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Levonorgestrel

PLAN B

What it isProgestin; contraception, emergency contraception and the intrauterine system.

Why this oneThe intrauterine system gives years of contraception and treats heavy bleeding, and the emergency pill is available without prescription.

What limits itEmergency use is less effective with higher body weight and after ovulation. Irregular bleeding with the IUS.

FDA-approved for

FDA label

FDA dosingPopulationStartTargetMax
Emergency contraception (backup after unprotected sex or contraceptive failure)Females of reproductive potential1 tablet ASAP, within 72 hr1 tablet within 72 hr of unprotected sex1 tablet

Renal Undefined

Hepatic Undefined

Use within 72 hours of unprotected sex.

Instructions

Pregnancy Undefined

Lactation Undefined

NO BOXED WARNINGS

Principal riskEmergency use is less effective at higher body weight

Cost, est. cash$300–$2,500/month

Generic entry2009

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4
Overdose danger1 / 4
Weight-gain liability0 / 4
Sedation liability0 / 4
QT / Torsades0 / 4
Direct muscarinic antagonism0 / 4
Embryofetal risk0 / 4

Legacy pregnancy categoryX

Defining liabilityVenous thromboembolism and hormone-related adverse effects; estrogen also lowers lamotrigine exposure.

Mechanism of action: Levonorgestrel ballicule

Levonorgestrel ballicule: receptor binding, kinetics and half-life diagram

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Memory aids: mascots and interaction avatars

Levonorgestrel CYP3A4 substrate avatar
CYP3A4 substrate

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