How does it work?

This medicine is commonly known as 'the morning after pill'. It is used to reduce the chances of becoming pregnant after unprotected sexual intercourse. It contains levonorgestrel, which is a synthetic derivative of the naturally occurring female sex hormone, progesterone. It is not fully understood how this medicine prevents pregnancy. It is thought to work by preventing ovulation and fertilisation and also by altering the lining of the womb, depending on which stage of the menstrual cycle the woman is at. In a woman's normal menstrual cycle, an egg matures and is released from the ovaries (ovulation). The ovary then produces progesterone, which prevents the release of further eggs. Levonorgestrel, tricks the body processes into thinking that ovulation has already occurred, as it provides high levels of synthetic progesterone. This prevents the release of eggs from the ovaries. Levonorgestrel also increases the thickness of the natural mucus at the neck of the womb (cervix), making it more difficult for sperm to cross from the vagina into the womb. By preventing sperm entering the womb, successful fertilisation of an egg, leading to pregnancy, is less likely. Levonorgestrel is also thought to alter the lining of the womb, preventing it from being prepared for a fertilised egg. This means that if an egg is released from the ovaries and is fertilised, it cannot implant into the womb and therefore pregnancy is avoided. The whole process from fertilisation to implantation in the womb can take up to three days, so the morning after pill is only effective for up to 72 hours after unprotected intercourse. The sooner it is taken after unprotected intercourse, the more effective it will be. It is estimated that 95% of pregnancies will be prevented if this medicine is taken within 24 hours of unprotected sex. This decreases to 85% if taken within 24-48 hours and to 58% if taken within 48-72 hours, so it is obviously important to start treatment as soon as possible to prevent pregnancy. There are two tablets to be taken. The first should be taken as soon as possible following unprotected sex. The second tablet should be taken 12 hours (and no later than 16 hours) after the first. This medicine should only be used as an emergency measure. It is not recommended for repeated use as it is possible that it can disrupt your cycle.

What is it used for?

Emergency contraception within 72 hours of unprotected sex

Warning!

This medicine is not recommended for use in children.

If you are sick within 3 hours of taking the first tablet, take the second tablet straight away, then consult your doctor, pharmacist or family planning clinic to obtain another tablet. If you are sick within 3 hours of taking the second tablet you will also need to obtain another tablet as soon as possible.

The use of emergency contraception does not protect against sexually transmitted infections.

The preparation of levonorgestrel that is available to buy from pharmacies (Levonelle) cannot be sold to girls under 16 years of age except in exceptional circumstances. Girls under 16 who need emergency contraception are advised to consult a doctor, family planning clinic or casualty department.

If your next menstrual period is more than 5 days late or is abnormal in any way consult your doctor for a pregnancy test.

The morning after pill does not provide continued contraceptive cover. You should use a barrier method of contraception such as a condom, even if you are taking the pill, until your next period comes.

This medicine will not always prevent a pregnancy. If you do become pregnant after taking this medicine there is a possibility that the pregnancy will be ectopic (ie occuring in the fallopian tubes rather than the womb).

This medicine is not recommended for women with severely decreased liver function.

Use with caution in

Crohn's disease

Not to be used in

Pregnancy

Women who have had unprotected intercourse more than 72 hours previously, or whose menstrual period is overdue

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used in pregnancy. Seek medical advice from your doctor.

This medicine passes into breast milk. To reduce the exposure of your baby to the medicine, take your dose after breastfeeding. Avoid breastfeeding your baby following each dose.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Headache

Abdominal pain

Diarrhoea

Fatigue

Dizziness

Nausea and vomiting

Breast tenderness

Menstrual spotting between periods

Early or delayed onset of next menstrual period

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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