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Levonorgestrel (Generic PLAN B®), Emergency Contraceptive - Application & Dosage

[Levonorgestrel 1.5mg]

Introduction

The generic of this medication is: Levonorgestrel 1.5mg
Other similar brand names are: Aftera, EContra, Fallback Solo, My Choice, My Way, New Day, Next Choice One Day, Opicon One-Step, React, Take Action
This emergency contraceptive plan reviews the risks and benefits of the treatment we are recommending. Please make sure to read it and the manufacturer's pamphlet that comes with the medicine. The manufacturer's pamphlet contains the full information on interactions, side effects, and other important information you should know about the medicine before you start. 

Instructions

You have stated that you wish to take an emergency contraception pill to prevent pregnancy after contraception failure. This medication is a progestin-only form of Emergency contraceptive. Emergency contraception is about 75 to 85 percent effective in preventing fertilization and implantation process of contraception when used within 72 hrs of contraception failure. 
This medication may be used at any time during the menstrual cycle: Single-dose regimen: One 1.5 mg tablet as soon as possible within 72 hours of unprotected sexual intercourse, or failure or contraception such as missed oral contraception pills, condom breakage. Routine contraceptive measures should be initiated or continued following use to ensure ongoing prevention of pregnancy. 
Any regular contraceptive method can be started immediately after levonorgestrel; however, a barrier method (or abstinence from sexual intercourse) is also needed for 7 days.
Do not use if you are already Pregnant, This medication is not intended to be used for routine contraception and is not effective in terminating an existing pregnancy.

Refills

One-time replacement doses may be ordered over the counter, but patients should not self-administer within 30 days of previously taking Plan B.

Active Ingredient

  • Levonorgestrel

Allergies/Contraindications

True anaphylactic allergic reactions to oral contraception are extremely rare because the active ingredients in these medications mimic naturally occurring hormones in your body. However, these medications do have other ingredients that may cause allergic reactions. If you experience any of the symptoms below, you should immediately go to the emergency room or call 911. 
  • Allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
There are several contraindications to taking hormonal combined contraception. If you have any of the following conditions please let your doctor know prior to starting medication
  • Adrenal insufficiency
  • Current or history of estrogen or progesterone sensitive cancer
  • Hepatic tumors
  • Pregnancy
  • Renal impairment
  • Undiagnosed abnormal uterine bleeding
  • Taking hepatitis c drugs (ombitasvir/paritaprevir/ritonavir with or without dasabuvir)
Use is also contraindicated in women at high risk of having a blood clot or arterial or venous thrombotic diseases including: 
  • Cerebrovascular disease or history of strokes
  • coronary artery disease or history of heart attack
  • Diabetes mellitus with vascular disease 
  • Current or history of DVT (deep vein thrombosis) or PE (pulmonary Embolism) 
  • Hyper Coagulopathies (easy to make blood clots) (inherited or acquired),
  • Hypertension or high blood pressure (uncontrolled)
  • Headaches with focal neurological symptoms or migraine headaches (with or without aura) if >35 years old
  • Thrombogenic valvular or rhythm diseases of the heart (eg, subacute bacterial endocarditis with valvular disease or atrial fibrillation)
We have evaluated your health history and the specific health information you provided us, however if anything changes and you develop or discover that one of these conditions applies to you please stop taking this medicine and call or message us immediately.

Pregnancy and Breastfeeding

Do not use if you are pregnant or breastfeeding

Emergency Side Effects

This medicine can cause dangerous and potentially life threatening side effects. If any of the emergency side effects listed in the manufacturer's pamphlet or those below happen to you please stop taking the medicine and call 911 or seek immediate medical help in-person.
  • Anaphylaxis/anaphylactoid reaction (shortness of breath, difficulty breathing, facial swelling or edema, tongue swelling)
  • Jaundice (yellowing of skin and eyes)

Other Side Effects

  • Bleeding irregularities: Spotting may occur following use; the possibility of pregnancy should be considered if menstruation is delayed for >7 days of the expected menstrual period 
  • Edema (swelling in legs)
  • worsening of varicose veins
  • Depression
  • Chloasma (brownish skin, on the forehead, nose, upper lip, and cheeks)
  • Amenorrhea (loss of period)
  • Breast Changes: breast enlargement, discharge, tenderness, pain
  • Increased or decreased Weight
  • Changes in menstrual flow
  • Abdominal cramps, bloating, nausea, vomiting
  • Breakthrough bleeding, spotting, changes in secretions
  • Yeast infection
  • Change in sexual drive
  • Acne

Medications, Supplements and Foods

We have evaluated your health history and the specific health information you provided us, however, if anything changes and you start or discover that you are taking any of the medicines, foods, or supplements listed below call or message us before you take the medicine. Some of these can cause your birth control to be less effective and cause more severe or dangerous side effects.
An alternative method of contraceptive (male condoms) should be used if you are taking these medications:
  • Rifampin
  • Anticonvulsants or anti-seizure medications such as carbamazepine (Tegretol®), phenytoin (Dilantin®), oxcarbazepine (Trileptal®), primidone or topiramate (Topamax®)
  • Antifungal medications such as griseofulvin (Gris-PEG®), ketoconazole (Extina®, Nizoral®, Xolegel®)
  • Antiretrovirals: ritonavir, ombitasvir, paritaprevir, dasabuvir
  • Herbal medications such as St. John’s wort, Saw Palmetto, Alfalfa, Garlic Pills, Flax Seed.
  • HIV Medications
  • Modafinil (Provigil®)

Accurate Information

We have evaluated the specific health information you provided and are making our recommendations based on it. If you forgot to provide or incorrectly provided that information we may misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. If you need to clarify or update any information about your health you can message or call us anytime.

Treatment Failure/Missed Doses

The possibility of pregnancy should be considered if menstruation is delayed for >7 days of the expected menstrual period

Accepting or Declining Our Recommendation

We are recommending this treatment for you because the potential benefits of treatment outweigh the risks. You should evaluate this information as well as the manufacturer's pamphlet, and any input from your in-person healthcare team, or other relevant information to decide if this treatment plan is appropriate for you. You are free to decline our treatment recommendations. 

Alternative Treatment

We have based our recommendation on your specific case and current medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can't provide. Message us or talk to your doctor in-person to discuss alternative treatments. Here are some other treatments or strategies that you might consider:
  • Pregnancy Testing

Share with Your In-Person Healthcare Team

You can access your records anytime. We strongly recommend that you update your in-person doctor, pharmacist, and the rest of your healthcare team to let them know about any new medicines you are taking or other changes in your health.
You can also ask us questions anytime and we are happy to help you share any information about your health with your in-person healthcare team.
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