Levonorgestrel Indications and Dosage
- contraception
- postcoital contraception
Levonorgestrel Indications and Dosage
For routine contraception:
Subdermal dosage (Norplant® only):
Adult females: NOTE: This drug product is discontinued in the US. Implant the system, containing 6 Silastic capsules (36 mg/capsule) beneath the skin of the upper arm as per system instructions during the first 7 days of the menstrual cycle. The total implanted dose is 216 mg. Remove implants within 5 years.
Subdermal dosage (Jadelle® only):
Adult females: NOTE: This drug product remains un-marketed in the US. Implant the system, containing 2 implant capsules (75 mg/capsule) beneath the skin of the upper arm as per system instructions during the first 7 days of the menstrual cycle. The total implanted dose is 150 mg. Remove implants within 5 years.
Intrauterine dosage (Mirena® IUD only):
Adult females: Insert one IUD into the uterus as per device instructions. IUD delivers 20 mcg/day of levonorgestrel. Provides efficacy for up to 5 years, then remove and replace. Never reinsert a removed system. Wait until 6-weeks post-partum for insertion.
For use as postcoital contraception within 72 hours of unprotected intercourse, or known or suspected contraceptive failure, in females who have no known contraindications to oral contraceptives, have achieved menarche, and are not known or suspected to be pregnant:
Oral dosage (Plan B tablets - FDA-approved regimen):
Adult and adolescent females: Confirm negative pregnancy test, give 1 tablet (750 mcg levonorgestrel) PO as a first dose as soon as possible after intercourse (i.e., preferably within 12 - 24 hours and no later than 72 hours after the event). MUST give a second dose 12 hours after the initial dose. If patient vomits within 1 hour of the initial (1st) dose, repeat the dose. Rarely, an antiemetic may be needed, as progestin-only emergency contraception regimens induce vomiting much less than traditional Yuzpe methods.
Maximum Dosage Limits:
Not available. Dependent on route of administration.
Patients with hepatic impairment:
Avoid use if significant hepatic disease is present.
Patients with renal impairment:
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
[ Last revised: 10/17/2005 3:10:00 PM ]
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