Postinor tabs 0.75mg #2

Postinor instruction for use

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Composition

The composition of 1 tablet includes 750 mcg levonorgestrel, as well as silicon dioxide colloidal anhydrous, magnesium stearate, potato starch and corn, talc, lactose monohydrate.

Form of issue

Tablets, packaged in blisters for 2 pcs. In the package 1 blister.
Birth control pills Postinor flat, approximately 6 mm in diameter, with a bevel, almost white, on one side an inscription "INOR" is engraved on them.

pharmachologic effect

The drug helps prevent pregnancy, causes in the body effects similar to the action of the hormones of the yellow body of the ovaries, and also suppresses the effects caused by estrogens.

Pharmacodynamics and pharmacokinetics

What is Postinor?

Postinor is a remedy with pronounced antiestrogenic and progestogenic activity. These properties of the drug complicate the conception process at an early stage and contribute to the prevention of pregnancy.

Pharmacodynamics

As Postinor acts, it is not known exactly. The levonorgestrel contained in the tablets prevents ovulation and fertilization of the ovum if NPK (unprotected sexual contact) occurred before ovulation (when the probability of fertilization is highest).
Levonorgestrel also causes changes in the endometrium, which make it difficult to insert a fertilized egg into the mucosal layer of the uterine cavity. In cases where the attachment of the fetal egg has already begun, the drug does not give the expected effect.
Wikipedia indicates that the mechanism of action of levonorgestrel is most successfully realized when the size of the dominant follicle is 17 mm. It is best to suppress ovulation no later than three days before it.

Efficacy of tablets

The probability of pregnancy after the use of tablets Postinor 15-42%. The effect after taking the better, the less time passed after the NPC.
If the remedy was taken within 24 hours, its effectiveness is 95%, in the next 24 hours it drops to 85%, on the third day - to 58%. Take the drug later than 72 hours later, it makes no sense.

Is Postinor harmful?

Levonorgestrel in the manufacturer's recommended dose does not have a significant effect on lipid and carbohydrate metabolism, as well as on the coagulation system.

Pharmacokinetics

Absorption in the digestive canal is fast and complete. In the body, the drug binds to SHBG and albumin: approximately 65% ​​of the dose is associated with SHBG, in free form is only 1.5%.
After 96 minutes after taking the tablet, the plasma concentration of levonorgestrel reaches 14.1 ng / ml. Then there is a 2-stage decrease in Sma.
The drug is well distributed in tissues and organs.
Biotransformation of it is carried out in the liver. The resulting metabolic products (conjugated glucuronates) are pharmacologically inactive.
Levonorgestrel is excreted from the body solely in the form of metabolic products. About half of the dose taken is excreted in urine, the rest is with feces. The value of the indicator T1 / 2 varies from 9 to 14.5 hours.
With milk in the body of an infant when receiving a nursing woman Postinor gets about 0.1% of the dose.

Indications for use

"Urgent" contraception in case of unsuccessful application of the chosen method of protection or after NPK.

Contraindications

Contraindication to the use of the drug is intolerance to levonorgestrel or any of the auxiliary ingredients contained in it.
The drug is used in pediatric practice. Data on its use in girls under 16 years of age are limited, so in adolescence Postinor is not recommended for taking without a doctor's supervision.

Side effects of Postinor: how dangerous is the drug?

In the annotation to the drug, the manufacturer reports that the most common reaction to the use of levonorgestrel is nausea.
In addition, the following side effects of Postinor were documented during the study:
    dizziness;
    headache;
    diarrhea and vomiting;
    pain in the lower abdomen;
    nausea;
    not associated with the menstrual cycle of uterine bleeding;
    the failure of the menstrual cycle (namely, the delay of the monthly after taking the pill for more than a week);
    increased fatigue.
Postmarketing observations have shown that sometimes (rarely) the use of the drug may be accompanied by: hypersensitivity reactions (urticaria, skin rash, skin itching), dysmenorrhea, pelvic pain and / or abdominal pain, facial swelling.

What is bad for Postinor?

Reviews of side effects suggest that the most unpleasant, in the opinion of women, the phenomenon after receiving Postinor:
    bleeding (in separate reviews it is mentioned that, not knowing how to stop bleeding after Postinor, a woman was forced to seek medical help);
    a severe hormonal failure and severe cycle disorders (many cases have been described where, after taking Postinor, there are no menstrual cycles for several cycles, someone takes up to a year to restore the regularity of menstruation).
In this list, you can include the appearance of "male" signs, metabolic disorders and acne.
Sometimes the effects of taking the pill Postinor appear in the form of miscarriage of subsequent pregnancies and infertility.
To harm the body was minimal, use the drug should not be more than 3-4 times a year.

Tablets Postinor: instructions for use

How to take Postinor?

The instructions for Postinor indicate that the contraceptive effect is provided when taking two tablets (provided that the first tablet is drunk in the first 3 days after the NPC). Between doses 1 and 2, the doses are maintained for a 12-hour interval.
If within 3 hours after the drug was drunk (regardless of whether 1 or 2 doses), another 750 mcg of levonorgestrel (3rd tablet) should be taken immediately.
The agent can be used in any phase of the menstrual cycle. A mandatory condition is the absence of a woman's delay in menstruation.
After taking the pills before the start of the next month, it is recommended to use barrier contraception (cervical cap or condoms).
Taking the drug is not a contraindication for continuing the use of hormonal drugs for regular contraception.

How to understand that the drug acted?

The tablet starts to act immediately after dissolution and absorption in the intestinal tract.
Evidence that the drug "worked" is menstruation.
Bleeding after consumption excludes pregnancy in about 95-85% of cases, if it begins 3-6 days after taking the pill.

What is the delay after Postinor?

If after the use of the drug there is no bleeding or bleeding begins later than the specified time, a woman is recommended to have a blood test for HCG and undergo a gynecologist examination to exclude pregnancy.
Referring to the doctor is not only when the delay is monthly, but if after the adoption of Postinor, the consequences are expressed as an unusually strong bleeding for a woman. The causes of such bleeding may be an excess of the recommended dose and the negative impact of levonorgestrel on the endometrium of the uterus.
Sometimes women notice that they have brown discharge after taking the medication. The phenomenon is considered the norm if the secretions appear within a few days, thus completing the monthly induced monthly pills. Nevertheless, in some women, the melliferous discharge can last up to a month.
Most likely, this is an individual reaction to a strong stress for the reproductive system, but only the doctor can accurately diagnose the cause of secretions.
The cause for concern is menstrual bleeding lasting more than 14 days, lack of full-time menstruation, the appearance of clots or copious brown discharge, pain.

When should they go monthly after taking the pills?

It's impossible to say exactly when Postinor will start monthly. Tablets contain a large amount of levonorgestrel, so even a single use of the drug does not pass without a trace for the body.
In most cases, after taking the remedy, the menstrual cycle remains the same. Sometimes bleeding can begin earlier or a little later. Normally, the delay should not be more than 5-7 days. Otherwise, pregnancy should be excluded.
After taking levonorgestrel, a woman is recommended to visit a doctor who will help her choose the most appropriate method of regular contraception.

Should I take Postinor if NPC occurred during the months?

Women with irregular cycles are likely to become pregnant even during menstrual bleeding. The expediency of using the means of "urgent" contraception, if NPC took place during the period, can be determined by the doctor.

How often can I take Postinor?

To the question "How often can I take emergency contraceptive pills?" Doctors respond that preparations like Postinor are not intended for systematic use. They are used only in emergency situations and not more than 3-4 times during the year.

Overdose

The clinical picture of an overdose of hormonal emergency contraception is not described. Most likely, the first signs of poisoning will be nausea and bleeding breakthrough.
There is no specific antidote for Postinor.

Interaction

In combination with inducers of hepatic enzymes, activation of the metabolism of levonorgestrel is noted.
The effectiveness of drugs in which levonorgestrel is present may decrease with simultaneous use with:
    barbiturates;
    preparations of St. John's wort (Hypericum perforatum);
    rafibutin;
    carbamazepine;
    ritonavir;
    phenytoin;
    griseofulvin;
    rifampicin.
Those taking these drugs, women, before taking Postinor should consult a doctor.
Levonorgestrel-containing drugs can provoke an increase in the toxicity of cyclosporine, which is associated with the possible suppression of its metabolism.

Storage conditions

Tablets should be stored at a temperature of 15-25 ° C.
Shelf life - 5 years.

special instructions

Means of "urgent" contraception are intended for occasional use and do not replace the regular method of protection from pregnancy.
Because of the possibility of hormonal failure, it is not recommended to use the drug again for one cycle.
"Urgent" contraception does not always prevent pregnancy. If there is doubt about the time of the CDD, or if the unprotected act took place more than 72 hours during the same cycle, it can not be ruled out that the fertilized egg has already been implanted into the uterine wall.
In this regard, the use of tablets with the next sexual encounter may be ineffective. If the cycle is delayed by more than 5 days, with the development of atypical bleeding on the day of expected menstruation, and if there are other grounds for suspecting the occurrence of pregnancy, the fact of pregnancy should be excluded.
After taking levonorgestrel, there is a risk of developing ectopic pregnancy. The absolute likelihood of this is low, because the remedy prevents ovulation and fertilization.
Ectopic pregnancy can persist, despite the appearance of uterine bleeding.
The most likely ectopic pregnancy in women who have observed an unconscious condition or severe abdominal pain, and if there is an anamnesis of an operation on the fallopian tubes, an ectopic pregnancy, or PID.
Based on this, patients at risk are not recommended to take Postinor tablets.
The intake of tablets may slightly change the nature of the bleeding, but in most cases the next menstruation begins within a week after the usual date.
When delaying menstrual bleeding for more than 5 days, it is necessary to exclude the fact of pregnancy.
The drug should not be used in women with severe liver diseases. The effectiveness of tablets may be adversely affected by severe absorption disorders (eg, granulomatous enteritis).
Women suffering from such diseases before the emergency contraception is advised to consult a doctor.
In tablets Postinor contains lactose, which should be warned patients with lactase deficiency and impaired absorption of glucose and galactose.
The drug is ineffective as a means of regular contraception and is not an alternative to it. It should also be remembered that this tool does not replace the necessary precautions associated with protection against STDs.
If a woman applies for repeated use of Postinor, the doctor should recommend that she use long-term methods of protection from pregnancy.
Studies on the impact of levonorgestrel on the ability to drive a vehicle or work with mechanisms have not been carried out, but one should forget about the possibility of dizziness.

Postinor and alcohol

Can I combine Postinor with alcohol? In the manufacturer's instructions there are no recommendations on this matter.
Nevertheless, it should be remembered that alcohol with an overwhelming majority of pharmaceutical products is not compatible.
Drinking alcohol in combination with Postinor may cause a sharp expansion, and then an equally sharp narrowing of the vessels, which in turn will complicate the condition of the woman when the drug provokes rejection of the mucous uterus.
In addition, alcohol increases the level of liver enzymes, thereby accelerating metabolism. And since biotransformation of levonorgestrel is carried out in the liver, the contraceptive effect of Postinor on the background of taking alcohol can be very doubtful.
Reviews about the use of the drug with alcohol indicate that the side effects when used in this case develop at about the same frequency as in cases where a woman did not drink alcohol, but the probability of getting pregnant really increases.

Postinor and pregnancy

During pregnancy, Postinor should be avoided.

Whether it is possible to interrupt pregnancy by means of a preparation?

Tablets do not cause termination of pregnancy and can not be used to interrupt pregnancy in the early stages.
If the application of Postinor did not produce the expected result, and pregnancy did occur, this will not affect the development of the fetus in any way. Levonorgestrel does not have a teratogenic effect.
There are no clinical data on the possible consequences of pregnancy after taking levonorgestrel in a dose exceeding 1.5 mg.

Can I get pregnant after taking Postinor?

The effectiveness of the drug is 58-95%. It depends on when the pill was taken. If a woman drinks Postinor after ovulation, the remedy may not work at all. Also, the probability that pregnancy could begin to develop even before taking the drug can not be completely ruled out.
Women who plan to have a baby in the future, but now had to resort to Postinor's help, should not be afraid, as they usually get pregnant after taking these pills without difficulties and delays.

Application in breastfeeding

Levonorgestrel is excreted with milk. Potential effects of the drug on children's body can be reduced if the woman will take it immediately after feeding. The next time you can breast-feed your baby after 8 hours.

Reviews of Postinor

Reviews on the forums about Postinor are quite diverse. In most cases, the drug really helps to avoid an unplanned pregnancy, but often causes significant side effects: it happens that the woman has drunk the pills, but there are no menstruation, the bleeding starts or after the abdomen hurts.
Reviews gynecologists about Postinor allow to conclude that levonorgestrel is tolerated by women better than the Yuzpe method (an alternative to the use of the drug, a method involving a high dose of tablets for regular contraception). In addition, Postinor has established itself as a more effective tool.
However, these pills should be taken only in case of emergency: if there was a CPD, if a woman showed a spontaneous prolapse of the IUD or a condom broke during sexual intercourse, if the woman forgot to take the pill and also if forced to have sexual intercourse.
It should be remembered that the consequences of taking the drug are often serious and unforeseen, and also that the organism of each woman reacts to a high dose of levonorgestrel in its own way.
The doctors comments on the effects of Postinor are proof that, with mindless application, this drug can cause serious (and sometimes irreparable) damage to health. In the worst case, a woman can remain barren.
The main recommendations are that:
    the drug may be used occasionally;
    if it is necessary to re-use the woman should seriously think about the possibility of using regular contraception, which act on the body is much softer.
In addition, if a woman was forced to take a pill, she should stop drinking alcohol.