Norlevo (Levonorgestrel)

• Norlevo, containing levonorgestrel, is used within the emergency contraception pathway to prevent unintended pregnancy after contraceptive failure.
• Unprotected intercourse: prevents pregnancy when taken within the recommended time frame after vaginal sex without effective contraception.
• Contraceptive failure: provides backup protection after a condom break or missed hormonal pill dose.
• Emergency post‑coital use: offers a non‑prescription option for women seeking rapid pregnancy prevention.

• Levonorgestrel exerts its effect by binding to progesterone receptors in the hypothalamic‑pituitary‑ovarian axis, thereby inhibiting or delaying the luteinizing hormone surge that triggers ovulation. By preventing the release of a mature oocyte, it reduces the chance of fertilization. If ovulation has already occurred, levonorgestrel may also impair tubal transport or alter endometrial receptivity, decreasing the likelihood of implantation.

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

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Headache: transient cranial pain.
• Fatigue: feeling of tiredness.
• Abdominal pain or cramps: mild pelvic discomfort.
• Menstrual changes: spotting or altered timing of next period.

Serious or Rare Side Effects

• Severe allergic reaction: rash, swelling, or difficulty breathing requiring immediate medical attention.
• Chest pain or palpitations: possible cardiovascular symptom needing evaluation.
• Persistent vomiting or severe abdominal pain: may indicate a serious complication.

• Before using Norlevo, consider the following precautions to ensure safe and effective use.
• Timing of administration: Take as soon as possible after unprotected intercourse, ideally within 72 hours.
• Contraindications: Known hypersensitivity to levonorgestrel or any tablet excipients.
• Pregnancy: Not indicated for an established pregnancy; it does not terminate an existing pregnancy.
• Breastfeeding: Consult a healthcare professional before use while breastfeeding.
• Drug interactions: Effectiveness may be reduced by enzyme‑inducing medicines such as certain antibiotics or anticonvulsants.
• Store at ambient temperature: keep in the original pack, protect from moisture and direct sunlight.

Levonorgestrel can interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Rifampicin (and other strong enzyme inducers): significantly reduces levonorgestrel effectiveness, increasing risk of pregnancy.
• Antiepileptic drugs such as phenytoin, carbamazepine, phenobarbital: may lower plasma levels and compromise emergency contraception.

Moderate Interactions (Monitor Closely)

• St. John’s Wort: herbal inducer that can diminish contraceptive effect.
• Antifungal azoles (e.g., ketoconazole, itraconazole): may increase levonorgestrel concentrations, potentially raising side‑effect risk.
• Efavirenz (HIV medication): may reduce levonorgestrel efficacy, requiring alternative contraception.