Pharmacological properties of the drug Postinor
The mechanism of action of levonorgestrel (D-13в-ethyl-17в-ethynyl-17-hydroxy-4-gonen-3-one) at the indicated dose is mainly due to inhibition of ovulation and prevention of fertilization (in the event that sexual intercourse occurred before ovulation, when the likelihood of fertilization is higher), as well as changes in the endometrium when taking the drug, which prevent the implantation of a fertilized egg. The drug is ineffective if implantation of a fertilized egg has already occurred. When using Postinor, unwanted pregnancy can be prevented in approximately 85% of cases. The longer the interval between sexual intercourse and taking Postinor, the lower the effectiveness of the drug (in the first 24 hours - 95%; from 24 to 48 hours - 85%; from 48 to 72 hours - 58%). There is no data on the effectiveness of the drug when taken 72 hours after sexual intercourse. At the recommended dose, levonorgestrel does not have a significant effect on blood clotting, lipid and carbohydrate metabolism. After oral administration, levonorgestrel is rapidly and almost completely absorbed. After taking 1 tablet of Postinor, the maximum concentration of levonorgestrel in the blood serum (on average - 14.1 ng/ml) is achieved after 1.6 hours. Then the decrease in the concentration of levonorgestrel occurs in two stages, the half-life ranges from 9 to 14.5 hours. Levonorgestrel excreted from the body in the form of metabolites with urine and feces in approximately equal quantities. The biotransformation of levonorgestrel is similar to that of steroids. The drug is hydroxylated in the liver, and its metabolites are excreted in the form of glucuronides. Known metabolites of levonorgestrel do not have pharmacological activity. Levonorgestrel binds to plasma proteins, mainly albumin and sex hormone-binding globulin. Only 1.5% of the administered dose is found in the blood serum in free form, and 65% has a specific association with sex hormone-binding globulin. Absolute bioavailability is almost 100%. About 0.1% of the drug dose is excreted in breast milk.
Important!
The “pill after 5 days” should be used exclusively as a method of emergency contraception and only in emergency cases. This drug should not be an alternative to classical contraceptives, especially since there are cheap and safe ways to prevent unwanted pregnancy.
MAKE AN APPOINTMENT
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Abortion and contraception clinic in St. Petersburg - department of the medical gynecological association "Diana"
Make an appointment, tests or ultrasound via the contact form or by calling +8 (812) 62-962-77. We work seven days a week from 09:00 to 21:00.
We are located in the Krasnogvardeisky district, next to the Novocherkasskaya, Ploshchad Alexander Nevsky and Ladozhskaya metro stations.
The cost of a medical abortion in our clinic is 3,300 rubles. The price includes all pills, an examination by a gynecologist and an ultrasound to determine the timing of pregnancy.
Use of the drug Postinor
2 tablets inside. To achieve a more reliable effect, the first tablet should be taken as soon as possible after sexual intercourse (but no later than 72 hours), and the second - 12 hours (but no later than 16 hours) after taking the first. If vomiting is observed within 3 hours after taking any tablet, you should take 1 more tablet. Postinor can be taken on any day of the menstrual cycle, but only if the previous menstruation was timely. After using the drug, barrier contraception must be used until the next menstruation. After using Postinor, taking permanent oral hormonal contraceptives is not contraindicated.
What you need to buy in different countries
In most countries, birth control and abortion pills are sold strictly by prescription. Therefore, in such a situation you will have to come to the doctor for a prescription. For example, in Italy, in October 2022, AIFA (Italian Medicines Agency) gave the green light to the sale of a 5-day tablet even to those under 18 years of age, eliminating the requirement to present a prescription.
In this country, the “five day pill” can be purchased directly from the pharmacy, since the drug ulipristal acetate is available without a prescription. But the purchase of the drug is accompanied by a booklet and instructions from the pharmacist in order to prevent the inappropriate use of emergency contraception. At the same time, a package of ellaOne® containing a 30 milligram tablet of ulipristal acetate is not cheap - approximately 26 - 30 euros.
But a drug based on levonorgestrel (the active ingredient of the morning-after pill), even in Italy, can only be purchased with a prescription from a gynecologist. It will not be sold without a doctor's prescription for any money.
Gynecologist's prescription for emergency contraception
Previously, it was possible to purchase such contraceptives only upon presentation of a valid document proving identity and age, and only after a mandatory pregnancy test with a negative result for beta-hCG.
If you have an emergency or difficulty purchasing an emergency contraceptive pill, in most countries you can also go to a public health centre, health service or emergency department.
Note. Emergency contraception offers women an additional choice. The pharmacist or health care worker is required to provide all the information so that the patient can receive the medicine and take it on time, but the entire responsibility for taking the pills lies with the patient herself.
Special instructions for the use of the drug Postinor
The drug can only be used in extreme cases. Postinor is not a contraceptive for regular use. Taking it does not always prevent pregnancy. If a woman does not remember when sexual intercourse took place, or if unprotected sexual intercourse has already taken place in the same menstrual cycle 72 hours before taking the drug, fertilization is possible. In this case, the use of the drug is ineffective. If menstruation is delayed by more than 5 days or its onset is timely, but the course is different from normal, it is necessary to exclude pregnancy. If, despite the use of the drug Postinor, fertilization still occurs, the possibility of ectopic pregnancy should be considered. The use of Postinor is not recommended for severe liver dysfunction. Severe intestinal diseases (for example, Crohn's disease) may cause impaired absorption of the drug . After using the drug, menstruation occurs at the expected time and occurs as usual. In some cases, menstruation may begin several days earlier or later than expected. After using Postinor, it is recommended to examine a doctor to decide whether to use the method for regular contraception. If Postinor was taken due to a missed dose of a regular hormonal contraceptive, and menstruation did not occur during the next 7-day break in taking the contraceptive drug, pregnancy should be excluded. Repeated use of Postinor during one menstrual cycle is not recommended due to possible disruption of this cycle. Postinor should not be taken during pregnancy; the drug does not terminate an existing pregnancy. In the event of pregnancy with the use of progestogens, a teratogenic effect has not been identified. Levonorgestrel practically does not pass into breast milk. The potential impact of levonorgestrel on infant development can be reduced if both tablets are taken immediately after breastfeeding and if breastfeeding is avoided after taking the drug.
Effectiveness of the tablet 5 days later
Although the drug can be used within 120 hours. After unsafe contact, emergency contraception is more effective the earlier it is taken. The ideal option is 12-24 hours. after the act, when the success rate reaches 95-98% of cases.
Obviously, if ovulation has already occurred, the ability to avoid pregnancy is reduced, which makes this method not unsuccessful. If the sperm manage to meet the oocyte and fertilize it, then the medicine stops working - the drug does not work in the case of an already ongoing pregnancy.
This means that such a pill cannot cause an abortion. Medical abortion is performed with completely different drugs.
Why are mifepristone-based products so popular?
Preparations based on mifepristone, Mifegin, Mifepristone, Miropriston, Pencrofton, Mifolian, block the production of progesterone, the female sex hormone, secreted in large quantities from the moment of fertilization to the 12th week. Progesterone is responsible for relaxing smooth muscles, facilitating implantation of the embryo into the uterine cavity. Mifepristone inhibits progesterone production and causes the production of prostaglandins, which stimulate uterine contractions. As a result, the cervix dilates and rhythmic contractions of the uterus push out the embryo.
The advantages of the drugs include:
- efficiency 98.6%;
- no need for anesthesia, as with abortion or curettage;
- the likelihood of infection, the formation of adhesions of the fallopian tubes and scars is eliminated;
- the uterine cavity is not injured;
- abortion is carried out without the risk of secondary infertility;
- the woman does not have great psychological trauma, as after a surgical abortion;
- If the instructions are followed correctly, bleeding and severe pain will not occur.
Operating principle
Levonorgestrel prevents conception, having a progestogenic and antiestrogenic effect on the body. Preventing the onset and maintenance of pregnancy is manifested in two methods:
- First, the ovulatory process is suppressed, which prevents the release of the egg of ovulation and pregnancy;
- If ovulation has occurred and the egg could be released from the ovary, levonorgestrel prevents implantation of the developing fertilized egg. Rejection of the endometrium occurs, which is manifested by the onset of bleeding, similar to menstruation.
What is medical abortion? How to reduce risks?
The content of the article
Medical termination of pregnancy is an induced abortion without surgical intervention. In this case, medications are used that stop the vital activity of the embryo and expel the fertilized egg.
Tablets are produced with different compositions of the active substance and different principles of action on the body. Therefore, you cannot select such products yourself - this is done by a gynecologist. The doctor focuses on the timing of pregnancy, the age and weight of the patient, the number of previous pregnancies, a history of miscarriages, contraindications, etc.
When deciding to have an abortion, even if it does not involve surgery, a woman must understand that the use of pills that cause a miscarriage, which is exactly how a medical abortion occurs, is stressful for the body. But in the case of correctly selected medications, there will be no major health problems in the future. The only way to reduce the risks is to see a good doctor and strictly follow his instructions.
