Postinor-2

Generic Name: Levonorgestrel
Product Name: Postinor-2

Indication: What Postinor-2 is used for

Postinor-2, commonly known as the morning after pill, is used only as an emergency contraceptive. It is used to prevent pregnancy when taken within 72 hours (3 days) of unprotected intercourse. It is not used as a regular, long-term method of contraception.

Action: How Postinor-2 works

The active ingredient in Postinor-2 is levonorgestrel.

It is not known exactly how this medication works. It is thought to reduce the chance of pregnancy in two ways:

• If taken before ovulation, it may delay the release of the egg.
• If taken after ovulation, it may interfere with the transport of eggs and sperm.

Dose advice: How to use Postinor-2

Dose information

• Take one 750 μg tablet as soon as possible (within 72 hours of unprotected intercourse);
• Take a second 750 μg tablet  12 hours after the first dose;
• If you vomit within 2 hours of taking a tablet, talk to your doctor for an additional tablet.

You must take the second tablet exactly 12 hours after the first tablet. Work out a time when you will be able to take the second tablet (e.g. not in the middle of the night). This means you may have to delay the first dose, although the sooner the first tablet is taken, the greater the chance of the treatment being effective.

Postinor-2 can be taken at any time during the menstrual cycle, unless the menstrual period is late.

Postinor-2 has an 85% chance of preventing pregnancy. If taken within 24 hours, there is a 95% chance of preventing pregnancy. If taken after 48-72 hours, there is a 58% chance. It is not known whether it is effective if taken more than 72 hours after unprotected intercourse.

You should have a follow-up with your doctor within 3 weeks of taking.

Postinor-2 will not prevent you from catching any sexually transmitted diseases.

Your next menstrual period is likely to arrive on time. However, it may be slightly early or late. If it is more than 1 week late, or if it is unusually light, perform a pregnancy test.

If you do not have a menstrual period after 3 weeks of taking Postinor-2, you may be pregnant. Consult your doctor.

Postinor-2 is intended as an emergency measure. If you need to take repeated doses, you should talk to your doctor about using long-term methods of contraception instead.

Contraindications

Postinor-2 should not be taken under certain conditions. Tell your doctor if you have any of the following:

• Current or suspected pregnancy;
• Unprotected intercourse more than 72 hours earlier in the same menstrual cycle;
• Unexplained vaginal bleeding;
• Breast cancer;
• Liver problems;
• Hypersensitivity to any ingredients.

Precautions

Care must be taken when using Postinor-2 under certain circumstances. Tell your doctor if you have any of the following:

• High blood pressure;
• Diabetes mellitus with nephropathy, retinopathy or neuropathy;
• Vascular heart disease;
• Ischaemic heart disease;
• Stroke;
• Past history of breast cancer;
• Malabsorption (for example caused by vomiting, severe diarrhoea, Crohn’s disease).

Pregnancy

Postinor-2 is an ADEC Category D drug.

It cannot be used in pregnant women, or women suspected of being pregnant. If a pregnancy is suspected, the menstrual period is late, or the last menstrual period was abnormal in character and timing, pregnancy should be excluded with a pregnancy test or pelvic examination before taking the treatment.

If pregnancy occurs after taking Postinor-2, an ectopic pregnancy is possible.

Lactation

Postinor-2 is identified in breast milk. It is not recommended for use in breastfeeding women.

Age

• Girls aged 14-16 years: There is limited data available.
• Girls aged less than 14 years: There is no data available.
• Postinor-2 is not recommended for children.

Schedule of Postinor-2

Postinor-2 is Schedule 3.

Side effects of Postinor-2

Common side effects

All medicines have side effects. Most commonly the side effects are minor, however some can be more serious. Usually the benefits of taking a medication outweigh the associated side effects. Your doctor would have considered these side effects before starting you on the medication.

Common side effects are those which occur in more than 1% of patients given Postinor-2. These include:

• Nausea, vomiting;
• Diarrhoea;
• Dizziness;
• Headache;
• Breast tenderness;
• Vaginal bleeding;
• Fatigue.

Uncommon side effects

Side effects which occur in less than 1% of patients are considered uncommon. Patients do not necessarily experience any of these side effects, so do not become alarmed by this list:

• Ectopic pregnancy;
• Acne;
• Symptoms of flu.

If you experience any of the listed side effects, or any other symptoms which appear abnormal or unusual, please tell your doctor.

References

1. Australian Medicines Handbook 2007, Adelaide, Pharmaceutical Society of Australia, 2007.
2. MIMS Online. Postinor-2 [Monograph online]. MIMS Australia. 12 October 2004 [cited May 15, 2008]. Available from: [URL Link]

For further information talk to your doctor.