Birth control pills against pregnancy after unprotected intercourse. The name of pills against pregnancy after unprotected intercourse and how to take them correctly

Pregnancy is the most joyful and beautiful life span for woman. However, not for everyone. In some cases, conception comes as a surprise and forces the fairer sex to accept emergency measures. This article will talk about what pills there are against pregnancy after unprotected act. You will learn how these drugs are used and whether they can be used regularly. It is also worth mentioning what they are. The price of such drugs and their name will be indicated below.

A little anatomy: how conception occurs

First, it’s worth finding out how conception occurs, as a result of which a child can be born. On average, once a month the average woman experiences hormonal changes in her body. The production of estrogen is replaced by progesterone, and an egg is released from the follicle. If sexual intercourse occurs at this moment, pregnancy may occur. Conception can also occur if sperm enters the woman’s body a few days before or after the follicle ruptures.

Immediately after ovulation, under the influence of progesterone, active preparation of the endometrium begins. The layer thickens and becomes looser. In this way, the body prepares to accept the fertilized female gamete. If conception has taken place, the fertilized egg descends to the reproductive organ through the fallopian tube within a few days. Once in the uterus, the embryo is securely attached to the endometrial layer. This is where it will develop in the following months if the pregnancy continues.

How can you interrupt an existing conception?

Currently, there are many ways to stop the development of an embryo. It is worth noting that in this case it is better not to engage in amateur activities. Otherwise you can earn serious problems with health.

One of the most popular methods of abortion is curettage or vacuum aspiration. During the procedure, the doctor removes the fertilized egg and part of the endometrium from the uterus. This manipulation is carried out up to 12 weeks of embryo development.

It can also be done with medication. In this case, a prerequisite is a delay in menstruation of no more than forty days. After taking certain medications, a woman’s endometrium and fertilized egg are shed and menstruation begins.

There are also special emergency methods of contraception. In this case, the drug is taken several hours after unprotected sexual intercourse. As a result of the action of the drugs, a woman begins to undergo hormonal changes, and menstrual bleeding.

Emergency methods of contraception

There are several that allow you to terminate a pregnancy even before the fertilized egg attaches to the wall of the uterus. Anti-pregnancy pills after unprotected intercourse have different action and method of use. Remember that these medications should not be used as permanent protection against unwanted conception. Anti-pregnancy pills should be used after unprotected intercourse only in emergency cases. Otherwise, you may end up with serious health problems. Let's consider what drugs exist for emergency interruption of the development of the fertilized egg.

The drug "Postinor"

This product contains synthetic progestin. It is this component that affects peristalsis fallopian tubes and the condition of the endometrium. Under the influence of a substance called levonorgestrel, the fallopian tubes reduce their mobility and slow down the activity of the fertilized egg. As a result, the fertilized egg dies before it reaches the uterine cavity. If a set of gametes descends into the reproductive organ, then levonorgestrel changes the state of the endometrium. The egg is simply not able to attach to such a cavity.

Postinor tablets should be taken two capsules every 12 hours. This is exactly the period of validity of the substance described above. The first pill should be taken no later than 16 hours after intercourse. The course of taking the medicine is three days. During this period, the woman should begin menstrual bleeding. Only then emergency contraception considered successful.

Postinor tablets, the price of which is approximately 250 rubles, can be purchased at any pharmacy chain. It is worth noting that one package of the medicine contains only two capsules. This means that for the course you will need 6 packs. In this case, the price for Postinor tablets increases and is about 1,500 rubles.

The drug "Escapelle"

These tablets are also based on the action of a substance called levonorgestrel. However, here the dosage of the medicine is slightly different. A woman needs to take one tablet within 24 hours after intercourse. Next, you should repeat the procedure twice with a difference of 24 hours.

For Escapelle tablets the price ranges from 250 to 300 rubles. The pack contains one capsule. This means that for the full course you will need three packs of Escapelle tablets. The price in this case will be approximately 1000 rubles. It is worth noting that this medicine is somewhat cheaper than the drug "Postinor".

The drug "Eskinor F"

This product has the same effect as Escapelle tablets. After taking the drug, the reverse transformation of the endometrium begins and the activity of the fallopian tubes decreases.

It is worth noting that this drug is less popular than the first two analogues. However, this does not mean that the drug will not be as effective.

Preparations containing mifetpristone

Anti-pregnancy pills after unprotected intercourse may have a slightly different effect. Such drugs include the following: “Mifegin”, “Zhenale”, “Miropriston” and others. It is worth noting that these tools are most often used for Active substance Such drugs change the transformation of the endometrium and enhance contractions reproductive organ. Under this influence, the endometrium is rejected and the egg is released from the female body.

Unlike drugs containing levonorgestrel, tablets containing mifepristone can interrupt even after a delay in menstruation. This way the woman has time to accept correct solution. Data birth control pills after sexual intercourse are taken once. In this case, you should first obtain a doctor’s approval for such a correction. If the drug was not taken within the first three days after sperm entered the woman’s body, then the patient will need additional ones that block the production of progesterone.

These medications containing mifepristone are slightly more expensive than previous medications. So, one package can cost you from 1,500 to 3,000 rubles.

An alternative method for emergency interruption of egg development

In addition to the above, there are medications (contraceptives) to prevent unwanted conception after sexual intercourse. These include the most common ones. However, doctors strongly do not recommend using this method due to possible side effects and complications. These drugs include the following drugs: birth control pills “Yarina”, “Logest”, “Novinet” and others.

They should be used only after carefully reading the instructions. Here you will need school knowledge in mathematics. It is necessary to calculate the amount of hormones contained in one tablet. After this, you should calculate how many capsules you need to take at one time to achieve the desired dose (as in Postinor tablets and its analogues). On average, a woman needs two to five capsules. You need to drink them every 12 hours for three days.

How effective are pregnancy pills?

It is worth noting that drugs that interrupt the development of the embryo at the most early stages, have different effectiveness. A lot depends on what time the medicine was taken. So, if you follow the instructions and take the first dose immediately after intercourse, the effectiveness of the drug will be more than 90 percent. In the case when at least a day has passed after sexual intercourse, the effect of the medicine will already be 70-80 percent effective. If the subsequent intake of the substance is disrupted or you are very late in taking the first dose, then the probability of a successful outcome will be from 50 to 70 percent.

It is worth recalling that if termination of pregnancy in the earliest stages with the help of the above drugs was not successful, then doctors strongly recommend curettage. The thing is that these drugs affect not only female body. The substances included in the tablets have a detrimental effect on the condition of the fertilized egg. If you want to leave the unborn baby, then be prepared for the fact that the child will be born sick or have some deviations.

and prices

In order to avoid the need to use emergency contraception, it is necessary to take care of methods of protection in advance. If you have a regular sexual partner, then it makes sense to start taking birth control pills. The price of such drugs can vary and range from 200 to 2000 rubles.

Absolutely all means of preventing pregnancy are divided into combined oral contraceptives and mini-pills. The latter contain a small dose of hormones and are not able to block ovulation in all women. However, it is worth noting that such drugs are the only tablets approved for use during breastfeeding. The drugs in the mini-pill group include the following:

• Charozetta tablets (cost about 800 rubles);
• drug "Laktinet" (price about 600 rubles);
• Orgametril pills (cost from 1000 rubles) and many others.

Action of combined oral contraceptives somewhat different. Such drugs completely block the functioning of the ovaries, preventing ovulation. The active substance of the tablets thickens the cervical mucus, preventing sperm from penetrating into the uterine cavity and surviving there. Besides hormonal drugs affect the condition of the endometrium, transforming it so that the fertilized cell cannot attach to the wall of the uterus. All oral contraceptives are divided into monophasic, biphasic and triphasic.

The following drugs are monophasic:

• Regulon tablets (cost from 300 rubles);
• “Zhanine” pills (approximately 800 rubles);
• birth control pills “35 Diane” (price from 1000 rubles) and others.

Two-phase contraceptives include Regvidon tablets (cost from 200 rubles) and other drugs.

Triphasic birth control pills include the following:

• Tri-Regol pills (cost from 200 rubles);
• Tri-Mercy capsules (price from 400 rubles).

Also, contraceptives may differ in the content of hormonal substances. So, tablets come in micro-dose and low-dose. There is also a group of high-dose drugs.

Microdosed ones include the following:

• Novinet tablets (cost from 500 rubles);
• the drug "Logest" (price approximately 900 rubles);
• Jess pills (cost around 1000) and others.

Low-dose products are:

• birth control pills “Yarina” (price from 700 rubles);
• the drug “Diane 35” (cost from 1000 rubles);
• means “Janine” (cost around 1000 rubles) and others.

Such drugs are more often prescribed to women who have given birth or to women over 30 years of age.

High-dose drugs have the following names:

• Trikvilar tablets (price about 500 rubles);
• the drug “Non-ovlon” (costs about 700 rubles) and so on.

Emergency (postcoital, urgent, fire) contraception is a special method of preventing the occurrence of unwanted pregnancy after unprotected sexual intercourse or if other methods of protection are ineffective.

Scientists long time studied the female body to find out how new life and what factors external environment necessary for her further development. Thanks to the development of science, doctors have learned to control the processes of fertilization. But not every pregnancy is long-awaited. Therefore, women, sacrificing their health and lives, tried various methods cessation of fetal development.

Today, the development of obstetrics and gynecology as a science has led to the creation of multiple means of contraception, including for emergencies. These drugs are separated into one special group due to a similar mechanism of action on the woman’s body in order to prevent unwanted pregnancy. Emergency contraception disrupts physiology menstrual cycle.

In addition to affecting the cycle itself, contraceptives increase the viscosity of cervical mucus, slow down the movement of germ cells and the embryo through the fallopian tubes, thereby disrupting the process of its implantation to the endometrium for further development.

Classification

There are two ways to administer fire contraceptives:

1. Tablets against unwanted pregnancy after sexual intercourse;
2. Copper-containing intrauterine devices.

According to the hormonal composition, emergency contraception is divided into drugs containing:

• High doses of estrogen.
• Gestagens.
• Combination of estrogen-gestagens.
• Antigonadotropins.
• Antigestagens.

According to experts, the effectiveness of emergency contraceptive drugs against pregnancy after unprotected intercourse is limited in time. The shorter the time interval between sex and reception medicines, the greater their effectiveness, but this time period should not exceed 72 hours. In case of exceeding of this period, the likelihood that fertilization of the egg has already occurred increases.

From the 6th day of pregnancy production begins human chorionic gonadotropin, which prevents the resorption of the corpus luteum. Its main task is to produce progesterone before the formation of the placenta for the further development of the fetus. It is much more difficult to interrupt the embryo development process at this time.

These pregnancy pills cannot be used continuously and they should not be the primary and only method of preventing sperm from fertilizing an egg. Drugs used for fire contraception affect not only the processes of conception and development of the embryo, but also the entire body as a whole. Since the drugs also have negative effects, not every woman can take them as contraceptives.

Therefore, before use, consultation and subsequent monitoring are necessary if prescribed by a gynecologist. Only a doctor can help you choose a specific method of emergency contraception for a woman.

The main indications for postcoital contraception are:

1. Rape.
2. Incorrect use/breakage of condom.
3. Delayed intake of combined oral contraceptives.
4. Interrupted sexual intercourse.
5. Unprotected sexual intercourse.

In addition to indications, there are diseases and conditions of the body when the use in various ways Emergency contraception is possible under the strict supervision of a doctor:

1. Diabetes.
2. A combination of factors – premenopausal age and the presence of tobacco smoking (more than 1 pack of cigarettes per day).
3. Hepatitis, cholecystitis, biliary dyskinesia.

Estrogens

These drugs were the first to be used for emergency contraception in gynecology. The use of steroid sex hormones is effective way. Used to prevent pregnancy high doses estrogen, so the main disadvantage of these contraceptives is frequent occurrence unfavorable side effects. Most common following symptoms: nausea, vomiting, imbalance between the coagulation and anticoagulation systems of the blood.

Besides, a large number of researchers are of the following opinion: if a woman managed to become pregnant after taking female sex hormones, then such pregnancy should be completed. Estrogens have a carcinogenic effect on the embryo. Women whose mothers took estrogens in the first half of pregnancy developed malignant diseases of the genital organs a few years later, and in men the processes of puberty were disrupted.

Gestagens

The most famous and widely used group of drugs in Russia. The main drugs are gestagens - Postinor and Escapelle. These drugs are disposable contraceptive pills after sexual intercourse. The gestagen underlying these drugs is levonorgestrel.

The principle of action of levonorgestrel is based on disruption of the processes of egg maturation. The drugs work only during the maturation phase of the dominant follicle and its subsequent development. During ovulation, levonorgestrel is not effective, and three days before it, the drug's potency decreases to 68%.

The following regimen for taking the drug Postinor has been developed: the starting dose is taken up to 72 hours after sex, and the second dose is taken 12 hours after the first tablet. The manufacturers of the drug remind you that Postinor should not be taken more than once per menstrual cycle.

Levonorgestrel is found in a drug called Escapelle. This emergency contraception contains only one pill, which is very good for use. Taking the drug is also limited to a time period of 72 hours after unprotected sexual intercourse. The effectiveness of these drugs in the first 24 hours is 95%.

Due to the heterogeneous effectiveness of gestagen preparations in different periods menstrual cycle, important issue It remains to be seen how these emergency measures affect the fetus in case of ineffectiveness of this method of contraception.

Based on many studies, experts claim that Postinor and Escapelle do not adversely affect the embryo and the course of pregnancy if they are ineffective.

Estrogen-gestagenic

Yuzpe and Lancee in 1977 developed an effective program for taking combined oral contraceptives containing progestogen-estrogen components. To prevent unwanted pregnancy, low-dose birth control pills can also be used to prevent unwanted pregnancy after intercourse. Depending on the dosage chemically active substances in them, only the number of tablets changes. The meaning of the method is to use fixed doses of estradiol and levonorgestrel, divided into two doses. The greatest effectiveness of the Yuspe method lies in the time frame - 72 hours after sex, and the interval between the first and second dose should be 12 hours.

The effectiveness of this method depends on:

• Time frame for taking medications.
• Phases of the menstrual cycle.
• Occurrences adverse reactions. Most common complication- vomiting; if you do not take another dose identical to the first one, the effectiveness decreases.

Drugs with antigonadotropic action

The mechanism of action of these drugs is based on a decrease in the production of hormones by the pituitary gland, which entails inhibition of ovarian function, a slowdown in the rate of egg release during the rupture of a mature follicle and changes in the mucous membrane of the uterine body, preventing the attachment of the fertilized egg. One of the drugs is Danazol or Danol.

The method of using Danazol is variable. The drug can be taken two or three times. The interval between doses should be 12 hours in order to create the required level of hormones in the blood. The main thing to remember is that the entire course of taking Danazol must be completed no later than 72 hours after unprotected sexual intercourse.

Antigestagens

Antigestagens - new and most studied pharmacological group substances whose pathogenetic effect is based on blocking progesterone-sensitive receptors. This hormone is produced at the beginning of pregnancy yellow body and is necessary for its maintenance.

The main advantage of the drugs is the highest efficiency during all stages of the menstrual cycle among tablet emergency contraceptives. This is due to the wide variety of mechanisms of action. In the preovulatory period, disposable contraceptive pills suppress ovulation; in the period after it, they act on the lining of the uterus and disrupt the process of implantation of the embryo into it.

Mifepristone is an emergency contraceptive that has these effects. By origin it is a synthetic antiprogestin. This substance contains pills against pregnancy after unprotected intercourse with the names: Agesta, Zhenale.

Mifepristone is an emergency contraceptive pill that affects all pathogenetic mechanisms of pregnancy, so the time period without reducing the percentage of effectiveness is 120 hours. If the fusion of germ cells has already occurred, then taking mifepristone can interrupt unwanted pregnancy, causing a reaction similar to menstruation.

The use of antigestagens as postcoital contraception is not permitted. In Russia, mifepristone is registered as a drug for medical abortion(if menstruation is delayed for no more than 42 days). In pharmacies, drugs may have different names, depending on the pharmacological company, but they are dispensed only with a doctor’s prescription and can only be taken after consulting a gynecologist.

Despite the high effectiveness of mifepristone, there is a possibility of pregnancy. In such cases, it is recommended to interrupt it, since the drug has an adverse effect on the embryo.

Mechanical emergency contraception

Installation of copper-containing intrauterine devices is the most effective for preventing pregnancy. The main condition for achieving the necessary goal is to set it no later than 5 days after unprotected sexual intercourse.

Today we have a wide range of different intrauterine devices. These emergency contraceptives come in different shapes, sizes, hardness and materials. Individual selection of the required spiral is the task of a gynecologist. The main principle of action is to prevent the migration of a fertilized egg to the endometrium - the mucous membrane of the uterine body, and copper has lethal effect on sperm, as a result of which they lose their ability to conceive.

Installation of any foreign devices in the uterine cavity is accompanied by an increased risk of infection or its spread due to existing infectious diseases genitals. There are cases when the use of these contraceptives is inappropriate:

• Should not be used by women with abnormal development of the genital organs.
• It is not recommended to use them for women with promiscuous sexual intercourse, since installed copper-containing IUDs do not protect against sexually transmitted diseases.
• The use of these emergency contraceptives is not recommended for women suffering from various inflammatory diseases pelvic organs.

Due to the fact that the IUDs are installed intrauterine, a small percentage of drugs enters the bloodstream. This explains the absence of hormone-mediated complications. Also, only 0.1–0.6% of the drug reaches breast milk, therefore, while taking the drug you can not stop breast-feeding. Well, the main advantage of intrauterine devices is the ability to use them later than 72 hours after unprotected sexual intercourse.

Don't forget about the risks of infection. Before using this method of contraception, a woman should be screened for sexually transmitted infections.

There are certain diseases and conditions of the body when the use this method Contraception is absolutely not acceptable:

1. Pregnancy or possible presence of it in a woman.
2. Any infectious and inflammatory diseases.
3. Oncological diseases of any parts of the uterus and mammary glands.
4. Congenital or acquired diseases leading to changes in the size, shape and configuration of the uterus.

Today, emergency contraception is becoming increasingly widespread, but it must be emphasized that the choice of method and method of contraception is the prerogative of the gynecologist.

Emergency contraception is a single dose emergency medicine to prevent pregnancy in order to reduce the number of abortions. Doctors do not recommend using it more than once per menstrual cycle or several cycles in a row. Therefore, after using emergency measures, a woman should choose another, more reasonable way to prevent pregnancy.

Postcoital contraceptive. Gestagen

Active substance

Levonorgestrel

Release form, composition and packaging

Pills white or almost white, disc-shaped, chamfered, with circular engraving "INOR." on one side.

Excipients: colloidal silicon dioxide, potato starch, magnesium stearate, talc, corn starch, lactose monohydrate.

2 pcs. - aluminum/PVC blisters (1) - cardboard packs.

pharmachologic effect

Synthetic gestagen with a contraceptive effect, pronounced gestagenic and antiestrogenic properties. With the recommended dosing regimen, levonorgestrel suppresses ovulation and fertilization if sexual intercourse occurs in the preovulatory phase, when the possibility of fertilization is greatest. It may also cause changes in the endometrium that prevent implantation. The drug is not effective if implantation has already occurred.

Efficacy: with the help of Postinor tablets, pregnancy can be prevented in approximately 85% of cases. The more time passes between sexual intercourse and taking the drug, the lower its effectiveness (95% during the first 24 hours, 85% from 24 to 48 hours and 58% from 48 to 72 hours). Thus, it is recommended to start taking Postinor tablets as soon as possible (but no later than 72 hours) after sexual intercourse, if no protective measures have been taken. At the recommended dose, levonorgestrel does not have a significant effect on blood clotting factors, fat and carbohydrate metabolism.

Pharmacokinetics

Suction and distribution

When taken orally, levonorgestrel is rapidly and almost completely absorbed. Absolute bioavailability is almost 100% of the dose taken. After taking 750 mcg of levonorgestrel, Cmax in serum equal to 14.1 ng/ml is achieved after 1.6 hours. After reaching Cmax, the content of levonorgestrel decreases. T 1/2 is about 26 hours.

Metabolism and excretion

Levonorgestrel is excreted approximately equally by the kidneys and through the intestines exclusively in the form of metabolites. The biotransformation of levonorgestrel corresponds to the metabolism of steroids. Levonorgestrel is hydroxylated in the liver, metabolites are excreted in the form of conjugated glucuronides. Pharmacologically active metabolites of levonorgestrel are unknown. Levonorgestrel binds to serum and sex hormone binding globulin (SHBG). Only 1.5% of the total dose is in free form, and 65% is associated with SHBG.

Indications

- emergency (postcoital) contraception (after unprotected sexual intercourse or unreliability of the contraceptive method used).

Contraindications

— increased sensitivity to the components of the drug;

— adolescence up to 16 years old;

- pregnancy;

- rare hereditary diseases, such as lactose intolerance, lactase deficiency or glucose-galactose malabsorption.

Carefully: diseases of the liver and biliary tract, jaundice (including history), lactation.

Dosage

The drug is taken orally. You must take 2 tablets in the first 72 hours after unprotected intercourse. The second tablet should be taken 12 hours (but not later than 16 hours) after taking the first tablet.

To achieve a more reliable effect, both tablets should be taken as soon as possible after unprotected intercourse (no later than 72 hours).

If vomiting occurs within 3 hours after the 1st or 2nd dose of Postinor tablet, then you should take another Postinor tablet.

Postinor can be used at any time of the menstrual cycle. In case of irregular menstrual cycle, pregnancy must first be excluded.

After taking emergency contraception, use a local barrier method (eg, condom, cervical cap) until your next period. The use of the drug during repeated unprotected sexual intercourse during one menstrual cycle is not recommended due to an increase in the frequency of acyclic spotting/bleeding.

Side effects

Allergic reactions: possible - urticaria, rash, itching, swelling of the face.

Transient side effects, occurring with different frequencies and not requiring drug therapy: very often (≥1/10), often (≥1/100,<1/10)

From the reproductive system: very often - pain in the lower abdomen, acyclic spotting (bleeding); often - soreness of the mammary glands, delayed menstruation (no more than 5-7 days, if menstruation is delayed for a longer period, it is necessary to exclude pregnancy).

From the digestive system: very often - nausea; often - vomiting, diarrhea.

From the nervous system: often - dizziness, headache.

Other: very often - fatigue.

Overdose

Symptoms: increased severity of side effects.

Treatment: there is no specific antidote. Symptomatic therapy is carried out.

Drug interactions

When taking drugs that induce liver enzymes simultaneously, the metabolism of levonorgestrel is accelerated.

The following drugs may reduce the effectiveness of levonorgestrel: amprecavil, lansoprazole, oxcarbazepine, tacrolimus, topiramate, tretinoin, barbiturates including primidone, phenytoin and carbamazepine; preparations containing St. John's wort (Hypericum perforatum), as well as rifampicin, ritonavir, tetracycline, rifabutin, griseofulvin.

Levonorgestrel reduces the effectiveness of hypoglycemic and anticoagulant (coumarin derivatives, phenindione) drugs. Increases plasma concentrations of GCS. Women taking these drugs should consult a doctor.

Drugs containing levonorgestrel may increase the risk of toxicity due to inhibition of its metabolism.

special instructions

Postinor should be used exclusively for emergency contraception. Repeated use of the drug Postinor during one menstrual cycle is not recommended.

The effectiveness of Postinor tablets after unprotected sexual intercourse, during which contraception was not used, decreases over time:

The drug does not replace the use of permanent methods of contraception. In most cases, Postinor does not affect the nature of the menstrual cycle. However, acyclic bleeding and a delay of menstruation for several days are possible. If menstruation is delayed by more than 5-7 days and its character changes (scanty or heavy discharge), pregnancy must be excluded. The appearance of pain in the lower abdomen and fainting may indicate an ectopic (ectopic) pregnancy.

Adolescents under 16 years of age, in exceptional cases (including rape), need to consult a gynecologist to confirm pregnancy.

After emergency contraception, a consultation with a gynecologist is recommended to select the most appropriate method of permanent contraception.

Emergency contraception does not protect against sexually transmitted diseases.

In case of gastrointestinal dysfunction (for example, Crohn's disease), the effectiveness of the drug may be reduced.

Impact on the ability to drive vehicles and machinery

The effect of Postinor on the ability to drive vehicles and operate machinery has not been studied.

Pregnancy and lactation

Postinor is contraindicated for use during pregnancy. If pregnancy occurs while using an emergency method of contraception, then based on the available data, no adverse effect of the drug on the fetus has been identified.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

The drug should be stored out of the reach of children at a temperature of 15° to 25°C. Shelf life - 5 years.

As sad as it is to write about this, Postinor in Russia ranks second among contraceptive methods. The first one, as you know, is . And yet, many women, despite the large selection of contraceptives, use postinor to prevent unwanted pregnancy, forgetting or not knowing about the complications, and what danger harmless 2 tablets pose in the future.

Meet Postinor

Postinor is available in a package containing only 2 tablets (only the number of tablets should suggest that this is not a drug for regular use). One tablet contains 750 mcg of levonorgestrel, which has an emergency contraceptive effect. Levonorgestrel has antiestrogenic and progestogenic properties.

Postinor refers to emergency or fire contraception, and should be used only in exceptional cases, and not constantly and regularly.

How does postinor work?

The contraceptive effect of the drug consists of three points. Firstly, levonorgestrel prevents the release of the egg from the follicle, that is, it inhibits ovulation (this is especially important in the preovulatory and ovulatory phases). Secondly, levonorgestrel, as a gestagen, changes the structure of the uterine mucosa and causes “glandular regression” of the endometrium, which makes it impossible for a fertilized egg to penetrate the uterine wall (impaired implantation). This mechanism is comparable to, that is, conception has already occurred, but the uterus expels the egg. And thirdly, levonorgestrel causes changes in the mucus in the cervical canal, making it viscous and thick. This mucus acts as a barrier and makes it difficult for sperm to penetrate into the uterine cavity.

From the described mechanisms of action of postinor, it becomes clear that the effectiveness of the drug is directly proportional to the time it is taken after unprotected sex. After using postinor 24 hours or less after sexual intercourse, it will protect against unwanted pregnancy in 95% of cases; when taking tablets after 25–48 hours, the effectiveness is 85%, and if postinor was taken between 49 and 72 hours, its reliability decreases up to 58%.

Rules for taking postinor

Postinor can be taken on any day of the menstrual cycle. If a woman has an irregular menstrual cycle, the absence of pregnancy should be confirmed. The first tablet from the blister should be taken no later than 72 hours after coitus. The second dose should be taken exactly 12 hours later (the interval can be increased by 4 hours, that is, no more than 16 hours later).

If a woman vomits within three hours after taking a postinor tablet (regardless of the first or second), she must take an additional tablet. Menstrual-like bleeding (withdrawal bleeding) can occur a few days after taking the drug (on average 3 to 7 days) and about a month later (during the expected period).

Postinor is not a means for regular contraception; if a woman is sexually active, she should consult a doctor and choose the optimal method of birth control. It is believed that you should not use the drug more than once a month, and preferably no more than 4 times a year. In fact, it is better not to resort to postinor at all, but to use it only in an exceptional situation.

When is postinor use justified?

Life is an unpredictable thing and there are situations when it is necessary to prevent pregnancy:

• rape;
• the condom broke;
• unprotected sexual intercourse for various reasons;
• expulsion of the intrauterine device or shift of the vaginal diaphragm;
• a missed dose from a series of combined oral contraceptives.

Consequences after using postinor

Since the drug contains an “elephant” dose of the hormone, its use can adversely affect a woman’s health. Firstly, there is a high probability of uterine bleeding, which can only be stopped surgically (that is, curettage of the uterus). Secondly, taking postinor, especially more than once in a lifetime, causes a blow to the ovaries, which leads to menstrual irregularities, hormonal imbalance and anovulation. All of these effects are a direct path to infertility. Thirdly, a large dose of levonorgestrel cannot but cause side effects:

• nausea and vomiting, diarrhea;
• headache, dizziness;
• mood changes (emotional lability, panic fears);
• delay of menstruation;
• allergic reactions;
• pain in the lower abdomen, fatigue;
• pain and engorgement of the mammary glands.

Registration number: P N011850/01

Tradename: Postinor

International nonproprietary name:
levonorgestrel

Dosage form: pills

Compound

Each tablet contains:

Active substance: levonorgestrel 0.75 mg.
Excipients: colloidal silicon dioxide, potato starch: magnesium stearate: talc; corn starch; lactose monohydrate.

Description
Flat tablets of white or almost white color, disc-shaped with a chamfer and with a circular engraving "I N O R ●" on one side.

F armacotherapy group: gestagen.

ATX code: G03A POP

Farmacological properties
Pharmacodynamics
Levonorgestrel is a synthetic gestagen with a contraceptive effect, pronounced gestagenic and antiestrogenic properties. With the recommended dosage regimen, levonorgestrel suppresses ovulation and fertilization if sexual intercourse occurs in the preovulatory phase, when the possibility of fertilization is greatest. It may also cause changes in the endometrium that prevent implantation. The drug is not effective if implantation has already occurred.
Efficacy: with the help of Postinor tablets, pregnancy can be prevented in approximately 85% of cases. The more time passed between sexual intercourse and taking the drug, the lower its effectiveness (95% during the first 24 hours, 85% from 24 to 48 hours and 58% from 48 to 72 hours). Thus, it is recommended to start taking Postinor tablets as soon as possible (but no later than 72 hours) after sexual intercourse, if no protective measures have been taken. At the recommended dose, levonorgestrel does not have a significant effect on blood clotting factors, fat and carbohydrate metabolism.

Pharmacokinetics
When taken orally, levonorgestrel is rapidly and almost completely absorbed.
After taking 0.75 mg of levonorgestrel, the maximum concentration of the drug in serum equal to 14.1 ng/ml is achieved after 1.6 hours. After reaching the maximum level of concentration, the content of levonorgestrel decreases, and the half-life is about 26 hours.
Levonorgestrel is excreted approximately equally by the kidneys and through the intestines exclusively in the form of metabolites. The biotransformation of levonorgestrel corresponds to the metabolism of steroids. Levonorgestrel is hydroxylated in the liver and metabolites are excreted in the form of conjugated glucuronides. Pharmacologically active metabolites of levonorgestrel are unknown. Levonorgestrel binds to serum albumin and sex hormone binding globulin (SHBG). Only 1.5% of the total dose is in free form, and 65% is associated with SHBG. Absolute bioavailability is almost 100% of the dose taken.

Indications for use
Emergency (postcoital) contraception (after unprotected sexual intercourse or unreliability of the contraceptive method used).

Contraindications
Hypersensitivity to any component of the drug, use in adolescents under 16 years of age, severe liver failure, pregnancy.
Patients with rare hereditary diseases such as lactose intolerance, lactase deficiency or glucose-galactose malabsorption.

Carefully
Diseases of the liver or biliary tract, jaundice (including a history), Crohn's disease, lactation.

Pregnancy and lactation
Postinor should not be used during pregnancy. If pregnancy occurs while using an emergency method of contraception, then based on the available data, no adverse effect of the drug on the fetus has been identified.
Levonorgestrel passes into breast milk. After taking the drug, breastfeeding should be stopped for 24 hours.

Directions for use and doses
The drug is administered orally. You must take 2 tablets in the first 72 hours after unprotected intercourse. The second tablet should be taken 12 hours (but not later than 16 hours) after taking the first tablet.
To achieve a more reliable effect, both tablets should be taken as quickly as possible after unprotected intercourse (no later than 72 hours).
If vomiting occurs within three hours after taking 1 or 2 Postinor tablets, then you should take another Postinor tablet.
Postinor can be used at any time of the menstrual cycle. In case of irregular menstrual cycle, pregnancy must first be excluded.
After taking emergency contraception, a local barrier method (eg, condom, cervical cap) should be used until the next menstrual period. The use of the drug during repeated unprotected sexual intercourse during one menstrual cycle is not recommended due to an increase in the frequency of acyclic spotting/bleeding.

Side effect
Allergic reactions are possible: hives, rash, itching, swelling of the face.
Transient side effects occurring with varying frequency (common: ≥1/100,<1/10, очень часто: ≥1/10) и не требующие медикаментозной терапии: часто: рвота, диарея, головокружение, головная боль, болезненность молочных желез, задержка менструации (не более 5-7 дней), если менструация задерживается на более длительный срок, необходимо исключить беременность.
Very common: nausea, fatigue, lower abdominal pain, acyclic spotting (bleeding).

Frelease form
Tablets 0.75 mg. 2 tablets in an AL/PVC blister. 1 blister in a cardboard box with attached instructions for use.

Ustorage conditions
List B. At a temperature of 15 °C to 25 °C, out of the reach of children.

WITHrock expiration date
5 years.
Do not use the drug after the expiration date.

Uterms of dispensing from pharmacies
On prescription.

Manufacturer
JSC "Gedeon Richter"
1103 Budapest, st. Demrei 19-21, Hungary

Consumer complaints should be sent to:
Moscow Representative Office of JSC Gedeon Richter
119049 Moscow. 4th Dobryninsky lane d.8.