Levonelle one step

How do I take Levonelle one step?

• There is one tablet to be taken. It should be taken as soon as possible after unprotected sex, preferably within 12 hours and no later than 72 hours after.
• The tablet can be taken either with or without food.
• If you are sick within two hours of taking the tablet, another one should be taken immediately. You'll need to consult your doctor, pharmacist or family planning clinic for advice and to get another tablet.

Important information about Levonelle one step

• Levonelle one step cannot be sold from pharmacies to girls under 16 years of age except in exceptional circumstances. Girls under 16 who need the morning after pill are advised to consult a doctor, family planning clinic or casualty department at a hospital. Some minor injuries departments at hospitals also provide the morning after pill.
• Your pharmacist will ask about your last period and when you last had sex in order to make sure this medicine is suitable for you. This medicine can be used at any point during your menstrual cycle, apart from if your period is late. If your period is late, or your last period was more than five days late or unusually light or heavy, you should tell your pharmacist, as you may already be pregnant and this medicine will not work.
• This medicine might make your next period earlier or later than expected by a few days. If your next period after taking this medicine is more than seven days late, or is abnormal in any way, you should consult your doctor for a pregnancy test.
• This medicine will not always prevent a pregnancy. If you do get pregnant after taking this medicine there is a possibility that the pregnancy will be ectopic (occurring in the fallopian tubes rather than the womb). For this reason, you should consult your doctor if you experience any sudden or abnormal abdominal pain after taking this medicine, and if your next period is shorter or lighter than your normal period.
• The morning after pill doesn't provide continued contraception to prevent pregnancy after you have taken it. It is recommended that after taking it, you use a barrier method of contraception such as a condom or cap, until your next period comes. This is also recommended even if you are also taking the pill. You should talk ask your doctor, pharmacist or family planning clinic for advice about regular methods of contraception.
• This medicine should only be used as an emergency measure. It is not recommended for repeated use, as it is possible that it can disrupt your menstrual cycle.
• Emergency contraception does not protect you from sexually transmitted infections.

Who should not take Levonelle one step?

• Women who are or think they might already be pregnant (see below).
• Women with rare hereditary blood disorders called acute porphyrias.
• Women with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Levonelle one step tablets contain lactose).
• This medicine is not recommended for women who may be more at risk of ectopic pregnancy, for example women who have previously had inflammation or infection in the fallopian tubes (salpinigitis) or an ectopic pregnancy.
• This medicine is not recommended for women with severely decreased liver function.
• This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Levonelle one step should be used with caution by

• Women with severe malabsorption syndromes, such as Crohn's disease (as these may prevent the tablet being properly absorbed).

Can I take Levonelle one step while pregnant or breastfeeding?

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine should not be taken by women who are already pregnant. If you think you could be pregnant, if your period is late, or if your last period was more than five days late or unusually light or heavy, you should tell your doctor, as you may already be pregnant. Taking this medicine if you are already pregnant will not stop the pregnancy.
• Emergency contraception does not prevent a pregnancy in every instance. If this medicine doesn't work to prevent a pregnancy, it is not known to have adverse effects on a pregnancy that develops in your womb. However, there is a possibility that a pregnancy could be ectopic after taking the morning after pill, so you should consult your doctor immediately if you think you could be pregnant after taking it. Ask your doctor, pharmacist or family planning clinic for more information.
• Small amounts of this medicine pass into breast milk. If you need to take this medicine while you are breastfeeding this is not thought to be harmful to the nursing baby. However, you can minimise your baby's exposure to the medicine by taking the tablet immediately after giving a feed. By the time the next feed is due, the amount of medicine in the breast milk will then be reduced.

What are the possible side effects of Levonelle one step?

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Very common (affect more than 1 in 10 people)

• Headache.
• Feeling sick.
• Abdominal pain.
• Fatigue.
• Vaginal bleeding (not related to your normal period).

Common (affect between 1 in 10 and 1 in 100 people)

• Breast tenderness.
• Delayed start of next menstrual period (consult your doctor if your next period after taking this medicine is more than seven days late).
• Menstrual spotting or irregular bleeding.
• Diarrhoea.
• Vomiting.
• Dizziness.

Talk to your doctor, nurse or pharmacist if you want any more information about the possible side effects of this medicine.

Can I take Levonelle one step with other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you take this medicine, to make sure that the combination is safe.

The morning after pill may be less effective if you are taking any of the following medicines, because these medicines speed up the breakdown of levonorgestrel by the liver:

• aprepitant
• bosentan
• barbiturates
• carbamazepine
• crizotinib
• dabrafenib
• efavirenz
• eslicarbazepine
• fosaprepitant
• fosphenytoin
• griseofulvin
• nevirapine
• oxcarbazepine
• perampanel (12mg)
• phenobarbital
• phenytoin
• primidone
• rifampicin
• rifabutin
• ritonavir
• rufinamide
• the herbal remedy St John's wort (Hypericum perforatum)
• topiramate
• vemurafenib.

If you are taking any of these medicines regularly, you may be advised to have a copper coil (IUD) fitted as emergency contraception, as this is not affected by the medicines you are taking. An alternative would be to take two Levonelle tablets (ie a total dose of 3mg). This is an unlicensed use of the medicine. You should discuss your options with your doctor, pharmacist or family planning clinic.

This medicine may increase the blood levels of the following medicines and this could possibly increase the risk of their side effects:

• ciclosporin
• selegiline
• tizanidine
• voriconazole.

Ask your doctor or pharmacist for advice if you are taking any of these medicines.

Levonelle should not be taken together with an emergency contraceptive containing ulipristal (EllaOne). It won't have a combined effect with this; in fact EllaOne is likely to make Levonelle less effective.

References:

http://www.nhs.uk/conditions/contraception-guide/pages/emergency-contraception.aspx

http://www.netdoctor.co.uk/medicines/sexual-health/a8240/levonelle-one-step-levonorgestrel/

https://www.dred.com/uk/morning-after-pill-side-effects.html

https://www.medicines.org.uk/emc/medicine/16887/SPC/Levonelle+1500+microgram+tablet/

https://www.medicines.org.uk/emc/medicine/15361