Norlevo (Levonorgestrel)

Levonorgestrel in Norlevo is used within the reproductive health pathway as an emergency contraceptive.

• Emergency contraception: reduces the risk of pregnancy when taken after unprotected sexual intercourse.
• Contraceptive failure: provides post‑coital protection following a known failure of barrier or hormonal methods.
• Post‑coital contraception: can be effective when administered within 72 hours of intercourse.

• Levonorgestrel binds to progesterone receptors in the hypothalamic‑pituitary‑ovarian axis, inhibiting or delaying the luteinising hormone surge and thereby preventing or postponing ovulation. It may also impair fertilisation by altering tubal motility and, in rare cases, affect implantation of a fertilised ovum, contributing to its emergency contraceptive effect.

Levonorgestrel is generally well tolerated, but a range of adverse reactions have been reported.

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Abdominal pain: cramping or discomfort in the lower abdomen.
• Fatigue: feeling unusually tired or weak.
• Headache: transient mild to moderate headache.
• Dizziness: occasional light‑headedness.
• Menstrual changes: spotting or altered timing of the next period.

Serious or Rare Side Effects

• Allergic reaction: rash, itching, swelling, or anaphylaxis.
• Severe abdominal pain: persistent or worsening pain.
• Unusual vaginal bleeding: heavy or prolonged bleeding.
• Liver dysfunction: rare signs of hepatitis or jaundice.
• Thromboembolic events: extremely rare clotting disorders.

When considering Norlevo, several safety measures should be observed.

• Timing of intake: take as soon as possible after intercourse, preferably within 72 hours.
• Contraindications: avoid if known hypersensitivity to levonorgestrel or tablet excipients.
• Medical conditions: use with caution in patients with liver disease or hormonal disorders.
• Drug interactions: be aware of enzyme‑inducing medicines that may lower effectiveness.
• Pregnancy testing: not indicated for an existing pregnancy; it does not terminate established pregnancies.
• Store at ambient temperature: keep below 25 °C, retain in the original pack, protect from moisture and direct sunlight.

Levonorgestrel may interact with other medicines, altering its efficacy.

Major Interactions (Avoid)

• Enzyme inducers (e.g., rifampicin, carbamazepine, phenytoin): may substantially reduce contraceptive effectiveness.
• Antifungal azoles (e.g., ketoconazole): can increase levonorgestrel plasma levels, raising risk of side effects.
• St. John's wort: strong inducer that may diminish drug activity.

Moderate Interactions (Monitor Closely)

• Anticonvulsants (e.g., valproate): may modestly affect hormone levels.
• Antiretrovirals (e.g., efavirenz): potential reduction in efficacy.
• Herbal supplements (e.g., ginseng): possible interaction affecting hormonal balance.