Levosert One (Levonorgestrel)

Levosert One, a levonorgestrel‑based intrauterine system, is indicated for hormonal contraception.

• Contraception: provides up to five years of reliable pregnancy prevention.
• Heavy menstrual bleeding: may reduce menstrual blood loss and the need for additional therapy.
• Dysmenorrhea: can lessen menstrual pain associated with prostaglandin‑mediated cramps.

• Levosert One releases levonorgestrel locally within the uterine cavity at approximately 20 µg per day. The progestin binds to progesterone receptors in the endometrium, cervical mucus, and tubal epithelium, producing a thickened cervical mucus barrier, inhibiting sperm motility and viability, suppressing endometrial proliferation, and occasionally preventing ovulation, thereby creating a multifactorial contraceptive effect.

Levosert One may be associated with a range of adverse reactions.

Common Side Effects

• Irregular vaginal bleeding or spotting.
• Amenorrhea (absence of periods).
• Cramping or pelvic discomfort after insertion.
• Insertion‑related pain.
• Hormonal changes such as breast tenderness.
• Headache or mild nausea.

Serious or Rare Side Effects

• Uterine perforation during insertion.
• Expulsion or displacement of the device.
• Pelvic inflammatory disease or severe infection.
• Ectopic pregnancy if contraception fails.
• Device migration to adjacent organs.
• Severe allergic reaction to device components.

Prior to insertion, clinicians should assess patient suitability and counsel on potential risks.

• Pregnancy screening: confirm the patient is not pregnant before placement.
• Uterine anomalies: avoid use in women with known congenital uterine malformations.
• Active infection: contraindicated in the presence of pelvic inflammatory disease or genital infections.
• Malignancy: not recommended for patients with estrogen‑dependent cancers.
• Follow‑up: schedule a post‑insertion check to verify correct positioning.
• Storage: Store at below 25 °C: keep in the original packaging, protect from moisture and direct sunlight.

Levonorgestrel released from an intrauterine system can be affected by certain concomitant medicines.

Major Interactions (Avoid)

• Rifampicin, carbamazepine, phenytoin, or St. John’s wort: potent enzyme inducers that may lower levonorgestrel levels.
• Antiretroviral efavirenz: may reduce contraceptive efficacy.
• High‑dose enzyme‑inducing anticonvulsants: can compromise hormonal protection.

Moderate Interactions (Monitor Closely)

• Ketoconazole or other azole antifungals: may increase levonorgestrel exposure.
• Phenobarbital: moderate enzyme induction requiring monitoring.
• Certain herbal supplements (e.g., ginseng): may alter hormone metabolism.