Levonorgestrel/Ethinylestradiol Morningside Healthcare (Ethinylestradiol, Levonorgestrel)

Levonorgestrel/Ethinylestradiol is a combined oral contraceptive that acts on the hypothalamic‑pituitary‑ovarian axis to prevent pregnancy.

• Prevention of pregnancy: provides reliable contraceptive protection for women of childbearing potential.
• Menstrual cycle regulation: helps achieve more predictable bleeding patterns.
• Management of androgen‑related acne: reduces sebum production and improves skin appearance.

• Ethinylestradiol and levonorgestrel work together to suppress the mid‑cycle luteinizing hormone surge, thereby inhibiting ovulation. The estrogen component stabilises the endometrial lining, while the progestogen thickens cervical mucus and alters the endometrium, creating conditions that prevent fertilisation and implantation.

Levonorgestrel/Ethinylestradiol may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Headache: tension‑type or migraine‑like.
• Breast tenderness: temporary swelling or discomfort.
• Spotting or breakthrough bleeding: irregular light bleeding.
• Weight gain: modest increase in body weight.
• Mood changes: irritability or emotional fluctuations.

Serious or Rare Side Effects

• Venous thromboembolism: deep‑vein thrombosis or pulmonary embolism.
• Hypertension: new‑onset or worsening high blood pressure.
• Hepatic adenoma: benign liver tumor.
• Gallbladder disease: gallstones or cholecystitis.
• Severe allergic reaction: rash, swelling, or anaphylaxis.
• Visual disturbances: sudden loss of vision or eye pain.

Before prescribing Levonorgestrel/Ethinylestradiol, clinicians should consider several safety factors.

• Smoking: avoid use in women over 35 who smoke due to increased cardiovascular risk.
• History of thrombosis: contraindicated in patients with prior venous or arterial clotting events.
• Hypertension: monitor blood pressure regularly.
• Liver disease: use with caution in active hepatic impairment.
• Migraine with aura: avoid because of elevated stroke risk.
• Store at ambient temperature: keep below 25 °C, in the original packaging, protected from moisture and light.

Levonorgestrel/Ethinylestradiol can interact with other medicines, altering its effectiveness or safety.

Major Interactions (Avoid)

• Antiepileptic enzyme inducers (e.g., carbamazepine, phenytoin): reduce contraceptive efficacy.
• Rifampin and other antimycobacterial agents: decrease hormone levels.
• Certain HIV protease inhibitors: may increase hormone concentrations.

Moderate Interactions (Monitor Closely)

• Antifungal azoles (e.g., ketoconazole): may raise hormone levels.
• St. John’s wort: potential reduction in effectiveness.
• Antibiotics (e.g., tetracycline): generally no significant effect, but monitor for breakthrough bleeding.