Norlevo (Levonelle)

Norlevo is an emergency contraception pill you can take when you have had unprotected sex. It works up to 72 hours after unprotected sex, but it is better to take it as soon as possible. Sometimes emergency contraception is necessary to prevent an unplanned pregnancy. This may be because usual contraception has failed or sex was not planned. Norlevo is a safe, reliable method for women to prevent pregnancy. You do not need a prescription for Norlevo pill.

What is Norlevo?

Norlevo is an emergency contraceptive pill that is used to prevent pregnancy in women who have had unprotected sex or whose birth control method has failed. It is sometimes referred to as the Norlevo ‘morning after pill’. This is a non-invasive and private treatment to avoid pregnancy.

You can take Norlevo in an emergency if you have forgotten to take your usual contraceptive pill, you are on the pill but have sickness and/or diarrhoea, or if a condom has broken or slipped off and you do not wish to get pregnant.

Norlevo is a progesterone-only emergency birth control pill. Progesterone is a hormone that a woman’s ovaries produce. Taking progesterone can prevent or delay the release of the egg (ovulation) which sperm fertilises to create a foetus

It comes as a 1 x Norlevo 1.5g tablet and you take it orally as soon as possible after having unprotected sex. You can take it up to 72 hours (3 days) after, but the chance of getting pregnant is less if you take Norlevo within 24 hours of having unprotected sex.

• You do not have to wait until the following morning after unprotected sex to take Norlevo. You should take it as soon as possible and within 72 hours;
• You do not need a prescription for Norlevo;
• It will reduce your chances of becoming pregnant if you have had unprotected sex.

Norlevo is not a form of contraception and must only be used in an emergency. It is a safe and effective way to prevent an unplanned pregnancy after unprotected sex. It is not a regular form of contraception. Norlevo will not prevent you against pregnancy if you have unprotected sex soon after taking it.

When is Norlevo used?

Norlevo is used to prevent pregnancy if a woman has had unprotected sex for any reason. Her current contraception method may have failed (forgetting to take the contraceptive pill, vomiting or diarrhoea while taking the contraceptive pill, having a contraceptive implant or contraceptive injection late, or a condom slipping off or splitting, not using the withdrawal method correctly). Or she may have had unprotected sex and be at risk of being pregnant (for example, sexual assault).

Norlevo morning after pill must be taken as soon as possible after unprotected sex and within 72 hours for it to be effective. You should take one tablet and the sooner you take it the less chance there will be of pregnancy. You do not have to wait until the next morning after unprotected sex to take Norlevo.

Sperm can survive for up to 5 days after sexual intercourse. If you do not ovulate during this time your egg will not be fertilised. Therefore it is difficult to know exactly when you are at your most fertile during your monthly cycle. The Norlevo pill prevents ovulation or the fertilised egg attaching itself to the uterus. It may also affect the lining of the womb, which reduces the chance of implantation. Norlevo does not terminate an established pregnancy (abortion), it prevents implantation or conception.

Norlevo does not protect you against sexually transmitted diseases (STDs).

Note that Norlevo should not be used as a regular birth control method. It is an emergency solution to prevent an unplanned pregnancy.

If you are not taking contraception but are having sex, even if only occasionally, it is advisable to use regular contraception if you do not want to start a family.

Norlevo is only intended as emergency contraception, it should not be used as regular contraception. Contraception methods to consider are:

• The contraceptive pill;
• The contraceptive injection;
• A contraceptive implant;
• An intrauterine system (IUS);
• An intrauterine device (IUD or coil);
• Condoms.

You should talk to your doctor or sexual health/family planning clinic about the contraceptive methods available to you.

How do you use Norlevo?

• Take 1 Norlevo 1.5mg tablet as soon as possible after unprotected sex and within 72 hours;
• As soon as you receive your Norlevo pill take it. Do not wait as it can be less effective after 24 hours of having unprotected sex;
• You can take Norlevo at any time during your menstrual cycle;
• Take the Norlevo pill with a glass of water. Do not chew it, swallow it whole.

Norlevo will not protect you against further unprotected sex during your cycle. It is not a method of contraception. If you have unprotected sex again after taking Norlevo you are at risk of getting pregnant.

Note that you do not take Norlevo before having sex as this will not prevent you from getting pregnant.

Norlevo is suitable for most adult women and girls under 16 to prevent an unwanted pregnancy. You can use Norlevo even if you are unable to take the combined contraception pill or contraceptive patch. You can take Norlevo after unprotected sex to prevent an unplanned pregnancy. Your risk of pregnancy reduces the sooner you take the Norlevo.

You can take Norlevo if you are breastfeeding. Small amounts of the hormones in the medication may pass into your breast milk, but it is believed this will not harm your baby. It is advisable to breastfeed immediately before taking Norlevo and not to feed again for at least 8 hours. You should express and discard your breast milk during these 8 hours. There is no increased risk of ectopic pregnancy after taking Norlevo.

Note that Norlevo does not protect you against sexually transmitted diseases (STDs).

What Dosages are there?

The dosage is 1 x Norlevo 1.5g tablet as soon as possible after unprotected sex and up to 72 hours after. Norlevo can be less effective after 24 hours of having unprotected sex.

Norlevo is also known as Levonelle and contains a synthetic version of the natural hormone progesterone, known as levonorgestrel. ‘It prevents approximately 84% of expected pregnancies when you take it within 72 hours of having unprotected sex’. Levenorgestrel has been extensively studied in women of reproductive age and is safe for use by all women, including adolescents’.

You can take Norlevo more than one in your cycle, but it is not advisable to use it as a regular method of contraception. It is only intended for emergencies. Note also the Norlevo could be less effective if used more than once in a cycle.

What are the Side Effects of Norlevo?

Some morning after pills had fairly serious side effects in the past. The Norlevo morning after pill contains similar hormones to the standard contraceptive pill but in a higher dose. Because of this higher dose, there may be some side effects when taking Norlevo.

However, it is unlikely you will experience any prolonged or serious side effects when you take the Norlevo pill. If you do experience any side effects they can appear up to 48 hours after taking the pill and are likely to be temporary.

These side effects could be:

• Headache;
• Stomache ache;
• Feeling sick;
• Dizziness;
• Fatigue;
• Breast tenderness.

Taking Norlevo may affect your menstruation cycle. Your next period may be late or early and may be heavier or more painful than usual. In addition, you can take Norlevo more than once in your cycle, and this is likely to upset it, but long-term use is not advisable. If you vomit within 3 hours of taking Norlevo you should take another tablet as the first is unlikely to have been digested. If you have any doubts speak to your doctor.

Once you have taken Norlevo you don’t need to see your doctor again. However, if you experience bleeding or spotting that seems different from your normal period and lasts longer than 7 days, if your period is lighter or shorter than usual, and/or you have any sudden stomach pain contact your doctor.

If you usually take the contraceptive pill and you do not have a period during the week you do not take the pill (after taking Norlevo) you should see your doctor to check you are not pregnant.

If you are overweight there is a possibility that Norlevo may not work for you. If you weigh over 70 kg or have a BMI (body mass index) of 30 or above you should take the advice of a doctor before taking the Norlevo as it may not be effective.

Does Norlevo Interact with other Medication?

When using liver enzyme-inducing substances such as anti-epileptics the effect of levonorgestrel is reduced. After you take Norlevo your should still take your regular contraception at the usual time if you use the contraceptive pill. In addition, you should use barrier methods (condoms) until after your next period. This is because when you are able to conceive depends on your own personal menstrual cycle. Before taking Norlevo ensure you are not allergic to any of the ingredients listed in the packet leaflet. You may also not be able to take Norlevo if you are asthmatic.

Some medications also interact with Norlevo such as:

• St. John’s Wort;
• HIV, epilepsy or tuberculosis medications.

Speak to your doctor before taking Norlevo if you are taking any other medication (including natural remedies) or are asthmatic.

When you request Norlevo you should also mention if:

• You have a disease of your small bowel (such as Crohn’s disease) that interferes with the way you digest your food You have severe liver problems;
• You have a history of ectopic pregnancy (where the baby develops outside the womb) You have a history of inflamed fallopian tubes (salpingitis).

Remember, Norlevo must not be used as a form of regular contraception. Neither will it continue to protect you against pregnancy after you have taken one tablet.

You should not use Norlevo if you are already pregnant. Taking Norlevo should not affect your future fertility. Note that you are unlikely to have any symptoms of pregnancy immediately after unprotected sex. If you have had unprotected sex and are worried you may be pregnant you should contact a doctor as soon as possible if you wish to avoid an unplanned pregnancy.

The sooner you take Norvlevo the more effective it will be. It is safe to drive and drink alcohol after taking Norlevo.

Can I get Norlevo without a Prescription?

Yes, you do not need a prescription for the Norlevo morning after pill. It is available over the counter at some pharmacies. You might also find it easier to order online rather than take time off to attend an appointment with your G.P. Norlevo price varies with different pharmacies, but make sure you always purchase medication from a regulated pharmacy.

You can get the morning after pill for free with a prescription. You should take your Norlevo pill immediately once you receive it as it will work better the sooner you take it.

References

Bayer plc. January 2010. Patient Information Leaflet. Retrieved from https://www.dokteronline.com/pils/en/patient_information_leaflet-286-levonelle-uk.pdf-1510755062.pdf

Fact sheet on the safety of levonorgestrel-alone emergency contraceptive pills (LNG ECPs). (n.d.). Retrieved November 21, 2018 from http://apps.who.int/iris/bitstream/handle/10665/70210/WHO_RHR_HRP_10.06_eng.pdf;jsessionid=612557E5B7E4DC929FDF3DAC0C971681

Morning-after pill. (n.d.). Retrieved November 21, 2018 from https://www.mayoclinic.org/tests-procedures/morning-after-pill/about/pac-20394730

Patient Information Leaflet: Levonelle-uk. (n.d.). Retrieved November 21, 2018 from https://downloads.dokteronline.com/leaflets/en/patient_information_leaflet-286-levonelle-uk.pdf-1510755062.pdf

The emergency contraceptive pill. (n.d.). Retrieved November 21, 2018 from https://www.nhs.uk/conditions/contraception/how-effective-emergency-contraception/#the-emergency-contraceptive-pill

‘The morning after pill’: four common myths debunked. (2017, March 22). Retrieved November 21, 2018 from https://www.mariestopes.org.au/your-choices/emergency-contraception-myths-debunked/

What is the morning-after pill? (updated 2019, January 15). Retrieved November 21, 2018 from https://www.medicalnewstoday.com/articles/304527.php

World Health Organization, 2010. Fact sheet on the safety of levonorgestrel-alone emergency contraceptive pills (LNG ECPs). Retrieved from http://apps.who.int/iris/bitstream/handle/10665/70210/WHO_RHR_HRP_10.06_eng.pdf