Levosert (Levonorgestrel)

• Levosert (levonorgestrel) is a hormonal contraceptive that acts within the reproductive system to prevent pregnancy.
• Contraception (long‑acting reversible contraceptive): Provides continuous birth control for up to five years after insertion of the intrauterine system.

• Levonorgestrel released from the intrauterine system binds to progesterone receptors in the hypothalamus and pituitary, suppressing the luteinizing hormone surge and thereby inhibiting ovulation. The hormone also thickens cervical mucus, creating a barrier to sperm, and induces endometrial changes that reduce the likelihood of implantation. This localized release maintains effective contraceptive concentrations within the uterine cavity while keeping plasma levels low.

Levosert may be associated with a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Irregular bleeding or spotting: Unpredictable menstrual bleeding patterns, especially during the first six months.
• Cramps or pelvic pain: Mild to moderate discomfort in the lower abdomen.
• Headache: Transient headache episodes.
• Breast tenderness: Mild soreness or swelling of the breasts.
• Acne or skin changes: Occasional worsening of acne.

Serious or Rare Side Effects

• Uterine perforation: Rare injury to the uterine wall during insertion.
• Expulsion of the device: The IUS may be partially or completely expelled.
• Pelvic inflammatory disease: Infection that can affect reproductive organs.
• Allergic reaction: Severe hypersensitivity to levonorgestrel or device components.

Before using Levosert, certain precautions and warnings should be considered to ensure safe and effective use.

• Pregnancy status: Do not insert in women who are already pregnant; confirm negative pregnancy test prior to placement.
• Breastfeeding: Use with caution; discuss benefits and risks with healthcare provider.
• Uterine abnormalities: Evaluate for fibroids, septum, or scarring that may increase insertion complications.
• Infection risk: Treat any active pelvic infection before insertion.
• Copper IUD use: Not applicable; avoid concurrent use of other intrauterine devices.
• Store at room temperature: Keep in original packaging, protect from moisture and direct sunlight.

Levosert can interact with other medicines or substances that affect hormone metabolism or uterine environment.

Major Interactions (Avoid)

• Enzyme inducers (e.g., rifampin, carbamazepine, phenytoin): May reduce levonorgestrel levels, decreasing contraceptive efficacy.
• Antifungal agents (e.g., griseofulvin): Can lower hormone concentrations, risking failure.

Moderate Interactions (Monitor Closely)

• Antibiotics (e.g., tetracycline, metronidazole): May have a modest effect on hormone levels; monitor for breakthrough bleeding.
• Antiretroviral drugs (e.g., efavirenz): May slightly reduce efficacy; consider additional contraception.
• Herbal supplements (e.g., St. John’s wort): Potential enzyme induction; advise caution.