Levosert Two (Levonorgestrel)

• Levosert Two, containing levonorgestrel, is used in the hormonal contraceptive pathway to prevent pregnancy.
• Contraception (prevention of pregnancy): provides highly effective reversible birth control for women of reproductive age.
• Hormonal intrauterine device: maintains low local levonorgestrel concentrations to inhibit ovulation and alter cervical mucus.
• Long‑acting reversible contraception: eliminates the need for daily dosing and offers up to several years of protection.

• Levonorgestrel released from the intrauterine system acts locally on the endometrium, cervical mucus and hypothalamic‑pituitary axis. It suppresses ovulation, thickens cervical mucus to impede sperm passage, and induces endometrial changes that prevent implantation, thereby delivering sustained contraceptive effect without significant systemic exposure.

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

Common Side Effects

• Irregular vaginal bleeding or spotting
• Amenorrhea (absence of periods)
• Pelvic or uterine cramping
• Breast tenderness or mild pain
• Headache or mild migraine
• Mild abdominal discomfort

Serious or Rare Side Effects

• Uterine perforation during insertion
• Pelvic inflammatory infection
• Expulsion of the intrauterine system
• Ectopic pregnancy if contraception fails
• Severe allergic reaction to levonorgestrel

• Prior to insertion, clinicians should evaluate patient suitability and counsel on potential risks.
• Screen for contraindications: ensure no active pelvic infection, unexplained vaginal bleeding, or known hypersensitivity to levonorgestrel.
• Pregnancy testing: confirm the patient is not pregnant before device placement.
• Follow‑up visit: schedule a post‑insertion check to verify correct positioning.
• Avoid use in women with known uterine anomalies or severe fibroids.
• Store at room temperature: keep in original packaging, protect from moisture and direct sunlight.

Levosert Two may interact with other medicines that affect hormone metabolism.

Major Interactions (Avoid)

• Enzyme‑inducing anticonvulsants (e.g., carbamazepine) may reduce levonorgestrel efficacy.
• Rifampin therapy can lower hormone levels and increase risk of contraceptive failure.
• Certain antiretroviral protease inhibitors may alter levonorgestrel metabolism.

Moderate Interactions (Monitor Closely)

• Broad‑spectrum antibiotics such as tetracycline may slightly affect contraceptive reliability.
• Herbal supplements like St. John’s wort can reduce hormone concentrations.
• Antifungal azoles (e.g., ketoconazole) may increase levonorgestrel levels, requiring monitoring.