Levest

What is Levest?

Levest tablets are called combined oral contraceptives because each pill combines two hormones, a type of oestrogen known as ethinylestradiol and progesterone called levonorgestrel, to prevent pregnancy.

When Levest is taken as directed over 21 days it is a very effective, reversible method of contraception. Unlike progesterone-only contraceptives, which you take every day without a break. On Levest you will have a 7-day pill-free break each month where most women will experience a bleed.

What is Levest used for?

Levest is used as an oral contraceptive to prevent pregnancy. Alongside this many people find Levest is very effective at reducing premenstrual symptoms and improving the pain and flow of periods.

Please be aware that oral contraceptives do not prevent the spread of sexually transmitted infections (STIs). Barrier methods of contraception such as condoms are recommended to prevent STIs. If you are concerned you should speak to a doctor or visit your local sexual health clinic for advice.

How does Levest work?

Levest works in the same way as other combined hormonal contraceptives and prevents the body from ovulating, so you do not produce an egg each month.

Combined pills cause the cervical mucus in the neck of the uterus to build up, making it more difficult for sperm to get through to the uterus to fertilise an egg. They also thin the lining of your uterus making it harder for a fertilised egg to be able to embed into the uterus wall.

How effective is Levest?

When Levest is taken as directed over 21 days it is a very effective, reversible method of contraception. Unlike progesterone-only contraceptives (which you take every day without a break), with Levest you will have a 7-day pill-free break each month where most women will experience a bleed.

Levest vs. Microgynon

Levest and Microgynon 30 are different brands of combined oral contraceptives that contain the same amount of the active ingredients ethinylestradiol and levonorgestrel.

At The Independent Pharmacy, we also have available on prescription, Ovranette and Rigevidon, which contain the same active ingredients and can be taken as alternatives to Levest and Microgynon.

Sources

• https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/
• https://patient.info/medicine/combined-hormonal-contraceptives#nav-4
• Levest, Patient Information Leaflet: https://www.medicines.org.uk/emc/product/9565/pil

How to take Levest?

Levest can be prescribed by The Independent Pharmacy and bought by adults over the age of 18 years.

• Levest is for oral use only.
• Take 1 tablet, at the same time each day, for 21 days. Take your first tablet, next to the correct day of the week, from the top row of the pack and follow the directions of the arrows printed on the pack.
• After 21 days, have a 7-day pill-free break, where you should expect to have a bleed.
• Start your new pack, after your 7 days pill-free, on the same day of the week that you started your previous pack.

For full details on how to take Levest, please read the Patient Information Leaflet thoroughly.

Starting Levest

If you have not used any contraceptive with hormones in the previous month:

Start Levest on the first day of your period. Starting Levest on the first day of your period means you are immediately protected against pregnancy and do not need to use additional barrier contraceptives.

If you start Levest any time after day 1 of your period you must use additional barrier contraceptives such as condoms for 7 days.

Switching from another combined hormonal contraceptive pill:

Start Levest the day after your last pill from your previous pill packet. Do not have a 7-day pill-free break. If you start Levest after your 7-day break you will need to use an additional barrier contraceptive such as condoms for 7 days.

Changing from a progestogen-only pill, injection, implant or a progesterone-releasing IUD:

You may switch to Levest, any convenient day, from the progestogen-only pill, from the day of removal of an implant or an IUD and the due date of the injection. In all of these cases, you must use an additional barrier contraceptive such as condoms for 7 days.

After having a baby:

You can start taking Levest between 21 and 28 days after having a baby. If you start taking Levest later than day 28 you must use an additional barrier method of contraception such as condoms for the next 7 days.

Levest missed pill

If you forget to take your daily Levest tablet or you are sick or have diarrhoea within 3-4 hours after taking your tablet, take it as soon as you remember or when you feel better, even if this means taking 2 tablets on the same day.

If you are more than 12 hours late taking your Levest tablet:

• You will not be protected from getting pregnant and should use additional barrier contraception such as a condom for 7 days.

You are at more risk of becoming pregnant if you miss multiple tablets within one packet or if the missed pill is at the start or the end of your packet. If you think you are at risk of being pregnant while taking Levest you should speak to a doctor for advice as soon as possible.

If you are less than 12 hours late taking your Levest tablet:

• You will be protected from getting pregnant. You will not need to use additional contraception.

Levest ingredients

Each Levest tablet contains the active ingredients: levonorgestrel 150 micrograms and ethinylestradiol 30 micrograms.

Each Levest tablet contains the inactive ingredients: lactose monohydrate, povidone k-25, sucrose, calcium carbonate, povidone k-90, glycerin, macrogol 6000, titanium dioxide, magnesium stearate and carnauba wax.

Please ensure that you have read the Patient Information Leaflet thoroughly before taking Levest to ensure you are familiar with all of the ingredients contained within each tablet.

Levest side effects

In the same way as other medicine, Levest can cause some people to experience side effects. The most commonly reported side effects are usually mild but if you are bothered by them or are concerned you should speak to a doctor or pharmacist for advice.

Most commonly people who take Levest report the following side effects:

• Feeling sick
• Abdominal cramps
• Headaches
• Breast tenderness
• Weight gain or fluid retention
• Mood changes
• Change in sex drive
• Irregular bleeding
• Increased blood pressure

If you experience an allergic reaction or severe side effects while taking Levest you should seek immediate medical attention from a doctor or your nearest emergency department.

For full details on reported side effects associated with taking Levest please read the Patient Information Leaflet.

Levest warnings

Before taking Levest please ensure that you have read and understood all the warnings and precautions associated with taking combined oral contraceptives detailed in the Patient Information Leaflet.

If you start taking Levest you will need to continue to have your health monitored as combined oral contraceptives can increase your risk of developing certain health conditions.

• You should not take Levest if you have ever had a blood clot, problems with your heart or liver are at risk of having a stroke or suffer from migraines.
• You also should not take Levest if you have high blood pressure, have high levels of fat in your blood or have ever had breast cancer or cancer of the genital organs.
• You should discuss with your doctor before taking Levest if you have diabetes, inflammatory bowel disease, sickle cell anaemia, HUS or SLE or if you have a disease that first appeared during pregnancy.
• You should tell your doctor if you have recently been taking or are currently taking any other prescribed or non-prescribed medication.

Levest and blood clots

The use of combined hormonal contraception, including Levest, can increase a woman's

risk of developing arterial and venous blood clots or venous thrombosis.

The risk of developing blood clots increases:

• During the first year of taking a combination pill.
• As you age
• If you are overweight
• If someone in your family has suffered from blood clots
• After you have had an operation or had an extended period of immobilisation

Levest and cancer

Taking a combined oral contraceptive such as Levest can slightly increase the risk of developing breast cancer. This risk appears to decrease once contraception is stopped.

Women taking Levest must regularly check their breasts for any changes and you should contact your doctor if you are concerned.

Levest and pregnancy

You should not take Levest during pregnancy. If you think you have become pregnant while taking any oral contraceptive you should speak to a doctor for advice. Taking Levest while breastfeeding is not advisable, you should speak to a doctor or nurse for advice about your contraceptive options.