Progestogen-only contraceptive (POP + emergency contraception)
ATC code: G03AC03 (Levonorgestrel)
Levonorgestrel is a second-generation progestin. At 30 µg (POP) acts via cervical mucus and endometrium with 3-hour missed-dose window. At 1.5 mg (emergency contraception) blocks ovulation if taken before the LH surge; efficacy drops after the surge. Effective up to 72 h post-coitus, with diminishing effect up to 96 h.
First line
Levonorgestrel POP 30 µg during breastfeeding – MEC 2015 category 1. Does not reduce milk supply. Emergency 1.5 mg in breastfeeding women is also compatible (Hale L2), no feeding interruption needed. RID about 1.3%.
First line
Emergency contraception 1.5 mg within 72 h of unprotected sex. Per SEGO 2023, second-line after ulipristal but cheaper and OTC. Reduced efficacy at BMI ≥30 – ulipristal or copper IUD preferred. Pregnancy rate 2.2% (vs 1.4% with ulipristal).
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Accidental use in early pregnancy is not linked to defects. Do not use in confirmed pregnancy.
WHO MEC 2015 category 1 for POP 30 µg from day 1 postpartum. Emergency 1.5 mg also compatible (Hale L2), no feeding pauses. RID about 1.3%.
Levonorgestrel is evaluated for the following indications with varying evidence strength: Emergency contraception (evidence tier A), Contraception during breastfeeding (evidence tier A). See the full indication matrix with dosing and citations above on this page.
Common side effects of Levonorgestrel (≥ 1 in 100): Nausea (14%), Headache, Fatigue, Breast tenderness, Menstrual irregularity. See the Safety section for uncommon and serious reactions.
FDA category X. Accidental use in early pregnancy is not linked to defects. Do not use in confirmed pregnancy.
WHO MEC 2015 category 1 for POP 30 µg from day 1 postpartum. Emergency 1.5 mg also compatible (Hale L2), no feeding pauses. RID about 1.3%.
Levonorgestrel is contraindicated in: Hypersensitivity; Confirmed pregnancy; Severe liver disease; Breast cancer (for POP). Full list in the Safety section.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.