Leverette 28 (Ethinylestradiol, Levonorgestrel | Lactose)

Leverette 28 is a combined oral contraceptive that acts on the hormonal regulation of the menstrual cycle to prevent unintended pregnancy.

• Contraception: prevents pregnancy in women of reproductive age.
• Menstrual cycle regulation: helps establish a regular monthly bleeding pattern.
• Acne management: may improve hormonal acne in some users.

• Ethinylestradiol and levonorgestrel bind to estrogen and progesterone receptors, respectively, suppressing the hypothalamic‑pituitary‑ovarian axis. This inhibition prevents the mid‑cycle surge of luteinizing hormone, thereby blocking ovulation. In addition, the progestin thickens cervical mucus and the estrogen component alters the endometrial lining, creating an environment hostile to fertilization and implantation.

Leverette 28 may cause a range of adverse reactions. Patients should be aware of both common and serious possibilities.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Headache: tension‑type or migraine‑like pain.
• Breast tenderness: swelling or discomfort of the breasts.
• Spotting between periods: light vaginal bleeding.

Serious or Rare Side Effects

• Blood clots: deep vein thrombosis or pulmonary embolism.
• Stroke: neurological deficits due to cerebrovascular occlusion.
• Severe allergic reaction: rash, swelling, or anaphylaxis.

Before prescribing Leverette 28, clinicians should evaluate individual risk factors and advise patients accordingly.

• Assess thromboembolic risk: review personal and family history of clotting disorders.
• Monitor cardiovascular health: avoid use in uncontrolled hypertension or smoking over age 35.
• Evaluate hepatic function: caution in patients with liver disease.
• Review medication history: certain enzyme‑inducing drugs may reduce effectiveness.
• Store at room temperature below 25°C: keep in the original pack, protect from moisture and light.

Leverette 28 can interact with several drug classes, altering its contraceptive efficacy or increasing adverse effects.

Major Interactions (Avoid)

• Antiepileptic enzyme inducers (e.g., phenytoin, carbamazepine, phenobarbital): markedly reduce hormone levels.
• Rifampin and other strong antibiotics: decrease contraceptive effectiveness.
• St. John's wort: herbal inducer that may compromise efficacy.

Moderate Interactions (Monitor Closely)

• Antifungal agents (e.g., ketoconazole, itraconazole): may increase hormone concentrations.
• HIV protease inhibitors (e.g., ritonavir): can affect hormone metabolism.
• Certain antidepressants (e.g., SSRIs): may modestly alter plasma levels.
• Ginkgo biloba: potential additive effect on bleeding risk.