Levosert (Levonorgestrel)

Levosert, a levonorgestrel intrauterine system, is indicated for long‑acting reversible contraception in women of reproductive age.

• Contraception: Provides up to five years of highly effective pregnancy prevention.
• Endometrial suppression: Inhibits endometrial proliferation to maintain contraceptive efficacy.
• Cervical mucus thickening: Increases cervical mucus viscosity, reducing sperm motility and viability.

• Levosert releases levonorgestrel locally within the uterine cavity at approximately 20 µg per day. The hormone binds to progesterone receptors in the endometrium, leading to reduced endometrial growth, thickened cervical mucus, and impaired sperm motility. These combined actions create an environment that prevents fertilisation and may also suppress ovulation in some users, thereby providing reliable contraception.

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

Common Side Effects

• Irregular vaginal bleeding or spotting.
• Amenorrhea (absence of periods) after initial months.
• Pelvic or abdominal cramping.
• Headache.
• Breast tenderness.
• Mood changes.

Serious or Rare Side Effects

• Uterine perforation during insertion.
• Device expulsion or displacement.
• Pelvic inflammatory disease.
• Ectopic pregnancy if contraception fails.
• Severe allergic reaction (e.g., rash, swelling, anaphylaxis).

Before using Levosert, certain precautions should be observed.

• Pregnancy testing: Confirm non‑pregnant status prior to insertion.
• Infection screening: Evaluate for active pelvic infection and treat before placement.
• Uterine anomalies: Assess for structural abnormalities that may affect device positioning.
• Breastfeeding: Discuss benefits and potential risks with a healthcare professional.
• Follow‑up: Schedule a post‑insertion visit to verify correct placement and address any concerns.
• Store at ambient temperature: Keep in original packaging, protect from moisture and direct sunlight.

Levosert may have interactions with other medications that affect hormone levels or uterine health.

Major Interactions (Avoid)

• Rifampicin or other strong enzyme inducers: May reduce levonorgestrel efficacy.
• Anticonvulsants (e.g., carbamazepine, phenytoin): Can lower hormone concentrations, increasing risk of contraceptive failure.

Moderate Interactions (Monitor Closely)

• Hormonal therapies (e.g., estrogen‑containing contraceptives): May increase risk of thromboembolic events.
• Antifungal agents (e.g., griseofulvin): Potentially modest reduction in levonorgestrel levels.
• Antiretroviral drugs (e.g., efavirenz): May slightly decrease contraceptive effectiveness.
• Herbal supplements (e.g., St. John’s Wort): Possible induction of metabolism, requiring monitoring.