Progestins
Class: Contraceptives
ATC Class: G03FA10
VA Class: HS200
CAS Number: 54048-10-1
Brands: Fallback Solo, Implanon, Micronor, Mirena, Next Choice One Dose, Nor-QD, Opcicon One-Step, Plan B One-Step
Introduction
Contraceptives containing synthetic progestinic steroids.
Uses for Progestins
Contraception
Prevention of conception in women.
Predominantly used by women who are breastfeeding and in those who do not tolerate estrogens or in whom estrogens are contraindicated.
Levonorgestrel-releasing intrauterine system (Mirena): Intended for women who have had ≥1 child; are in a stable, mutually monogamous relationship; have no history of pelvic inflammatory disease (PID); and have no history of ectopic pregnancy or any condition that would predispose to ectopic pregnancy.
Postcoital (Emergency) Contraception
Prevention of conception after unprotected intercourse (including known or suspected contraceptive failure) as an emergency contraceptive (“morning-after” pills). Postcoital (emergency) contraceptive regimens are not as effective as most other forms of long-term contraception; do not use as routine forms of contraception.
An emergency contraceptive regimen employing a progestin alone (levonorgestrel) appears to be more effective and better tolerated than a common estrogen-progestin emergency contraceptive (“Yuzpe”) regimen when the regimens are initiated within 72 hours of unprotected intercourse; levonorgestrel generally preferred when readily available.
Progestins Dosage and Administration
Administration
Administer norethindrone orally.
Administer levonorgestrel orally or as an intrauterine system.
Administer etonogestrel implant by sub-Q insertion.
Oral Administration
Contraception
Take as near as possible to the same time each day (i.e., at regular 24-hour intervals) and continue daily without interruption to ensure maximum contraceptive efficacy.
If vomiting occurs soon after a dose, use a back-up method of contraception (e.g., condoms, foam, sponges) for 48 hours.
Available in a mnemonic dispensing package designed to aid the user in complying with the prescribed dosing regimen.
Postcoital (Emergency) Contraception
Plan B One-Step, Next Choice One Dose: Administer as soon as possible but preferably within 72 hours following unprotected sex.
Levonorgestrel 2-dose regimen: Administer the first dose as soon as possible within 72 hours of unprotected sex followed by a second dose 12 hours after the first dose.
Most data support administration of either regimen up to 120 hours† after unprotected intercourse if necessary, but efficacy decreases as initiation of contraception becomes more remote from unprotected intercourse.
May be used at any time during the menstrual cycle. Efficacy not established if administered >120 hours after unprotected sex.
Plan B One-Step, Next Choice One Dose : If vomiting occurs within 2 hours after administration, contact clinician to discuss repeating the dose.
Levonorgestrel 2-dose regimen: If vomiting occurs within 2 hours after administration of either the first or second dose, contact clinician to discuss taking another dose.
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