Understanding Levonorgestrel Oral Tablets: What They Are and How They Work

Have you ever been curious about what actions women take after having unprotected intercourse or failure of contraceptives? In India, emergency contraception measures are common and practical.

Among the most popular options for these are levonorgestrel oral tablets, which are affordable, effective, and generally safe. Commonly referred to as the 72-hour contraceptive pill, the tablets have gained a reputation as a solid backup against unplanned pregnancy.

This blog provides a detailed overview of levonorgestrel tablets, including their use, dosage, mechanism of action, cost, and safety considerations, enabling you to make informed decisions about your reproductive health.

Levonorgestrel is a man-made hormone that is mainly used as an emergency birth control. In India, it is considered the 72-hour contraceptive pill, and the pill is most effective when taken within 72 hours of having unprotected intercourse.

Primary Uses:

• Emergency contraception: Prevents unintended pregnancy after unprotected intercourse, missed birth control pills, or contraceptive failure such as a broken condom.
• Part of intrauterine devices (IUDs): Levonorgestrel is also used in hormonal IUDs for long-term birth control.
• Hormonal therapy: In some cases, it is prescribed for menstrual irregularities and endometriosis management.

The use of Levonorgestrel tablets is mainly centred on their functions in emergency contraception. It prevents the process of ovulation, delays the release of the egg, and also changes the lining of the uterus such that a fertilised egg does not implant easily. It is important to note that it is not an abortion pill, and it cannot work if pregnancy has already taken place.

The ordinary emergency birth control tablet contains a levonorgestrel 1.5 mg tablet. It is a single-dose form, convenient and intended to be used once after having unprotected sex.

• Take one levonorgestrel 1.5mg tablet as soon as possible, ideally within 24 hours, but it remains effective up to 72 hours.
• The sooner it is taken, the higher the success rate. Effectiveness is around 95% within 24 hours, decreasing slightly over time.
• Only one tablet is required per incident of unprotected intercourse.

• Swallow the tablet with water.
• No special preparation is required, but avoid vomiting within two hours of intake. If vomiting occurs, consult a doctor for advice on retaking the dose.
• It should not replace regular contraceptives and is not recommended for frequent use.

The affordability and accessibility of levonorgestrel in India are among the reasons why many use it as an emergency contraception.

• Levonorgestrel pills price varies depending on the brand, but they usually cost between ₹50 and ₹200 per tablet.
• Available without prescription in most pharmacies across India.
• Brands may differ in packaging and cost, but generally contain the same levonorgestrel 1.5 mg tablet formulation.

Marketed under the name of the contraceptive pills 72 or 72 contraceptive pill, levonorgestrel disrupts the natural cycle of the hormones. It acts primarily by:

• Delaying ovulation: Stops or delays the release of an egg from the ovary.

• Preventing fertilisation: Changes cervical mucus, making it harder for sperm to reach an egg.

• Preventing implantation: Alters the endometrium (uterine lining) to reduce the chance of implantation of a fertilised egg.

Important fact: Levonorgestrel cannot terminate an ongoing pregnancy. It is not identical to medical abortion pills such as Mifepristone and misoprostol.

One of the frequently asked questions by women is - ‘Will the 72-hour contraceptive pill still be effective if I take it even after three days?’ The answer to that depends on the pill, but it generally is not as effective. This may be because effectiveness reduces considerably within 72 hours. As such, you should try to take the pill as early as possible.

Levonorgestrel tablets are a very safe drug, but like all medications, they can cause some side effects, such as:

• Nausea or vomiting
• Fatigue or dizziness
• Headache
• Breast tenderness
• Irregular bleeding or changes in the menstrual cycle

Most side effects are mild and temporary, but here are the precautions to take:

• Women with certain health conditions should consult a doctor before use. This includes those with liver disease, unexplained vaginal bleeding, or allergies to levonorgestrel.

• It should not be used as a substitute for routine contraception. Overuse may cause menstrual irregularities.

• These do not protect against sexually transmitted infections (STIs).

Another vital point to note about levonorgestrel tablets is that studies and reviews show that it has no effect on fertility in the future. Once the drug comes out of the body, a woman can conceive normally in other cycles.