Levosert (Levonorgestrel)

Levosert, containing levonorgestrel, is used as a hormonal contraceptive to prevent pregnancy.

• Contraception: Provides up to five years of highly effective reversible birth control.
• Post‑abortion contraception: Offers immediate, reliable contraception following surgical or medical abortion.
• Family planning: Enables long‑term pregnancy prevention without daily pill adherence.

• 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 induces thickening of cervical mucus, creating a barrier to sperm penetration, and causes endometrial atrophy, reducing the likelihood of implantation. The low, continuous local dose maintains these effects while minimizing systemic exposure through localized delivery.

Levosert may be associated with a range of adverse reactions, most of which are mild and resolve without intervention.

Common Side Effects

• Irregular bleeding: Unpredictable spotting or changes in menstrual pattern.
• Amenorrhea: Absence of menstrual bleeding.
• Pelvic pain: Discomfort in the lower abdomen.
• Headache: Mild to moderate tension‑type headaches.
• Breast tenderness: Sensitivity or swelling of the breasts.
• Mood changes: Slight fluctuations in mood or irritability.

Serious or Rare Side Effects

• Uterine perforation: Rare injury to the uterine wall during insertion.
• Ectopic pregnancy: Occurs if contraception fails and implantation is outside the uterus.
• Infection: Pelvic inflammatory disease following insertion.
• Allergic reaction: Severe hypersensitivity requiring medical attention.
• Device expulsion: Partial or complete loss of the IUS from the uterine cavity.

Before using Levosert, clinicians should evaluate patient history and follow recommended safety measures.

• Pregnancy status: Confirm the patient is not pregnant before insertion.
• Uterine abnormalities: Assess for fibroids, septum, or scarring that may impede placement.
• Infection risk: Treat active pelvic infections prior to insertion.
• Breastfeeding: Consider alternative contraception during early lactation if advised.
• Smoking: Advise cessation in women over 35 who smoke, due to increased cardiovascular risk.
• Storage: Store at ambient temperature below 25 °C: keep in original packaging, protect from moisture and direct sunlight.

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

Major Interactions (Avoid)

• Antiepileptic enzyme inducers (e.g., carbamazepine, phenytoin): May reduce levonorgestrel efficacy.
• Rifampin and other strong antibiotics: Potentially decrease hormone levels.

Moderate Interactions (Monitor Closely)

• Hormonal therapies (e.g., estrogen‑containing contraceptives): May increase overall hormone exposure.
• Antifungal azoles (e.g., ketoconazole): Can increase levonorgestrel concentrations.
• Herbal supplements (e.g., St. John’s wort): May modestly lower effectiveness.