AlternativeLevonelle
Levonorgestrel 1.5 mg (EC)
Progestogen emergency contraception
OTC EC up to 72 h — safe in breastfeeding, compatible with quick-start.
Oral
First-line for
- EC within 72 h if UPA unavailable or breastfeeding
Mechanism
Delays or inhibits ovulation if given before LH surge; ineffective once LH surge started.
"Levo before surge"
- Best < 72 h
- Ineffective peri-ovulation
- Double dose if BMI > 26 or > 70 kg
Dosing
- Standard
- 1.5 mg PO stat within 72 h
- BMI > 26 / weight > 70 kg
- 3 mg PO stat
Contraindications
- AbsoluteConfirmed pregnancy (no known harm but ineffective)
Side effects
- Nausea (vomit < 3 h → repeat)
- Menstrual disturbance
Fetal & maternal notes
- • Safe in breastfeeding — no interruption required
Key interactions
Enzyme inducers
CautionDouble dose (3 mg) or use Cu-IUD
Clinical pearls
- 💡 Quick-start hormonal contraception immediately after LNG-EC
- 💡 Cu-IUD > UPA > LNG in efficacy
Content last reviewed: REPLACE_ME (e.g. 2026-07)
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