Levonorgestrel prices

How does levonorgestrel work?

Levonorgestrel is a progestogen hormone which delays the hormone change that triggers egg release (ovulation) and so reduces the chance of pregnancy after sex.

If ovulation has already happened, levonorgestrel may not work. This is why it should be taken as soon as possible after unprotected sex.

It can be used up to 72 hours (3 days) after sex, but is most effective when taken early.

Levonorgestrel is intended for occasional emergency use and does not replace regular contraception.

Levonorgestrel is a generic medicine; it contains the same active ingredients as branded Levonelle and is equally effective. Available branded as Levonelle at a higher cost.

How to take levonorgestrel

Take one levonorgestrel tablet by mouth as soon as possible after unprotected sex.

It should be taken no later than 72 hours after sex.

If vomiting occurs within 3 hours, a repeat dose should be taken.

Women with a BMI (Body Mass Indicator) result of 26 or above, or over 70kg, should either take two levonorgestrel tablets at the same time (a double dose of 3g) or order ellaOne instead. Do not take a double dose of ellaOne - this has not shown to be more effective.

Taking a double dose, recommended by the CoSRH (College of Sexual and Reproductive Health), is 'off-label' and not mentioned in the patient information leaflet. If a medicine is used for an off-label (unlicensed) purpose, the manufacturer is not liable in case of adverse events and doctors take responsibility for the prescribing.

Levonorgestrel should not usually be used more than once in the same menstrual cycle without medical advice, as it may be less reliable and cause changes in your menstrual cycle.

Levonorgestrel should not be taken at the same time or in the same menstrual cycle as ellaOne, as they can prevent the other from working.

When not to take levonorgestrel

Do not take levonorgestrel if:

• You are allergic to levonorgestrel or any of the ingredients in the tablet.
• You are already pregnant or think you may be pregnant.
• You have severe lactose intolerance.
• You need emergency contraception urgently and are relying on postal delivery.

Levonorgestrel cautions

Levonorgestrel may cause spotting or bleeding between periods, and your next period may arrive early or late and may be shorter or longer than usual. If your period is not 'normal' or it is more than 5 days late, or you have symptoms of pregnancy, then take a pregnancy test.

Levonorgestrel does not protect against sexually transmitted infections. If there is a risk of infection, arrange testing through a GP, pharmacist, or sexual health clinic for full checks.

There is no increased risk of ectopic pregnancy (pregnancy outside the uterus/womb) after taking a morning after pill. However, ectopic pregnancy can still occur. Take a pregnancy test and seek medical advice if there is unusual abdominal pain and vaginal bleeding 4-5 weeks after taking Levonelle as there is a chance these could be symptoms of an ectopic pregnancy.

If you have a condition that affects how your body absorbs medicines, such as Crohn’s disease or severe diarrhoea, Levonelle may be less effective, and a copper coil is a more reliable option.

Levonelle should not be taken if you have severe liver disease.

Levonorgestrel and other medicines

Some medicines can reduce how well levonorgestrel works. These include:

• Medicines often used to treat epilepsy (for example, primidone, phenytoin, and carbamazepine).
• Medicines used to treat tuberculosis (for example, rifampicin, rifabutin).
• Treatment for HIV (ritonavir, efavirenz).
• Medicine used to treat fungal infections (griseofulvin).
• Herbal remedies containing St John’s wort (Hypericum perforatum).

If you have used any of these medicines in the last 4 weeks, seek advice from a pharmacist, GP, or sexual health clinic. A copper coil is a more reliable form of emergency contraception for you. If this is not an option or unacceptable to you, you can take a double dose of levonorgestrel (TWO 1.5mg tablets at the same time).

Levonorgestrel should not be taken with cyclosporin, a medicine used to suppress the immune system.

It is unknown if GLP-1 weight loss medications such as Monjaro/ tirzapetide affect the morning after pill so the copper IUD (coil) is recommended if you are using these.

Possible side effects of levonorgestrel

Levonorgestrel has the potential to cause side effects, although these are usually not severe and do not occur in most cases. The commonest side effects are dizziness, nausea, mild lower abdominal pain, bleeding not related to periods and fatigue.

More information on the side effects of levonorgestrel can be found in the manufacturer's Patient Information Leaflet supplied with the medication.

Contraception and levonorgestrel

Levonorgestrel is a 'morning after pill' for emergency use AFTER unprotected intercourse. It should be used only when other contraception has not been used or has failed, not to replace routine regular contraception, which is more reliable and effective.

Women taking a contraceptive pill, who need to take levonorgestrel after missing one or more pills in a cycle, should NOT stop taking their contraceptive pill after taking levonorgestrel.

If using the contraceptive patch or vaginal ring, that should be started again immediately after taking levonorgestrel.

Start/restart the hormonal contraception within 12 hours. Use condoms as well for 7 days with the patch, the ring, and the combined pill (9 days condom use for Qlaira); Use condoms as well for 2 days with the progestogen-only pill (mini pill).

Long acting reversible methods of contraception (LARC) such as injections, implants, IUD (copper coil) and IUS (hormone coil) are the most reliable forms of contraception and may suit you better if you have found yourself in need of emergency contraception.

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