"Postinor" refers to postcoital drugs. It is available in the form that must be taken immediately after intercourse without contraception (rape, torn condom). You can be guaranteed if you take the first one within 24 hours after having sex, and the second one 12 hours after the first one.

"Postinor" contains a "shock" dose of the hormone levonorgestrel. It acts simultaneously in three directions: it delays, creates obstacles for spermatozoa and prevents the attachment of an already fertilized egg to the endometrium. Such a serious remedy is recommended to be used only in the most extreme cases and no more than once every six months. After all, a "hormonal shock" can cause serious harm to the female body.

What can the reception of "Postinor" lead to?

At first glance, "Postinor" seems to be a good way of protection. However, two small ones, if you use them often or accidentally violate the instructions, can cause tremendous harm to the body. If you are going to use the drug, be prepared for unexpected consequences.

Most often, women note a violation of the cycle, as well as intermenstrual bleeding. But if you used Postinor once, this situation will quickly improve. If "Postinor" has become your constant "companion", the violation of menstruation can become regular, which will gradually lead to infertility.

If a woman has a disturbed blood coagulation system, taking Postinor (even once) can provoke the formation of blood clots. This is due to hormones that thicken the blood. The most dangerous consequence is the development of thrombosis and thromboembolism of the vessels of the heart and brain.

"Postinor" is dangerous to take for girls and women with liver pathologies, a tendency to urolithiasis, and dysfunction of the biliary tract. Also be prepared for nausea, headache, vomiting. Doctors call such consequences “transient”, arising from a strong “hormonal shock”. However, be careful: if vomiting occurs within the first two to three hours after taking the pill, immediately drink another one.

"Postinor" can cause severe uterine bleeding. If it does not end on its own, be sure to consult a doctor. The other side is the absence of bleeding after taking the pills. Not the onset of menstruation within two to three weeks may signal a negative effect of the drug on the reproductive organs or a conception that has taken place.

No matter how sad it is to write about it, but postinor in Russia ranks second among contraceptive methods. On the first, 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 the harmless 2 pills pose in the future.

Meet Postinor

Postinor is produced in a package in which there are 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 is in three points. Firstly, levonorgestrel prevents the release of the egg from the follicle, that is, it inhibits ovulation (this moment is especially relevant in the preovulatory and ovulatory phases). Secondly, levonorgestrel, as a progestogen, changes the structure of the uterine mucosa and causes "glandular regression" of the endometrium, which makes it impossible for a fertilized egg to penetrate into the uterine wall (violation of 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. Such mucus plays the role of a barrier and makes it difficult for sperm to enter 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 intercourse, it will protect against unwanted pregnancy in 95% of cases, when taking pills after 25-48 hours, the effectiveness is 85%, and if postinor was taken in the interval from 49 to 72 hours, its reliability decreases up to 58%.

Rules for accepting a 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 intercourse. The second dose should be taken exactly 12 hours later (an interval of 4 hours is allowed, 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 one), an additional tablet should be taken. Menstrual-like bleeding (withdrawal bleeding) can occur a few days after taking the drug (on average after 3 to 7 days) and about a month later (at the time of the expected period).

Postinor is not a means for regular contraception, if a woman has an active sex life, she should consult a doctor and choose the best method of contraception. It is believed that you can 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 justified?

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

• rape;
• the condom broke;
• unprotected intercourse for various reasons;
• expulsion of the intrauterine device or shift of the vaginal diaphragm;
• missed taking a pill 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, by curettage of the uterus). Secondly, taking postinor, especially more than once in a lifetime, hits 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 swings (emotional lability, panic fears);
• delay of menstruation;
• allergic reactions;
• pain in the lower abdomen, fatigue;
• pain and engorgement of the mammary glands.

1 tablet contains 750 mcg , as well as anhydrous colloidal silicon dioxide, magnesium stearate, potato and corn starch, talc, lactose monohydrate.

Release form

Tablets packaged in blisters of 2 pcs. The package contains 1 blister.

Contraceptive pills Postinor are flat, approximately 6 mm in diameter, with a chamfer, almost white, on one side they are engraved with the inscription "INOR".

pharmachologic effect

The drug helps to prevent pregnancy, causes effects in the body similar to the action of hormones of the corpus luteum of the ovaries, and also suppresses the effects caused by .

Pharmacodynamics and pharmacokinetics

What is Postinor?

Postinor is a remedy with a pronounced antiestrogen And progestogenic activity. These properties of the drug make it difficult to conceive at an early stage and help prevent pregnancy.

Pharmacodynamics

How Postinor works is not exactly known. Contained in tablets levonorgestrel prevents ovulation and fertilization of the egg if UPC (unprotected sexual intercourse) happened before ovulation (when fertilization is most likely).

Levonorgestrel also causes changes in the endometrium, which make it difficult for a fertilized egg to enter the mucous layer of the uterine cavity. In cases where the attachment of the fetal egg has already begun, the drug does not give the expected effect.

Wikipedia states that the mechanism of action levonorgestrel is most successful when the size of the dominant follicle is 17 mm. Best of all, the drug suppresses ovulation no later than three days before it.

The effectiveness of tablets

The probability of pregnancy after the use of Postinor tablets is 15-42%. The action after taking the better, the less time has passed after NPC.

If the drug was taken within 24 hours, its effectiveness is 95%, in the next 24 hours it decreases to 85%, on the third day - up to 58%. It makes no sense to take the drug later than 72 hours later.

Is Postinor harmful?

Pharmacokinetics

Absorption in the alimentary canal when ingested is rapid and complete. In the body, the drug binds to SHBG and albumin: approximately 65% ​​of the dose taken is associated with SHBG, only 1.5% is in the free form.

96 minutes after taking the tablet, the plasma concentration levonorgestrel reaches 14.1 ng/ml. Then there is a 2-stage decrease in Cmax.

The drug is well distributed in tissues and organs.

Its biotransformation is carried out in the liver. The resulting metabolic products (conjugated glucuronates) are pharmacologically inactive.

Levonorgestrel It is excreted from the body exclusively in the form of metabolic products. About half of the dose taken is excreted in the urine, the rest - in the faeces. The value of T1 / 2 varies from 9 to 14.5 hours.

With milk, about 0.1% of the dose enters the body of an infant when a nursing woman takes Postinor.

Indications for use

“Urgent” contraception in case of failure of the chosen method of contraception or after CPD.

Contraindications

A contraindication to the use of the drug is intolerance levonorgestrel or any of the auxiliary ingredients contained therein.

The drug is used in pediatric practice. Data regarding its use in girls under 16 years of age are limited, therefore, in adolescence, Postinor is not recommended to be taken without medical supervision.

Side effects of Postinor: why is the drug dangerous?

In the annotation to the drug, the manufacturer reports that the most common reaction to the use of levonorgestrel is an nausea .

In addition, the following side effects of Postinor were recorded during the studies:

• dizziness;
• headache;
• And vomit ;
• nausea;
• not related to the menstrual cycle ;
• failure of the menstrual cycle (namely, a delay in menstruation after taking the pill for more than a week);
• increased fatigue.

Post-marketing observations have shown that sometimes (quite rarely) the use of the drug may be accompanied by: hypersensitivity reactions ( , the appearance of rashes on the skin, skin itching), , pain in the pelvis and / or in the abdomen, swelling of the face.

What is harmful Postinor?

Reviews of side effects allow us to conclude that the most unpleasant, according to women, phenomena after taking Postinor:

• bleeding (in some reviews it is mentioned that, not knowing how to stop the bleeding after Postinor, the woman was forced to seek medical help);
• severe hormonal imbalance and severe cycle disorders (many cases have been described when, after taking Postinor, there are no periods for several cycles; it takes up to a year for someone to restore the regularity of menstruation).

This list can include the appearance of "male" signs, metabolic disorders And acne .

Sometimes the consequences of taking Postinor tablets manifest themselves in the form of miscarriage of subsequent pregnancies and infertility.

To minimize harm to the body, the drug should be used no more than 3-4 times a year.

Tablets Postinor: instructions for use

How to take Postinor?

The instructions for Postinor indicate that the contraceptive effect is provided by taking two tablets (provided that the first tablet is drunk in the first 3 days after the NPC). Between doses 1 and 2 doses withstand a twelve-hour interval.

If within 3 hours after the drug was drunk (regardless of whether 1 or 2 doses), you should immediately take another 750 mcg levonorgestrel (3rd tablet).

The tool can be used in any phase of the menstrual cycle. A prerequisite is the absence of a woman's delay in menstruation.

After taking the pills before the start of the next menstruation, it is recommended to use funds barrier contraception (cervical cap or condoms).

Taking the drug is not a contraindication for the continued use of hormonal contraceptives for regular use.

How to understand that the drug has worked?

The tablet begins to act immediately after dissolution and absorption in the intestinal tract.

The evidence that the drug "worked" is menstruation.

Bleeding after consumption excludes pregnancy in about 95-85% of cases if it begins 3-6 days after taking the pill.

What can the delay after Postinor indicate?

If there is no bleeding after taking the drug, or if the bleeding begins later than the indicated dates, the woman is recommended to do and undergo an examination by a gynecologist to exclude pregnancy.

It is worth consulting a doctor not only with a delay in menstruation, but also if, after taking Postinor, the consequences are expressed in the form of unusually strong bleeding for a woman. The causes of such bleeding may be an excess of the recommended dose and the negative impact levonorgestrel on the uterine endometrium .

Sometimes women note that they have brown discharge after taking it. The phenomenon is considered the norm if the discharge appears within a few days, thus completing the menstruation artificially induced by the pills. However, for some women, spotting can last up to a month.

Most likely, this is an individual reaction to severe stress for the reproductive system, but only a doctor can accurately diagnose the cause of the discharge.

Cause for concern are menstrual bleeding lasting more than 14 days, the absence of a full period, the appearance of clots or heavy brown discharge, pain.

When should my period start after taking the pills?

It is impossible to say exactly when menstruation will begin after the use of Postinor. The tablets contain a large amount levonorgestrel Therefore, even a single use of the drug does not pass without a trace for the body.

In most cases, after taking the remedy, the menstrual cycle remains the same. Sometimes bleeding may start earlier or later. Normally, the delay should not be more than 5-7 days. Otherwise, pregnancy should be excluded.

After taking levonorgestrel a woman is advised to visit a doctor who will help her choose the most suitable method of regular contraception.

Is it worth taking Postinor if NPK occurred during menstruation?

Women with irregular cycles are more likely to get pregnant even during their menstrual bleeding. The appropriateness of the use of "urgent" contraceptives, if the NPC occurred during menstruation, can be determined by the doctor.

How often can I take Postinor?

To the question “How often can I take emergency contraceptive pills?” doctors answer that Postinor-type drugs are not intended for systematic use. They are used only in emergency situations and no more than 3-4 times a year.

Overdose

Clinical picture of overdose hormonal means emergency contraception not described. Most likely, the first signs of poisoning will be nausea and breakthrough bleeding.

Postinor does not have a specific antidote.

Interaction

In combination with liver enzyme inducers, metabolism is activated levonorgestrel .

The effectiveness of drugs that contain levonorgestrel , may decrease with simultaneous use with:

• barbiturates ;
• preparations of St. John's wort (Hypericum perforatum);
• rafibutin ;
• ritonavir ;
• phenytoin ;

Women taking these drugs should consult a doctor before taking Postinor.

Levonorgestrel-containing drugs can lead to increased toxicity , which is associated with the possible suppression of its metabolism.

Terms of sale

On prescription.

Storage conditions

Tablets should be stored at 15-25°C.

Best before date

special instructions

Means of "urgent" contraception are intended for occasional use and do not replace the regular method of contraception.

“Emergency” contraception does not always prevent pregnancy. If there is any doubt as to the timing of CPP, or if an unprotected intercourse has taken place more than 72 hours during the same cycle, the possibility that a fertilized egg has already implanted in the uterine wall cannot be ruled out.

In this regard, the use of tablets at the next sexual contact may be ineffective. If the cycle is delayed by more than 5 days, if atypical bleeding develops on the day of the expected menstruation, as well as if there are other reasons to suspect the occurrence of pregnancy, the fact of pregnancy should be excluded.

After taking levonorgestrel there is a risk of developing ectopic pregnancy . The absolute probability of this is low, since the drug interferes with ovulation and fertilization.

Ectopic pregnancy may persist despite the occurrence of uterine bleeding.

most likely in women who noted fainting or severe pain in the abdomen, as well as in the presence of a history of surgery on the fallopian tubes, , or PID .

Based on this, patients at risk are not recommended to take Postinor tablets.

Taking pills can slightly change the nature of bleeding, but in most cases the next menstruation begins a maximum of a week after the usual date.

With a delay in menstrual bleeding for more than 5 days, it is necessary to exclude the fact of pregnancy.

The drug should not be used in women with serious liver pathologies. The effectiveness of tablets can be negatively affected by severe malabsorption (eg, granulomatous enteritis ).

For women suffering from similar diseases, before carrying out emergency contraception it is recommended to consult a doctor.

Postinor tablets contain lactose, which should be warned in patients with lactase deficiency And malabsorption of glucose and galactose .

The drug is ineffective as regular contraceptives and is not an alternative. It should also be remembered that this tool does not replace the necessary precautions related to protection against STD .

If a woman seeks repeated use of Postinor, the doctor should recommend that she use long-term methods of contraception.

Impact Studies levonorgestrel on the ability to drive a vehicle or work with mechanisms have not been carried out, but one should forget about the possibility of dizziness. levonorgestrel. Only in the first case, its concentration is 1.5 mg / tab., And in the second - 0.75 mg / tab.. That is Escapelle in the case of NPC, it should be taken once, and Postinor - in 2 doses with an interval of 12 hours.

Which is better - Genale or Postinor?

Active substance Jenale - synthetic antiprogestin . The substance is a derivative norethisterone and is used to terminate early pregnancy. Its content in each tablet is 10 mg.

Mifepristone is an non-hormonal agent , which reversibly and briefly blocks only peripheral PR (receptors progesterone ). Depending on the phase of the menstrual cycle, the drug prevents the release of luteotropin , delays or blocks ovulation and causes disturbances in the transformation of the endometrium, which, in turn, makes it difficult for the implantation of the egg.

WHO data indicate that the use of low doses mifepristone more effective and safer than emergency contraception using levonorgestrel .

In addition, it has been experimentally proven that the contraceptive effect mifepristone does not decrease with an increase in the interval between NPK and reception Jenale up to 120 hours. This is also a significant advantage of the latter over Postinor.

If necessary "urgent" contraception it is enough to take 1 tablet during the first 72 hours Jenale . The drug is used 2 hours before meals.

Which is better - Postinor or Ginepriston?

active ingredient Ginepriston is also mifepristone at a concentration of 10 mg / tab .. Thus, the drug has the same advantages over Postinor as Jenale .

The tool is highly effective, characterized by the absence of pronounced side effects and can be used for episodic contraception in women with an irregular sexual life.

In addition, the drug is more affordable than Postinor. Its price in Russian pharmacies is about 100-120 rubles lower than the price of Postinor.

Postinor and alcohol

Is it possible to combine Postinor tablets with alcohol? There are no recommendations in the manufacturer's instructions for this.

However, it should be remembered that alcohol is not compatible with the vast majority of pharmaceutical products.

The use of alcoholic beverages in combination with Postinor can cause a sharp expansion, and then an equally sharp vasoconstriction, which in turn will complicate the woman's condition when the drug provokes rejection of the uterine mucosa.

In addition, alcohol increases the level of liver enzymes, thereby speeding up the metabolism. Since biotransformation levonorgestrel carried out in the liver, the contraceptive effect of Postinor while taking alcohol can be very doubtful.

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

Efficacy: Postinor tablets can prevent pregnancy in about 85% of cases. The more time elapsed 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 contact, if no protective measures have been taken. At the recommended dose, levonorgestrel does not have a significant effect on blood coagulation factors, fat and carbohydrate metabolism.

Pharmacokinetics

When taken orally, Postinor is rapidly and almost completely absorbed. Absolute bioavailability is almost 100% of the dose taken. After taking 0.75 mg of levonorgestrel, C max in serum, equal to 14.1 ng / ml, is reached after 1.6 hours. After reaching C max, the content of levonorgestrel decreases. T 1/2 is about 26 hours.

Levonorgestrel is excreted approximately equally by the kidneys and through the intestines exclusively in the form of metabolites. 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 albumin and to sex hormone-binding globulin (SHBG). Only 1.5% of the total dose is in free form, and 65% is associated with SHBG.

Release form

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

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

2 pcs. - blisters (1) - packs of cardboard.

Dosage

The drug is taken orally. It is necessary to 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 the Postinor tablet, then another Postinor tablet should be taken.

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

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

Overdose

Increased severity of side effects. There is no specific antidote. Carry out symptomatic therapy.

Interaction

With the simultaneous administration of drugs-inducers of liver enzymes, the metabolism of levonorgestrel is accelerated.

The following drugs may reduce the effectiveness of levonorgestrel: amprecavil, lansoprazole, nevirapine, oxcarbazepine, tacrolimus, topiramate, tretinoin, barbiturates, including primidone, phenytoin, and carbamazepine, drugs containing St. rifabutin, griseofulvin. Levonorgestrel reduces the effectiveness of hypoglycemic and anticoagulant (coumarin derivatives, phenindione) drugs. Increases plasma concentrations of corticosteroids. Women taking these drugs should contact their doctor.

Preparations containing levonorgestrel may increase the risk of cyclosporine toxicity due to suppression of its metabolism.

Side effects

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

Transient side effects that occur with varying frequency and do not require drug therapy: sometimes (1-10%) - vomiting, diarrhea, dizziness, headache, breast tenderness, delayed menstruation (no more than 5-7 days; if menstruation is delayed for more than long term, it is necessary to exclude pregnancy); often (more than 10%) - nausea, fatigue, pain in the lower abdomen, acyclic spotting (bleeding).

Indications

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

Contraindications

• adolescence up to 16 years;
• severe liver failure;
• pregnancy;
• rare hereditary diseases such as lactose intolerance, lactase deficiency or glucose-galactose malabsorption;
• hypersensitivity to the components of the drug.

With caution: diseases of the liver and biliary tract, jaundice (including history), Crohn's disease, lactation.

Application features

Use during pregnancy and lactation

Postinor is contraindicated for use during pregnancy. If pregnancy occurred while using an emergency method of contraception, then, based on the available data, an adverse effect of the drug on the fetus was not detected.

Levonorgestrel is excreted in breast milk. After taking the drug, breastfeeding should be stopped for 24 hours.

Application for violations of liver function

The drug is prescribed with caution to patients with diseases of the liver and biliary tract, is contraindicated in severe liver failure.

Application for violations of kidney function

Data on the use of the drug in patients with impaired renal function are not provided.

Use in children

The drug is contraindicated in adolescents under 16 years of age.

special instructions

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

The effectiveness of Postinor tablets after unprotected intercourse, in which contraceptives were 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, there may be acyclic spotting and a delay in menstruation for several days. With a delay in menstruation for more than 5-7 days and a change in its nature (scanty or heavy discharge), pregnancy must be excluded. The appearance of pain in the lower abdomen, fainting may indicate an ectopic (ectopic) pregnancy.

Adolescents under 16 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.

With violations of the function of the gastrointestinal tract (for example, with Crohn's disease), the effectiveness of the drug may decrease.

Influence on the ability to drive vehicles and control mechanisms

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

Unprotected intercourse does not always lead to pregnancy. But in order not to push your luck, modern pharmaceuticals offer hormonal preparations for postcoital contraception. One of the oldest representatives of the group is Postinor. It continues to be sold in pharmacies, although safer analogues have been developed at the moment. But with proper use, you can use this tool.

What is postocital contraception

The effectiveness of the attempt to prevent pregnancy depends on the day of the menstrual cycle and the time of initiation of treatment. Women with a normal cycle for the onset of conception have a short period of time at 12 hours - the time when the egg leaves the follicle and moves through the fallopian tubes. If during this time there is no meeting with the sperm, then the embryo will not form.

For it, it is necessary to observe a clear time frame. The age of the embryo should not exceed 3-5 days. Only at this time the endometrium has the properties necessary for implantation. Therefore, under natural conditions, the number of pregnancies that successfully progress after conception is only 30%.

High risk of pregnancy during sexual intercourse, which occurred three days or less before the onset of ovulation. Sex a day after the release of the egg is not able to lead to pregnancy.

Therefore, before deciding to take hormonal drugs, it is necessary to assess the risk of becoming pregnant. If a woman knows exactly the time of ovulation (), the duration of her cycle, then this is as simple as possible. A day or two after the follicle burst, unprotected sex will not lead to pregnancy. Therefore, there is no need to take hormones that can disrupt the menstrual cycle.

Emergency contraception is used within 1-3 days after sexual intercourse. The sooner this is done, the higher the effectiveness of Postinor and other drugs.

Composition and mechanism of action

The composition of the drug includes levonorgestrel. This is a synthetic progestogen, which is part of. It also has an antiestrogenic effect.

How does Postinor work?

It inhibits the gonadotropic function of the pituitary gland. Under its influence, the concentration of gonadotropins - luteinizing and follicle-stimulating hormones - decreases. Therefore, if ovulation has not yet occurred, then it will slow down.

Levonorgestrel affects the endometrium, changes its properties, which prevents the implantation of an already fertilized egg. It also increases the viscosity of cervical mucus, which prevents sperm from entering the fallopian tubes.

The active substance is rapidly absorbed when taken orally, its bioavailability is almost 100%. The maximum serum concentration is reached after 1.6 hours. The half-life is 26 hours. Levonorgestrel is excreted in an equal proportion by the kidneys and through the intestines.

Indications and contraindications

Contraceptive pills Postinor women take for after intercourse without the use of contraception. It can also be used if there is no complete confidence in the effectiveness of the fixed asset:

• slipping of the condom into the genital tract;
• violation of the integrity of the condom, the female diaphragm;
• missing one or more oral contraceptive pills;
• loss or spontaneous removal of the intrauterine device;
• incorrect calculation of ovulation days when using the calendar method;
• unsuccessful coitus interruptus.

The drug acts on the mechanism of implantation, so taking Postinor to terminate a pregnancy in the early stages does not make sense.

Contraindications include the following conditions:

1. Individual intolerance or hypersensitivity to the components of the drug. If once after taking the tablets there were signs of an allergic reaction, a second dose will be accompanied by a similar reaction or even more pronounced.
2. Age up to 18 years. begins on average at 12-14 years of age and continues for 4-5 years. Any intervention can lead to serious disruption of the cycle, which may take several years to recover.
3. Severe liver failure is accompanied by metabolic disorders. Most hormones, including levonorgestrel, pass through the liver. With insufficient organ function, excessive accumulation and increased side effects may occur.
4. Pregnancy is also among the contraindications. Postinor will not cause miscarriage, but its effects on the developing fetus are not well understood. There is always a risk of violating the laying of internal organs.
5. Lactose intolerance, lactase deficiency, glucose-galactose malabsorption may be exacerbated by the use of Postinor, since it contains lactose monohydrate and corn and potato starch.

With caution, you need to drink Postinor if you have Crohn's disease, inflammatory diseases of the liver and biliary tract, cholelithiasis.

In women over 35 years of age, the chance of developing thrombosis increases. The risk increases with bleeding disorders, smoking a large number of cigarettes per day. The presence of migraine indicates a tendency to thrombosis. Therefore, in this case, you should also take the drug with caution.

Combination with other drugs and alcohol

Due to the peculiarities of metabolism, some drugs are not recommended to be combined simultaneously with Postinor. These include:

• proton pump inhibitors: Lansoprozole, Omeprazole;
• reverse transcriptase inhibitor: Nevirapine;
• antiretroviral: ritonavir;
• antiepileptic drugs: Oxcarbazepine, Carbamazepine, Primidon, Phenytoin;
• immunosuppressants: Tacrolimus;
• antibiotics: Rifampicin, Ampicillin, Tetracycline, Rifabutin, Griseofulvin;
• retinoids: Tretinoin.

Levonorgestrel reduces the effectiveness of hypoglycemic drugs, worsens the use of anticoagulants of coumarin derivatives, Fenindione. Plasma concentrations of glucocorticosteroids may increase.

Simultaneous administration of Levonorgestrel and Cyclosporine inhibits the mechanism of metabolism of the latter. It is an immunosuppressant that is prescribed for transplantation of internal organs and bone marrow. Violation of the neutralization of the drug leads to its accumulation in the liver and the appearance or intensification of adverse reactions.

A contraindication is also the treatment with drugs based on St. John's wort, including those prepared at home.

The compatibility of Postinor and alcohol is controversial. Ethanol is metabolized through the liver. There are several ways of oxidation and removal of ethyl alcohol from the body. In some cases, they coincide with those for hormonal agents. Competition for transport proteins can lead to impaired metabolism of either alcohol or drugs.

Unwanted Effects

Side effects from Postinor have individual severity. The most common side effects are:

1. Damage to the digestive tract: the lower abdomen hurts, nausea, vomiting, digestive disorders, and in some cases diarrhea appear.
2. Pathology of the mammary glands: there is pain on palpation of the chest.
3. Reproductive system: menstrual disorders, bleeding after ingestion, which is not associated with the normal menstrual cycle. The delay after Postinor can be up to 7 days or more. The duration of the failure of the menstrual cycle is different. Menstruation can start earlier or later.
4. The defeat of the nervous system manifests itself in the form of increased fatigue, frequent headache, dizziness. The appearance of this side effect is associated with the effect of Postinor on the coagulation system and an increase in blood viscosity.

Most side effects go away on their own within a few days. If they are delayed for a longer period, it is necessary to consult a doctor, and also exclude pregnancy.

Menstruation after Postinor must be calculated based on previous data on the duration of the cycle and the time of onset of menstrual bleeding. With a delay of more than 5-7 days, you should consult a doctor. In this case, it is likely that the drug did not work and the pregnancy continued.

The appearance of brown discharge may be an indicator of the onset of normal menstruation or a manifestation of a side effect in the form of a cycle disorder.

If there is no menstruation after taking the drug, but the pregnancy test is negative, in this case it can be assumed that the luteal phase of the cycle is insufficient. Under the influence of a large dose of levonorgestrel, a deep depression of the function of the pituitary gland could occur. Therefore, the lack of luteinizing and follicle-stimulating hormones affects ovulation: it is delayed indefinitely. To confirm the diagnosis, a hormonal profile examination is used: they donate blood for the main sex hormones. Such women are recommended to carry out in order to establish the onset or impossibility of ovulation.

A positive test after taking the medicine indicates the onset of pregnancy. This means that Postinor was taken incorrectly or out of time.

The consequences of contraception with Postinor may be long-term. Some women complain about the lack of menstruation or irregular periods for several years.

Association with pregnancy and lactation

Postinor is not designed to terminate pregnancy, it is not a means for medical abortion. But it is impossible to call it completely safe for pregnant women: it is impossible to evaluate the effect on the developing fetus empirically. There are also no data on such experiments on animals.

Whether Postinor is harmful to the developing fetus is not known. But in cases of pregnancy on the background of taking the drug, the preservation of the fetus did not end with the detection of severe vascular pathology or the occurrence of deformities incompatible with life.

The active substance is found in the blood unchanged, it is able to penetrate into breast milk. The newborn does not need the action of hormones that affect the unformed pituitary gland. Therefore, if there is a need for emergency contraception during breastfeeding, after taking the pills, you must refrain from feeding for at least 1 day.

How to take Postinor

The first condition for the successful use of tablets is a period of no more than 72 hours after sexual intercourse, which occurred without contraception. The package contains two tablets. The first is taken as early as possible, and the second 12 hours after it. The maximum gap in taking two tablets is 16 hours.

An adverse reaction in the form of vomiting that occurs within 3 hours after taking 1 or 2 tablets becomes the basis for taking an additional tablet.

Use Postinor on any day of the menstrual cycle. If menstruation goes regularly, then there is no likelihood of a short term pregnancy. If it is necessary to exclude the existence of pregnancy using a rapid test.

During one menstrual cycle, you can not take the drug again. This leads to the appearance of spotting, acyclic uterine bleeding.

How often can Postinor be used?

Peculiarities

The effectiveness of contraception with levonorgestrel depends on the time the first pill was taken. The sooner this is done after intercourse, the higher the likelihood of a successful outcome. For example, if you use it during the first day after unprotected sex, in 95% of cases or more, the promised effect occurs. When using the first tablet during the second day, the effectiveness decreases to 85%, and on the third day it is only 58%.

After using the drug, it is necessary to mark the date of unprotected sex and the day of admission in the women's calendar. From this time, a countdown is taken for the appearance of possible signs of pregnancy or its successful prevention.

How to understand that Postinor worked?

Menstruation should begin on time according to the calendar. Its duration and volume of blood loss should not differ significantly from normal days.

You should consult a doctor in the following case:

• profuse menstruation;
• meager discharge;
• delay more than 7 days;
• combination of discharge with pain in the lower abdomen.

Painful sensations can be cramping, but more often aching in nature. Sometimes this condition is accompanied by weakness, dizziness. With the appearance of acute pain in the abdomen, urgent hospitalization is necessary. This is how it usually appears. An interrupted pregnancy by the type of rupture of the tube is characterized by the appearance of acute pain in the abdomen, signs of internal bleeding (lowering blood pressure, tachycardia).

The effectiveness of a drug can be affected not only by other drugs, but also by pathological conditions. Crohn's disease, when it spreads to the upper intestines, leads to malabsorption of nutrients. Therefore, with this pathology, as well as other inflammatory diseases of the digestive tract, malabsorption is possible and, as a result, insufficiently effective contraception.

It should also be remembered that hormonal drugs do not protect against diseases that are sexually transmitted. To protect yourself from infection, you must use a condom correctly. If sexual intercourse carries the risk of not only an unwanted pregnancy, but also the development of an infection, emergency protective equipment should be used. To do this, a woman must urinate and treat the opening of the urethra with an antiseptic solution: Chlorhexidine, Miramistin. In some cases, preventive antibiotics are effective.