (breastfeeding).
What if I miss a pill?
The missed tablet should be taken within the next 12 hours. If the delay exceeds 36 hours, contraception is unreliable. In such cases, to prevent possible intermenstrual bleeding, the drug should be taken from the package that has already been started, with the exception of the missed tablet (s). If you missed active tablets, it is recommended to use another, additional, non-hormonal method of contraception (for example, barrier). This rule does not apply to inert tablets because they do not contain hormones. If you missed an inert tablet, just throw it away.
The drug should be immediately canceled if the following symptoms occur: early signs of phlebitis, thrombosis (clotting of blood vessels), embolism (vascular obstruction) – bloating, unusual pain in the legs, chest pain when breathing or coughing, chest tightness; migraine, sudden hearing and vision impairments, motor disorders.
The drug should be canceled 6 weeks before the planned surgical procedures. The risk of thrombosis increases with high blood pressure.
Vomiting or diarrhea can lead to the withdrawal of ethinyl estradiol and levonorgestrel from the body, so in this case, you need to take one more tablet.
If these symptoms remain for a longer time, you should temporarily use other birth control methods.