Levonorgestrel Double Dose for Emergency Contraception
Levonorgestrel is a synthetic version of the hormone progesterone. It’s used as a type of emergency contraception (often under the brand name Levonelle) and can be taken after unprotected sex to prevent pregnancy. It’s thought that levonorgestrel works by stopping or delaying the release of an egg. To do this effectively, however, it needs to be taken within 72 hours (three days) of unprotected sex – and ideally within 12 hours.
Understanding the Dosage
Most women who take levonorgestrel will need to take exactly one pill, but some might be instructed by their doctor or pharmacist to “double up” by taking two. The standard Levonelle dose is 1.5 milligrams (mg). However, some people might need double that dosage i.e. 3 milligrams (mg). Altering the dose can make taking levonorgestrel more effective for you. A healthcare professional will make sure you get what’s safe and right for you.
Why would I need a double dose of Levonorgestrel?
There are a few reasons why your doctor or nurse might prescribe this double dose of the morning after pill, including the following:
1. Weight
You might need a double dose of levonorgestrel if you weigh over 70 kilograms or have a BMI over 26. This is because having a higher bodyweight/BMI is thought to reduce the effectiveness of oral emergency contraceptives.
2. Medications
There are several types of medication that can prevent levonorgestrel from working properly. Depending on the medications you’ve been taking, you might need to double up on your dose of levonorgestrel. If you’re taking medicine for any of the conditions listed below, you should tell your pharmacist or doctor:
| Condition | Medication |
|---|---|
| Epilepsy | primidone, phenobarbital, phenytoin, fosphenytoine, carbamazepine, oxcarbazepine and barbiturates |
| Tuberculosis | rifampicin, rifabutin |
| HIV | ritonavir, efavirenz, nevirapine |
| Fungal infections | Griseofulvin |
| Various health conditions | St John's wort (Hypericum perforatum) |
3. Sickness
Another reason for taking two levonorgestrel pills is sickness. If you vomit within two hours of taking levonorgestrel, you’ll need to go back to your pharmacist or doctor to take another tablet or get advice about alternative emergency contraception.
Alternative Types of Emergency Contraception
Levonelle/levonorgestrel is probably the best-known type of emergency contraception, but it won’t be right for all women. There are alternative types of emergency contraception you can get for free on the NHS, such as ellaOne. This is another type of emergency contraceptive pill that contains ulipristal acetate and can be taken at any point during your menstrual cycle.
Advantages of ellaOne
- It can be taken up to five days after unprotected sex
- It’s generally thought to be more effective in preventing pregnancy than levonorgestrel
- It’s readily available at pharmacies and through services like Online Doctor
- It’s very easy to take
- It doesn’t require an appointment with a healthcare professional
Disadvantages of ellaOne
However, this type of morning after pill also has its downsides. You can’t take ellaOne if you’re taking certain types of medication e.g. those for epilepsy, HIV and tuberculosis. If you’ve had unprotected sex in the last couple of days and you don’t want to get pregnant, the best thing to do is get medical advice as soon as possible.