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Levora Review


Levora is a monophasic hormonal contraceptive drug. The dosage regimen includes 28 pills devoted for application by women from 18 to 35 years old.

Contents:

Indications for use

Levora is prescribed as a means of contraception and regulation of the menstrual cycle during the reproductive age. It also can eliminate any symptoms of ovulatory and premenstrual syndromes.

Mechanism of action

Levora is a low-dose monophasic oral combined estrogen-progestin birth control drug.

The contraceptive effect is achieved by means of complementary mechanisms, the most significant of which are ovulation inhibition and a change in the cervical secretion viscosity, as a result of which it becomes very difficult for spermatozoa to enter the uterine cavity.

With the correct Levora use, the Perl index (an indicator that reflects the frequency of pregnancy in 100 women taking a birth control during one year) is 0.69. When missing tablets or improperly used, the Pearl index may change on a greater scale.

In women taking combined oral contraceptives, the menstrual cycle becomes more regular, the pain and intensity of menstrual bleeding decreases, which reduces the risk of developing iron deficiency anemia.

Mode of application and dosage

Levora should be taken daily at about the same time, if necessary, with a small amount of water, in the regimen specified on the blister pack. The intake should be continuous. One tablet is taken for 28 days without any breaks. The taking of tablets from the next package begins the day after the last tablet from the previous package is applied. Menstruation which usually begins 2-3 days after the onset of taking placebo tablets, may continue until the beginning of taking the tablets from the next package.

Contraindications

Levora use is contraindicated in the presence of any of the conditions/diseases/risk factors listed below. If any of these conditions appear on the background of its administration, the drug should be withdrawn immediately:

  • thrombosis (venous and arterial) and thromboembolism diagnosed or in the anamnesis (including deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke);
  • conditions prior to thrombosis (including transient ischemic attacks, angina pectoris): diagnosed or in the anamnesis;
  • the presence of severe or multiple risk factors for venous or arterial thrombosis;
  • hereditary or acquired predisposition to venous or arterial thrombosis;
  • migraine with focal neurologic symptoms at present or in the medical history;
  • diabetes mellitus;
  • pancreatitis accompanied by severe hypertriglyceridemia: diagnosed or in the medical history;
  • liver insufficiency, acute or severe hepatic dysfunctions;
  • hepatic tumors (benign or malignant): diagnosed or in the medical history.
  • revealed hormone-dependent malignant disorders (including genital organs or mammary glands): diagnosed or suggested;
  • vaginal hemorrhages of unclear etiology;
  • amenorrhea of unclear etiology;
  • pregnancy: diagnosed or suspected;
  • breastfeeding;
  • hypersensitivity to levonorgestrel and/or ethinylestradiol;
  • intolerance to lactose, its deficiency, glucose-galactose malabsorption.

Side effects

The most common adverse reaction is headache (in 17-24%).

The following side effects were recorded manifested themselves on the background of the use of ethinyl estradiol or levonorgestrel:

Often (≥1 / 100 to <1/10) Infrequently (≥1 / 1000 to <1/100) Rarely (<1/1 000)
weight gain fluid retention hypersensitivity to the drug
headache, depressed mood, mood change migraine intolerance to contact lenses
nausea, abdominal pain decreased libido, increased breast weight loss
increased sensitivity and tenderness of the mammary glands rash, urticaria increased libido
vomiting, diarrhea allocations from the breast, vaginal bleeding or any kind of allocations
nodal erythema, erythema multiforme

The following serious side effects described in the section “Special instructions and precautions for use” were noted in women who took hormonal contraceptive drugs:

  • venous thromboembolism;
  • thromboembolism of the arteries;
  • hypertension;
  • liver tumors;
  • Crohn’s disease, ulcerative colitis, epilepsy, migraine, endometriosis, uterine fibroids, porphyria, systemic lupus erythematosus, herpes of pregnant women, Sydenham’s chorea, haemolytic uremic syndrome, cholestatic jaundice.

Among those who took Levora and other combined hormonal contraceptives, there was a slight increase in the breast cancer incidence. Since breast cancer rarely occurs in women younger than 40 years, an increase in the number of cases is insignificant in relation to the overall risk of breast cancer.

In women with hereditary angioedema, exogenous estrogens can induce or enhance symptoms of angioedema.

Interactions

  • The decrease in the estrogens’ effectiveness is observed in case of simultaneous administration with antibiotics of the penicillin structure, tetracyclines, ritonavir.
  • Ascorbic acid, paracetamol, atorvastatin increase the concentration of estrogens.
  • Levora decreases the effectiveness of glucocorticoids, clofibrate.
  • It enhances the effect of hepatotoxic drugs due to the fact estrogens activate hepatic blood flow.
  • When used simultaneously with cyclosporine, the risk of toxicity increases.
  • Levonorgestrel affects the effectiveness of anticoagulants and hypoglycemic drugs.

What if I miss a dose?

If you missed taking 1 tablet of white color:

  • take the tablet as soon as you remember. The next tablet is taken at the usual time. It implies that you can take 2 tablets in 1 day.
  • you do not need to use the other contraceptive method during sexual intercourses.

If a consecutive application of 2 tablets of white color is missed during the 1st or 2nd week (from the first or second row of tablets):

  • apply 2 tablets as soon as you remember and 2 tablets – the next day.
  • then take 1 tablet a day before the end of the current package.

You can become pregnant if you have sex in the period of 7 days after missed tablets. It is necessary to use the barrier method of contraception during these 7 days.

If a consecutive intake of 2 tablets of white color is missed during the 3rd week:

  • do not take the tablets when you remember and do not complete the current packaging.
  • wait for other 5 days. This will be 1 week without taking the pills.
  • then, on the 8th day, start taking a new package, even if menstruation still takes place.

During the 7-day period without tablets and during the first 7 days of taking the tablets from the new package, use an additional barrier method of contraception.

If a consecutive intake of 3 or more white tablets is missed:

  • do not apply the tablets when you remember and do not complete the current packaging.
  • wait for another 4 days. This will be 1 week without taking the pills.
  • then, on the 8th day, start taking a new package.

During the 7-day period without tablets and during the first 7 days of taking the tablets from the new package, use an additional barrier method of contraception.

If you missed any of the 7 tablets brown during the 4th week:

  • throw away the missed tablets;
  • continue taking 1 tablet daily until packaging is complete;
  • You will not need an additional barrier method of contraception if you start taking a new package on time.

If you missed taking any tablet from the package, and the expected menstruation did not occur, visit a doctor. Do not take pills until you get permission from a doctor you are not pregnant.

Levora and pregnancy

Levora is contraindicated during pregnancy and breastfeeding. The trials conducted on women to specify the possible risks to the fetus have not shown the possible risk of developmental damages for the fetus.

In fact, it is better to withdraw the preparation at the moment you have a suspicion of pregnancy symptoms appearance.

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