Levonorgestrel Norfri (Levonorgestrel)

Levonorgestrel Norfri is a progestin that acts within the hormonal contraceptive pathway to prevent fertilisation.

• Emergency contraception: reduces the risk of pregnancy when taken shortly after unprotected intercourse.
• Pregnancy prevention: incorporated into hormonal regimens to inhibit ovulation and block fertilisation.
• Hormonal contraceptive regimen: used as a progestin‑only component in combined or standalone birth‑control pills to maintain contraceptive efficacy.

• Levonorgestrel binds to progesterone receptors in the hypothalamus and pituitary, suppressing the luteinising hormone surge required for ovulation. It also thickens cervical mucus, creating a barrier that impedes sperm penetration, and alters the endometrial lining to reduce the likelihood of implantation.

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

Common Side Effects

• Nausea: mild to moderate stomach upset after ingestion.
• Headache: transient tension‑type headaches.
• Breast tenderness: temporary discomfort or swelling of breast tissue.
• Irregular bleeding: spotting or changes in menstrual flow.
• Fatigue: feeling unusually tired.
• Mood changes: brief fluctuations in mood or emotional state.

Serious or Rare Side Effects

• Thromboembolic events: rare blood clot formation in veins or arteries.
• Severe allergic reaction: anaphylaxis presenting with rash, swelling, or breathing difficulty.
• Liver dysfunction: abnormal liver enzymes or jaundice.
• Ectopic pregnancy: implantation outside the uterus if fertilisation occurs despite contraception.
• Persistent high blood pressure: sustained elevation requiring medical attention.

Before using Levonorgestrel Norfri, consider the following safety measures.

• Medical history review: assess for prior thromboembolic disease, liver disorders, or hormone‑sensitive cancers.
• Concurrent medications: evaluate for drugs that may reduce contraceptive effectiveness, such as enzyme inducers.
• Timing of administration: take as soon as possible after unprotected intercourse for optimal emergency effect.
• Pregnancy testing: avoid use if a confirmed pregnancy already exists.
• Breastfeeding: discuss potential risks with a healthcare professional before use.
• Store at ambient temperature below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Levonorgestrel can interact with several medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Enzyme inducers (e.g., rifampicin, carbamazepine, phenytoin): may markedly reduce contraceptive effectiveness.
• Antifungal azoles (e.g., ketoconazole): can increase levonorgestrel plasma levels, raising side‑effect risk.
• Protease inhibitor antiretrovirals: may alter hormone metabolism and affect efficacy.

Moderate Interactions (Monitor Closely)

• Certain antibiotics (e.g., ampicillin): may slightly diminish contraceptive reliability.
• Anticonvulsants (e.g., valproate): may have a moderate impact on hormone levels.
• Herbal supplements (e.g., St. John’s wort): can reduce levonorgestrel effectiveness.