Norlevo (Levonorgestrel)

Norlevo, a progestogen emergency contraceptive, is used to intervene in the reproductive cycle after a potential fertilisation event.

• Unprotected sexual intercourse: prevents pregnancy when taken within the recommended time window.
• Contraceptive failure: provides backup protection after missed pills or condom breakage.
• Delayed ovulation: reduces the likelihood of egg release and subsequent fertilisation.

• Levonorgestrel binds to progesterone receptors in the hypothalamic‑pituitary‑ovarian axis, suppressing the luteinising hormone surge required for ovulation. By preventing or delaying the release of an oocyte, it reduces the chance of fertilisation. If ovulation has already occurred, levonorgestrel may alter tubal motility or endometrial receptivity, potentially inhibiting implantation of a fertilised egg.

Norlevo may cause a range of adverse reactions, most of which are mild and self‑limiting.

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Headache: transient cranial discomfort.
• Fatigue: feeling of tiredness.
• Dizziness: occasional light‑headedness.
• Abdominal pain: cramping or discomfort.
• Menstrual changes: spotting or altered timing.

Serious or Rare Side Effects

• Severe allergic reaction: rash, swelling, or difficulty breathing.
• Persistent vomiting: may impede absorption of the tablet.
• Ectopic pregnancy: rare but serious if pregnancy occurs.
• Thromboembolic events: extremely rare clot formation.
• Liver dysfunction: abnormal liver enzymes in rare cases.

Before using Norlevo, consider the following safety measures.

• Timing: take as soon as possible after the contraceptive incident, ideally within 72 hours.
• Repeated use: avoid using emergency contraception frequently; consider regular contraceptive methods.
• Medical conditions: disclose any history of thromboembolic disorders, liver disease, or hormonal cancers.
• Medication review: inform healthcare provider of current drugs, especially enzyme‑inducing agents.
• Pregnancy testing: if menstrual period is delayed beyond a week, consider testing.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture and direct sunlight.

Levonorgestrel may interact with other medicines, affecting its efficacy or safety.

Major Interactions (Avoid)

• Rifampicin, carbamazepine, phenytoin, or St. John's wort: may markedly reduce levonorgestrel effectiveness.
• Antifungal agents (e.g., griseofulvin): can lower plasma concentrations.

Moderate Interactions (Monitor Closely)

• Antiretroviral drugs (e.g., efavirenz): may modestly decrease efficacy.
• Hormonal therapies (e.g., combined oral contraceptives): may alter hormonal balance.
• Herbal supplements (e.g., ginseng): potential for reduced effectiveness.
• Seizure medications (e.g., phenobarbital): may affect metabolism.
• Certain antibiotics (e.g., ampicillin): limited evidence of interaction, monitor pregnancy outcome.