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Levonorgestrel Birth Control: Uses, Dosage, and Side Effects
Summary or Key Points
Levonorgestrel is a hormone commonly used in various forms of birth control and for managing gynecological conditions such as heavy menstrual bleeding and endometriosis. It is available in oral, intrauterine, and emergency contraceptive forms. Levonorgestrel works by preventing ovulation and altering the uterine lining. Always consult a healthcare provider before starting or adjusting your dose. You can schedule a telemedicine appointment with one of our providers for personalized advice.
Names of Medication
US Brand Names: Plan B One-Step, Mirena, Kyleena, Skyla, Liletta
Levonorgestrel is the generic name for this medication. The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer.
Pharmacologic Category
Progestins
Contraceptives
Hormonal agents
Levonorgestrel Dosage Guidelines
Levonorgestrel is used to treat a variety of conditions. Below are the dosing guidelines for each indication. Always consult your healthcare provider before making any changes to your dose. If you need further guidance, you can schedule a telemedicine appointment with one of our providers.
Unintended Pregnancy (Emergency Contraception)
Dose: 1.5 mg taken as a single dose within 72 hours of unprotected sex.
Frequency: One-time dose.
Length of Treatment: Single-use.
Contraception (Long-term)
Dose: Intrauterine device (IUD) releasing 20 mcg/day.
Frequency: Continuous release.
Length of Treatment: Up to 5 years, depending on the device.
Heavy Menstrual Bleeding
Dose: Intrauterine device (IUD) releasing 20 mcg/day.
Frequency: Continuous release.
Length of Treatment: Up to 5 years.
Endometriosis
Dose: Intrauterine device (IUD) releasing 20 mcg/day.
Frequency: Continuous release.
Length of Treatment: Up to 5 years.
Polycystic Ovary Syndrome (PCOS)
Dose: Oral contraceptive containing levonorgestrel 0.15 mg and ethinyl estradiol 30 mcg, taken daily.
Frequency: Once daily.
Length of Treatment: Continuous use as prescribed by your doctor.
Ovarian Cysts
Dose: Oral contraceptive containing levonorgestrel 0.15 mg and ethinyl estradiol 30 mcg, taken daily.
Frequency: Once daily.
Length of Treatment: Continuous use as prescribed by your doctor.
Uterine Fibroids
Dose: Intrauterine device (IUD) releasing 20 mcg/day.
Frequency: Continuous release.
Length of Treatment: Up to 5 years.
Hormonal Imbalance
Dose: Oral contraceptive containing levonorgestrel 0.15 mg and ethinyl estradiol 30 mcg, taken daily.
Frequency: Once daily.
Length of Treatment: Continuous use as prescribed by your doctor.
Premenstrual Syndrome (PMS)
Dose: Oral contraceptive containing levonorgestrel 0.15 mg and ethinyl estradiol 30 mcg, taken daily.
Frequency: Once daily.
Length of Treatment: Continuous use as prescribed by your doctor.
Dosage Forms and Strengths
Oral tablet: 1.5 mg (emergency contraception)
Intrauterine device (IUD): 13.5 mg, 19.5 mg, 52 mg (long-term contraception and treatment of heavy menstrual bleeding)
Oral contraceptive (combined with ethinyl estradiol): 0.15 mg/30 mcg
Administration Instructions for Levonorgestrel
Levonorgestrel can be taken orally or administered via an intrauterine device (IUD), depending on the condition being treated. For emergency contraception, take the oral tablet as soon as possible after unprotected sex. For long-term contraception or treatment of conditions like heavy menstrual bleeding, your healthcare provider will insert the IUD. Always follow your doctor’s instructions carefully and consult them if you have any questions. You can also speak with one of our providers through telemedicine for further guidance.
Levonorgestrel Side Effects and Adverse Reactions
Like all medications, levonorgestrel may cause side effects. Some are common and mild, while others are rare but more serious. If you experience any side effects, contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers for advice.
Common Side Effects (affecting more than 1 in 10 people)
Nausea: Feeling sick to your stomach, especially after taking emergency contraception.
Headache: Mild to moderate headaches may occur.
Irregular bleeding: Spotting or changes in your menstrual cycle.
Less Common Side Effects (affecting 1 in 100 to 1 in 10 people)
Breast tenderness: Soreness or discomfort in the breasts.
Dizziness: Feeling lightheaded or faint.
Abdominal pain: Cramping or discomfort in the stomach area.
Rare Side Effects (affecting fewer than 1 in 1,000 people)
Severe allergic reaction: Rash, itching, swelling, or difficulty breathing. Seek medical attention immediately.
Blood clots: Rare but serious risk, especially in women with certain risk factors.
Ectopic pregnancy: A pregnancy that occurs outside the uterus, which can be life-threatening.
Contraindications for Levonorgestrel
A contraindication is a specific situation or condition in which a medication should not be used because it may be harmful to the patient. It’s important to understand these situations to avoid potential health risks. Below are the contraindications for taking Levonorgestrel:
Known or suspected pregnancy: Levonorgestrel is not intended for use during pregnancy. It will not terminate an existing pregnancy and may cause complications if taken while pregnant.
Hypersensitivity to Levonorgestrel or any of its components: If you have had an allergic reaction to Levonorgestrel or any ingredients in the medication, you should avoid taking it to prevent severe allergic reactions.
Unexplained vaginal bleeding: If you experience abnormal or unexplained vaginal bleeding, Levonorgestrel should not be used until the cause of the bleeding is identified by a healthcare provider.
Severe liver disease: Levonorgestrel is metabolized by the liver, and taking it with severe liver disease can lead to further liver damage or improper processing of the medication.
If you have any of these conditions, it’s important to consult with one of our healthcare providers through telemedicine to discuss alternative options.
Drug to Drug Interactions with Levonorgestrel
Certain medications can interact with Levonorgestrel, potentially reducing its effectiveness or increasing the risk of side effects. Below are some common medications that may interfere with Levonorgestrel:
- Rifampin (Rifadin): This antibiotic can decrease Levonorgestrel’s effectiveness by accelerating its breakdown in the liver.
- Carbamazepine (Tegretol): This anti-seizure medication can also speed up Levonorgestrel’s metabolism, making it less effective.
- Phenytoin (Dilantin): Another anti-seizure drug that reduces Levonorgestrel’s effectiveness by increasing its breakdown in the liver.
- St. John’s Wort: This herbal supplement can interfere with Levonorgestrel by enhancing its metabolism, reducing its effectiveness.
Always inform your healthcare provider about any medications or supplements you are taking before starting Levonorgestrel. If you’re unsure, consult one of our providers through telemedicine for personalized guidance.
Levonorgestrel and Pregnancy
Is it Safe to Take Levonorgestrel During Pregnancy?
No, Levonorgestrel is not safe to use during pregnancy. It is designed to prevent pregnancy and will not be effective if you are already pregnant. Taking Levonorgestrel while pregnant may lead to complications. If you suspect you are pregnant, contact a healthcare provider immediately. Our telemedicine providers are available to help you determine the best course of action.
Levonorgestrel While Breastfeeding
Is it Safe to Take Levonorgestrel While Breastfeeding?
Yes, Levonorgestrel is generally considered safe while breastfeeding. Only small amounts of the hormone pass into breast milk, and it is unlikely to affect your baby. However, it’s always a good idea to consult a healthcare provider before taking any medication while breastfeeding. You can schedule a telemedicine appointment with one of our providers to discuss your specific situation.
Estimated Cost of Levonorgestrel
The estimated cost of a 30-day supply of Levonorgestrel without insurance, using a GoodRx coupon, ranges from $10 to $50, depending on the pharmacy and location. Prices can vary, so check with your local pharmacy or use a coupon service like GoodRx to find the best price.
Possible Alternatives to Levonorgestrel
If Levonorgestrel is not suitable for you, there are alternative treatments and lifestyle changes that may help manage your condition. Discuss these options with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to help you explore these alternatives.
- Unintended pregnancy: Alternatives include other emergency contraception options, such as ulipristal acetate (Ella), or long-term contraceptive methods like intrauterine devices (IUDs) or birth control pills.
- Endometriosis: Hormonal therapies, such as GnRH agonists, birth control pills, or progestin-only treatments, may provide relief. Surgery may be considered for more severe cases.
- Menstrual disorders: Hormonal birth control, nonsteroidal anti-inflammatory drugs (NSAIDs), or lifestyle changes like diet and exercise can help regulate menstrual cycles.
- Contraception: Alternatives include barrier methods (condoms, diaphragms), hormonal contraceptives (pills, patches, rings), or long-acting reversible contraceptives (IUDs, implants).
- Heavy menstrual bleeding: Hormonal IUDs, birth control pills, or medications like tranexamic acid (Lysteda) can help reduce heavy bleeding.
- Polycystic ovary syndrome (PCOS): Lifestyle changes, such as weight loss and exercise, along with medications like metformin or hormonal birth control, can help manage symptoms.
- Ovarian cysts: Birth control pills or other hormonal treatments may help prevent new cysts. Surgery may be necessary for larger cysts.
- Uterine fibroids: Medications like GnRH agonists, hormonal IUDs, or surgery (myomectomy or hysterectomy) may be recommended depending on the severity of symptoms.
- Hormonal imbalance: Hormonal therapies, lifestyle changes, and stress management can help restore balance. A healthcare provider can guide you on the best approach.
- Premenstrual syndrome (PMS): Lifestyle changes, such as regular exercise, a balanced diet, and stress management, along with medications like NSAIDs or hormonal birth control, can help alleviate symptoms.
Recent Updates on Levonorgestrel Research
Recent research on Levonorgestrel has focused on its long-term safety and effectiveness, particularly in the form of intrauterine devices (IUDs) for contraception and the treatment of heavy menstrual bleeding. Studies show that Levonorgestrel-releasing IUDs are highly effective in reducing menstrual blood loss and providing long-term contraception for up to 5 years. Ongoing research is also exploring Levonorgestrel’s use in managing conditions like endometriosis and uterine fibroids, with promising results in reducing symptoms and improving quality of life.
As new studies emerge, staying informed is important. If you have concerns about Levonorgestrel or want to discuss the latest research, our telemedicine providers are available to answer your questions and provide personalized advice.
