A systematic review of effectiveness and safety of different regimens of levonorgestrel oral tablets for emergency contraception

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• 作者：Mohammad Shohel (3)
  Mohammad Mahfuzur Rahman (3)
  Asif Zaman (3)
  Mir Muhammad Nasir Uddin (3)
  Md Mamun Al-Amin (3)
  Hasan Mahmud Reza (3)
  
• 关键词：Levonorgestrel ; Oral contraceptive ; Emergency contraception ; Two dose regimen ; Postcoital contraception ; Single dose strategy ; Contraceptive efficacy ; Unintended pregnancy ; Postcoital hormonal contraceptives
• 刊名：BMC Women's Health
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：237 KB
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  45. The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1472-6874/14/54/prepub
  
• 作者单位：Mohammad Shohel (3)
  Mohammad Mahfuzur Rahman (3)
  Asif Zaman (3)
  Mir Muhammad Nasir Uddin (3)
  Md Mamun Al-Amin (3)
  Hasan Mahmud Reza (3)
  
  3. Department of Pharmacy, University of Chittagong, Chittagong, Bangladesh
  
• ISSN：1472-6874

文摘

Background Unintended pregnancy is a complex phenomenon which raise to take an emergency decision. Low contraceptive prevalence and high user failure rates are the leading causes of this unexpected situation. High user failure rates suggest the vital role of emergency contraception to prevent unplanned pregnancy. Levonorgestrel - a commonly used progestin for emergency contraception. However, little is known about its pharmacokinetics and optimal dose for use. Hence, there is a need to conduct a systematic review of the available evidences. Methods Randomized, double-blind trials were sought, evaluating healthy women with regular menstrual cycles, who requested emergency contraception within 72 h of unprotected coitus, to one of three regimens: 1.5 mg single dose levonorgestrel, two doses of 0.75 mg levonorgestrel given 12 h apart or two doses of 0.75 mg levonorgestrel given 24 h apart. The primary outcome was unintended pregnancy; other outcomes were side-effects and timing of next menstruation. Results Every trial under consideration successfully established the contraceptive effectiveness of levonorgestrel for preventing unintended pregnancy. Moreover, a single dose of levonorgestrel 1.5?mg for emergency contraception supports its safety and efficacy profile. If two doses of levonorgestrel 0.75?mg are intended for administration, the second dose can positively be taken 12-4?h after the first dose without compromising its contraceptive efficacy. The main side effect was frequent menstrual irregularities. No serious adverse events were reported. Conclusions The review shows that, emergency contraceptive regimen of single-dose levonorgestrel is not inferior in efficacy to the two-dose regimen. All the regimens studied were very efficacious for emergency contraception and prevented a high proportion of pregnancies if taken within 72 h of unprotected coitus. Single levonorgestrel dose (1.5 mg) can substitute two 0.75 mg doses 12 or 24 h apart. With either regimen, the earlier the treatment is given, the more effective it seems to be.