Contraceptives- Oral include

Ethinyl oestrdiol, norethindione, norgestrel, desogestrel, levonorgesrtrel, medoxyprogesterone, progesterone Refer Progesterone Cabamazepine and phenytoin- reduced efficacy(pregnancy) has occured.

Drug/Lab test interactions:

Certain endocrine tests may be affected by levonorgestrel implants. Sex hormone binding globulin concentrations are decreased; thyroxine concentrations may be slightly decreased and triiodthyronine uptake increased.

Headache, nervousness, nausea, dizziness, adnexal enlargement, dermatitis, acne, change of appetite, mastalgia, hirsutism, hypertrichosis, scalp hair loss.

Mammary cancer Cancer of reproductive organ Liver dysfunction Hypertension Diabetes and wimen > 40 years

Precautions- Tablets An individual should not take it as regular contraceptives and should adopt the reliable contrceptive mrasures in the period from the administration to the next menstrual occurance The women who vomit within 2 hrs after administration should take additional tablet immediately Some women may experience early or delayed onset of next menses.

If the next menstrual period is more than one wek overdue, visit te doctor to exclude the possbility of pregnancy. Patients who take other medicines at the same time should consult doctor or pharmacist before taking this medicine. 72 hours after

Indications:

An emergency contraceptive for women after sexual intercourse without protective measures.

Dosage:

One tablet should be taken orally as soon as possible preferably within 12 hours and not later than 72 hours after unprotected intercourse.

1. Provide the patient with a copy of the patient labelling to help describe the characterstics of the system

2. The prospective users be informed of the risks and the benefits of the system.

Pharmacology:

Levonorgestrel is administerd after an unprotected intercourse to prevent unwanted pregnancy. LKG is a synthetic derivative of the naturally occuring female sex hormone. progesterone., It is derived from 19- nortesterone. It has been used for many years both alone ( in low doses) in the progestogen only pill ( POP) and in combination with estrogen in combined oral contrception (COC) preparations LNG EC pills have been shown to prevent ovulation, fertilization without detectable effect on the endometrium or progesterone levels when given after ovulation. EC pills are not effective once the process of implantation has begun and will cause abortion.

Pharmacokinetics:

LNG is a hydrophobic drug with very poor aqueous solubility. The absolute bioavailability ofLNG is almost 100% of the dose administered. The LNG upon oral asministration is hydroxylated in the liver and metabolites are excreted as glucoonide conjugates.