Levest

Levest

Levest tablets are combined pills that contain two active ingredients. The first ingredient is ethinyl estradiol, which is a synthetic version of the female sex hormone, estrogen. More information

A doctor will review your order and write you a prescription, if appropriate. This prescription is then forwarded to a pharmacy. The pharmacy will have your medicine delivered to you within one to three working days. Read more about this process here.

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Instruction costs (includes consult & service fee)
Service – Instruction costs (includes consult & service fee)
Patient Leaflet(s)

Levest is a form of combined contraceptive pill. Levest is called a combined pill because it uses two synthetic versions of natural hormones in the female body. These hormones are ethinyl estradiol, which is a hormone based on estrogen, and levonorgestrel, which is similar to progestogen.  

What is Levest? 

Levest tablets are combined pills that contain two active ingredients. The first ingredient is ethinyl estradiol, which is a synthetic version of the female sex hormone, estrogen. The second ingredient is levonorgestrel, which is the synthetic version of progesterone. When taken regularly, these two substances work in the same way as the naturally occurring hormones in the female body.  

Combined pills like Levest work by over-riding the natural female menstruation cycle. That means that your ovaries are prevented from releasing an egg as normal at the end of each month. Pills like Levest can also increase the thickness of the natural mucus at the neck of the womb. This makes it harder for sperm to cross over from the vagina during sex.  

Levest can reduce the thickness of the womb lining, creating a less hospital environment for fertilized eggs to attach to.  

When is Levest used? 

Like similar combined contraceptive pills, Levest is usually prescribed to women who want to avoid unplanned pregnancy. Levest can help to prevent pregnancy when it is taken regularly according to the instructions provided on the packet. However, it will not protect against other side effects of unprotected sex, such as sexually transmitted infections.  

Aside from using Levest to prevent unplanned pregnancy, some women also take it when they have problems with particularly heavy and irregular bleeding during the menstrual cycle. Taking the combined pill can sometimes contribute to more regular and less painful periods.  

Levest is similar to other combined pills that contain 30 micrograms of ethinyl estradiol, and 150 micrograms of levonorgestrel. It is typically prescribed for younger women under the age of 35 who do not have a history of any major health problems. It will not be suitable for people with a higher risk of blood clots.  

How do you use Levest? 

Similar to other combined contraceptive pills, Levest works best when it is taken at the same time every day. You will need to continuously take Levest each day for a period of 21 days to protect against pregnancy. When you follow the instructions provided by your consultant and the patient leaflet that comes with Levest, it is 99% effective. Sometimes, vomiting, diarrhea, and missing pills can reduce the efficacy of this pill, however.  

Levest comes in a packet that is marked with the days of the week. You will need to take one pill at the same time every day for a period of 21 days. You can then follow the 21 day period with a seven day break when you don’t take any pill. During your break, you might notice a bleed that is similar to your typical period. You will still be protected against pregnancy during your break if you have been using this medication correctly.  

After your seven day break is up, you will need to start your next pill pack. Women can begin taking Levest at any time during their menstrual cycle. If you have regular periods and you begin on the first five days of your period, you should be protected against pregnancy immediately, and you will not need to use additional contraception. If you begin using Levest at any other time in your cycle, you will need to use additional contraception for the first seven days.  

What dosages are there? 

Levest needs to be taken for a period of 21 days continuously, followed by a break of seven days where you will not take any pills. The usual dose for this medication is a single tablet taken once per day. Your doctor will recommend taking your pill at the same time every day to ensure that you get the best results from it. 

If you miss a dose of Levest, then take it as soon as you remember. If you take the pill under 12 hours of when it is due then you are still protected, however if you take it later than 12 hours then you are not protected for 7 days and need to use barrier contraceptives.  

What are the side effects of Levest? 

Many medications, including Levest can come with unintended side effects as well as the effects that are intended. The most common side effects of the combined pill will tend to diminish over time after your body gets used to the regular dose of hormones. However, if any common side effects like the following persist or worsen, you should contact your doctor: 

  • Feeling sick or nauseous; 
  • Breast pain or tenderness; 
  • Slight bleeding between periods; 
  • Abdominal or stomach pain; 
  • Headaches; 
  • Lighter periods or no periods; 
  • Mood changes like stress and anxiety; 
  • Fluid retention that appears like weight gain. 

Other possible side effects of can be more significant, including a rise in your blood pressure, a change in your sex drive, and sometimes skin reactions. One of the more rare but serious side effects of taking a combined pill like Levest is that your risk of getting a blood clot is increased.  A blood clot in an artery can heighten your risk of having a heart attack or stroke. Alternatively, a blood clot in a vein can cause issues like pulmonary embolisms and deep vein thrombosis.  

The risk for the average person taking Levest to get a blood clot is relatively low. However, you might have a slightly higher risk of you are immobile for extended periods of time. If you are unable to move after an accident or surgery for a period of several months, then it might not be safe to take Levest. Some people who travel extensively can also have a higher risk of blood clots. Doctors will sometimes recommend using other strategies to reduce your risk of blood clots if you are a frequent traveler using Levest  

When shouldn't you use Levest? 

While Levest is a generally well-tolerated combined contraceptive pill, it will not be the most suitable solution for everyone. You will not be able to take this medication if you have specific issues in your medical history. It is important to answer any questions that your consultant has for you truthfully before you begin using this medication.  

Levest is not suitable for people over the age of 35 who smoke or have a BMI of more than 35. You will also not be able to take this medication if you have ever had a blood clot in your vein or artery before, or you have a history of very high blood pressure. People with heart conditions and blood disorders that increase their risk of blood clots may not be safe to take Levest.  

Your consultant may recommend an alternative form of contraception if you have severe diabetes with complications that affect the nerves, kidneys or eyes, or if you have ever suffered from migraines with an aura. You may also not be able to take this medication if you have ever had breast cancer, certain liver disease, or gall bladder disease. 

In some cases, your consultant will still prescribe this medication if you have had certain conditions in the past. However, they may need you to keep up-to-date with your doctor about your condition. For instance, people with high blood pressure and high cholesterol levels may still be able to take Levest with regular checkups. The same is true for people who use a wheelchair and those who have Crohn’s disease or a history of migraines.  

Follow the instructions provided by your consultant on how to take Levest safely to make sure that your risk of dangerous side effects is as low as possible.  

Does Levest interact with any other medications? 

Levest and other combined pills may sometimes interact with the other medications that you are using to handle various conditions. Before you begin using any new medication, it is important to tell your consultant about any substances that you are already taking. This includes making sure that your doctor is aware of any prescription pills you are taking, over the counter medications, or herbal remedies. Some of the medications that Levest can interact with: 

  • Certain medications for HIV such as nevirapine; 
  • Some antiepileptic medications like carbamazepine; 
  • Antibiotics like rifampicin and rifabutin for tuberculosis; 
  • Modafinil for narcolepsy; 
  • Herbal remedies like St John’s Wort; 
  • The antifungal medication Griseofulvin. 

If you are prescribed any of the medications above for a short period of time, then you may need to ask your doctor or consultant whether you will still be protected from pregnancy when you are using those medications. Remember, antibiotics other than the ones mentioned above are unlikely to make Levest less effective, unless you have vomiting or diarrhea when using them. If you have diarrhea or vomiting when Levest, you will need to ask your doctor whether you need additional forms of contraception.  

The morning after pill known as EllaOne can sometimes make Levest less effective. If you use this emergency contraception when you’re using the combined pill, you will need an extra form of protection for at least 14 days after use of EllaOne.  

Where can you buy Levest? 

You can purchase Levest online after completing a full consultation with one of our experts. We will require a recent blood pressure check. We can have a prescription sent to a pharmacy for you within 3 working days.  

Can you get Levest without a prescription?  

Because Levest is not suitable for everyone it is not available without a prescription. You will need a consultation to get this medication.  

Sources 

Medicines.org, online, 2019, “Levest 150/30 microgram Coated Tablets” [Accessed 3rd of December 2019], Available on: https://www.medicines.org.uk/emc/product/9565/smpc 

Mims.co.uk, 2019, online, “Levest” [Accessed 3rd of December 2019], Available on: https://www.mims.co.uk/drugs/contraception/combined-contraceptives/levest 

Nhs.uk, online, 2019, “Combined pill”, [Accessed 3rd of December 2019], Available on: https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/ 

Assessed by:

Dr Imran Malik, General practitioner
Registration number: GMC: 4741365

Dr Imran Malik studied undergraduate medicine at King's College University in Central London and clinical studies at the prestigious King's College Hospital. He graduated with a MBBS degree in 2000 and went on to gain postgraduate memberships with the Royal Society of Medicine and also General Practice in 2006.