Levofem birth control pill: Uses, dosage, price, drug interaction, and side effects

 Key takeaways:

• Levofem is a combination birth control pill containing levonorgestrel, ethinyl estradiol, and ferrous fumarate. This hormonal oral contraceptive consists of 21 active yellow pills and 7 inactive white pills.
• Levofem can interact with various medications, including antibiotics, antifungals, anticoagulants, and others, so it should be taken with caution. In fact, the National Agency for Food and Drug Administration and Control (NAFDAC) lists it as a prescription-only medicine, meaning people should only use it when their doctor prescribes it.
• Patients should inform their general practitioners of allergies, medications, and pregnancy status before using Levofem.

There are different forms of contraceptives, ranging from barrier methods like condoms to intrauterine devices (IUDs), implants, and oral pills.

Data from the National Center for Health Statistics shows that from 2015–2017, about 64.9% of the 72.2 million females of childbearing age in the United States were using contraception. Following female sterilization (18.6%), oral contraceptive pills were the second most commonly used contraceptive option (12.6%).

Levofem is an example of an effective oral contraceptive that people now commonly use to prevent pregnancy. This brand-name hormonal pill is commonly marketed and sold in pharmaceutical stores across Nigeria and other countries.

 What is Levofem?

Levofem is a combined oral contraceptive medication that is widely used for birth control or simply preventing pregnancy. Combined birth control pills are pills that contain agents that mimic estrogen and progesterone hormones. 

Levofem is a prescription-only birth control pill designed to be taken once daily to prevent pregnancy. This combination oral medication contains the synthetic forms of progesterone and estrogen, i.e., progestin (levonorgestrel; 0.03 mg) and ethinyl estradiol (0.15 mg). It also contains ferrous fumarate (75 mg). Levofem is manufactured by PT. Harsen Laboratories, Indonesia, and distributed by DKT Nigeria.

Doctors typically prescribe Levofem as a regular, everyday birth control pill. But it may also be used as an emergency contraceptive to prevent pregnancy when a person’s regular birth control method fails, e.g., when a condom breaks or slips off while in use.

However, to use combined oral contraceptives like Levofem as an emergency pill, you will need to take a higher-than-usual dose. Keep in mind that it might not be safe to regularly use it as an emergency contraceptive. So, discuss with your doctor before using it as an emergency contraceptive. 

 How Levofem works

Levofem works via the following mechanisms:

• Suppressing ovulation: Levofem suppresses ovulation, which is the release of eggs from the ovaries. Taking in synthetic estrogen and progesterone inhibits the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are hormones that induce ovulation. This means that people taking this pill don’t ovulate while they are on the pill, and therefore, there are no eggs available for fertilization by sperm. 
• Altering the uterine line: Additionally, combined oral contraceptives alter the lining of the uterus, making it less hospitable for the implantation of a fertilized egg, thereby preventing fertilized ova from developing. 
• Thickening cervical mucus: Levofem pills can also affect the cervical mucus, thickening it to create a barrier that restricts the entry of sperm into the uterus.

Oral contraceptives, such as Levofem, which contain these estrogen-progestin combinations, are widely recognized for their high efficacy in birth control. Levofem is a convenient and reliable method for many individuals to prevent unintended pregnancies. 

The ferrous fumarate in Levofem serves as a supplementary form of iron, helping improve hemoglobin levels in the bloodstream, particularly during the menstrual cycle. Hemoglobin, a protein in red blood cells, plays a crucial role in transporting oxygen throughout the body.

During menstruation, women may experience increased iron loss, leading to the potential depletion of hemoglobin levels and the development of iron deficiency anemia. Ferrous fumarate supplementation helps replenish iron stores, thereby promoting the production of hemoglobin and maintaining overall blood health during menstruation.

 Levofem dosage: How to take Levofem to prevent pregnancy

Levofem pills should be taken once daily for 28 consecutive days. A pack of Levofem consists of 21 active pills, which are yellow in color, and 7 inactive pills, which are white in color.

Take the yellow, active pills at about the same time for 21 days before starting the white pills. You should start taking the medication on the first day of your menstrual period. If there is a lapse that exceeds 24 hours between doses, the efficacy of this contraceptive pill may be reduced.

During the consumption of the white tablets, withdrawal bleeding may occur. The breakthrough bleeding will typically occur during the intake of the last 7 inactive pills, and this is because the pills don't contain the progestin and estrogen synthetic hormones, causing a sharp drop of these hormones in the body. Similar to what happens in a normal cycle, a drop in the estrogen and progesterone hormones is what triggers menstruation. This means that with its two active agents, Levofem mimics the intricate feedback loop that controls the menstrual and ovarian cycles.

Regardless of the status of your bleeding, continue with another pack of Levofem the day after consuming the final white tablet from the current pack. Ensure the consumption of all tablets within one pack before commencing a fresh one, and adhere to these instructions accordingly. 

 What to do if you forgot to take a Levofem pill

Here is what to do if you forget to take your Levofem birth control pill.

If you missed one Levofem pill, don’t worry:

• Take the missed pill right away, even if it means taking two pills at once.
• Continue taking your pills daily as usual.

If you missed two or more pills in a row:

• Take two pills as soon as you remember.
• Continue taking your pills daily as usual.
• For the next 7 days, use condoms or another form of birth control to prevent pregnancy.
• When you finish the active pills, skip the inactive pills and start a new pack of Levofem immediately.

If you missed any inactive pills:

• Just discard the missed ones. They do not affect your birth control.
• Start your next pack of Levofem on the scheduled day.

 Levofem drug interactions

Combination oral contraceptives such as Levofem can interact with certain medications and should be avoided when taking them. Some medications that can interact with Levofem include:

• Antibiotics such as ampicillin (Principen), clarithromycin (Biaxin), metronidazole (Flagyl), and tetracycline (Sumycin)
• Acetaminophen (APAP, Tylenol);
• Anticoagulants ('blood thinners) such as warfarin (Coumadin) 
• Antifungals such as fluconazole (Diflucan) and ketoconazole (Nizoral) 
• Medications for seizures such as carbamazepine (Tegretol), lamotrigine (Lamictal), oxcarbazepine (Trileptal), and primidone (Mysoline)
• Clofibrate (Atromid-S);
• Atorvastatin (Lipitor)
• Fluoxetine (Prozac, Sarafem)
• Vitamin C
• HIV protease inhibitors such as indinavir (Crixivan) and ritonavir (Norvir)
• Modafinil (Provigil)
• Morphine
• Oral steroids such as dexamethasone (Decadron, Dexone), prednisolone (Prelone), and prednisone (Deltasone)
• Thyroid medications, such as levothyroxine (Levothroid, Levoxyl, Synthroid)

 Side effects of Levofem

Levofem can cause side effects such as:

• Headaches
• Gastric upsets 
• Nausea and vomiting 
• Impaired appetite
• Breast tenderness 
• Breast enlargement 
• Slight changes in body weight or libido
• Depressive moods
• Spotting between periods

Some rare side effects that are serious and require immediate medical attention may include blood clots, allergic reactions, and liver problems.

 Precautions to take when taking Levofem tablets

Before taking Levofem, like every other oral contraceptive, you should take the following precautions:

• Inform your doctor or pharmacist if you are allergic to any of the main ingredients of Levofem, including levonorgestrel and ethinyl estradiol.
• Let your doctor in on any prescription and non-prescription medications, vitamins, and nutritional supplements you are taking.
• Tell your doctor what herbal products you are taking, such as St. John's wort.
• Do not take Levofem if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking Levofem, inform your doctor immediately.
• If you wear contact lenses, tell your doctor or pharmacist before taking Levofem. If you notice changes in vision or the ability to wear your lenses while taking oral contraceptives such as Levofem, see an eye doctor.
• If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking Levofem.

 Price of Levofem and where to buy it

The price of Levofem tablets ranges from ₦500.00 to ₦950.00 in Nigeria. It can be found in pharmacies across the country. However, it is worthy of note that Levofem is a prescription-only medicine (POM) and can only be dispensed with a prescription from a medical doctor.