What happens if I miss a dose?
Since Lessina emergency contraceptive is used as a single dose, it does not have a daily dosing schedule.
What are the uses for oral Lessina?
Emergency contraception pills are used to help prevent pregnancy after unprotected sex or when birth control methods fail. Emergency contraception is a backup method of preventing pregnancy and should not be used routinely.
Intrauterine system (Mirena): 52 mg Lessina
Tablets (Plan B): 1.5 mg
Uses of Lessina:
- It is used to lower the chance of pregnancy after unprotected sex.
The Lessina IUD or LNg 20‐IUD (Mirena) is a T‐shaped polyethylene device with a collar containing 52 mg of Lessina dispersed in polydimethylsiloxane attached to the vertical arm. This frame is also visible on x‐ray. The device releases 15 μg of Lessina daily in vivo.
The LNg 20‐IUD is approved for up to 5 years in the United States, but is effective for up to 7 years. It is currently the most effective form of reversible contraception available (see Table 7‐1 ). Unlike the copper IUD, the LNg 20‐IUD actually reduces dysmenorrhea and decreases menstrual blood loss. Women receiving this type of IUD should be counseled regarding the altered bleeding patterns that can occur. Significant intramenstrual bleeding and spotting may occur during the first few months of use as the endometrial lining is thinning. Most women will experience lighter, shorter menses with continued use, with 20% of women becoming amenorrheic after 12 months of use. In fact, this decrease in menstrual bleeding has allowed the LNg‐20 IUD to be used as an alternative to hysterectomy and endometrial ablation for the treatment of menorrhagia, as well as a means of protecting the endometrium with hormone replacement therapy and as an adjuvant therapy for tamoxifen users. The LNg 20‐IUD may be a particularly useful method of contraception for women with hematologic disorders or for those who are taking chronic anticoagulants.
Some side effects can be serious. If you experience the following symptom, call your doctor immediately:
- severe lower abdominal pain (3 to 5 weeks after taking Lessina)
Lessina may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
Lessina Food Interactions
Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Lessina, there are no specific foods that you must exclude from your diet when receiving this medication.
A Lessina Implants
Lessina implants (Norplant ) are a six-capsule system with each capsule containing 30 mg of Lessina. A newer two-rod device, known as Jadelle, also contains Lessina. The contraceptive efficacy is due to increasing the length of the rods to enhance delivery of the steroid ( 101, 102 ).
Lessina implants were developed by the Population Council beginning in 1968 to 1970. Several different progestational agents were evaluated for efficacy at that time, but Lessina was selected due to its release rate through silastic membrane ( 103 ).
Clinical trials have indicated that Lessina implants have a very low contraceptive failure rate, with a Pearl Index of less than 0.5 pregnancies per 100 women per year ( 104 ). Lessina implants can be used in older women because it contains no estrogen, as mentioned earlier for DMPA. The advantages of the Norplant contraceptive devices are the fact that the consumer requires little motivation after the insertion, and the duration of contraceptive efficacy is up to 5 years.
As with all progestin-only contraceptives, side effects include irregular uterine bleeding ( 101, 105 ). This is principally light bleeding and spotting and is similar to that described for DMPA. Thirty percent of women will experience irregular bleeding and spotting within the first 3 months after the insertion of Norplant and Jadelle ( 105–107 ). With continued use of Lessina implants, occurrences of menstrual bleeding decrease ( 101 ).
Other side effects that have been associated with the Lessina system include weight gain, depression, acne, and loss of scalp hair ( 101,108–110 ). No one has reported alopecia, although a heavy loss of hair has been anecdotally reported.
The principal contraindications to Lessina implants are active liver disease and undiagnosed uterine bleeding. Both these conditions should be evaluated prior to insertion, along with any other laboratory evaluation that is indicated. Overall, the Lessina implant systems have a very positive safety profile. They have not been linked to any risk of cardiovascular disease ( 101,107,110 ). There is no evidence of an increased risk of venous thromboembolism with progestin-only contraceptive methods ( 107 ).
How to use Lessina
If you are taking the over-the-counter product to self-treat, read all directions on the product package before taking this medication. If you have any questions, talk to your pharmacist. If your doctor has prescribed this medication, take it as directed.
Take this medication by mouth as soon as possible after unprotected sex. Your instructions for use depend on the brand you take. Therefore, check the label on your brand and ask your doctor or pharmacist if you have any questions. Take as directed, usually 2 tablets at once; or take 1 tablet and then take the second tablet 12 hours after the first tablet. This medication may be taken with or without food. This medication works best when it is taken within 72 hours (3 days) after unprotected sex.
If you vomit within 2 hours of taking a dose of this medication, contact your doctor to ask if you need to repeat the dose.
After you take this medication, the time when your period comes and how much you bleed may change. Tell your doctor right away if your period is more than 7 days late. You may need to take a pregnancy test.
If you think you may have a serious medical problem, get medical help right away.
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Lessina can cause serious side effects including:
- Pelvic inflammatory disease (PID). Some intrauterine device (IUD) users get a serious pelvic infection called pelvic inflammatory disease. PID is usually sexually transmitted. You have a higher chance of getting PID if you or your partner have sex with other partners. PID can cause serious problems such as infertility, ectopic pregnancy or pelvic pain that does not go away. PID is usually treated with antibiotics. More serious cases of PID may require surgery. A hysterectomy (removal of the uterus) is sometimes needed. In rare cases, infections that start as PID can even cause death.
- Tell your healthcare provider right away if you have any of these signs of PID: long-lasting or heavy bleeding, unusual vaginal discharge, low abdominal (stomach area) pain, painful sex, chills, or fever.
- Life-threatening infection. Life-threatening infection can occur within the first few days after the IUD is placed. Call your healthcare provider if you develop severe pain within a few hours after the IUD is placed.
- Embedment. IUD may become attached to the uterine wall. This is called embedment. If embedment happens, this medication may no longer prevent pregnancy and you may need surgery to have it removed.
- Perforation. The IUD may go through the uterus. This is called perforation. If your uterus is perforated, this medication may no longer prevent pregnancy. It may move outside the uterus and can cause internal scarring, infection, or damage to other organs, and you may need surgery to have the IUD removed.
Common side effects of Lessina include:
- think you are pregnant
- have pelvic pain or pain during sex
- have unusual vaginal discharge or genital sores
- have unexplained fever
- might be exposed to sexually transmitted diseases (STDs)
- cannot feel the IUD threads
- develop very severe or migraine headaches
- have yellowing of the skin or whites of the eyes. These may be signs of liver problems.
- have a stroke or heart attack
- or your partner becomes HIV positive
- have severe vaginal bleeding or bleeding that lasts a long time
- If you have an allergy to Lessina or any other part of Lessina (systemic).
- If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
- If you are pregnant or may be pregnant. Do not take Lessina (systemic) if you are pregnant.
- Lessina (Plan B) is emergency contraception (commonly called the morning after pill) that is used as backup contraception to prevent pregnancy when taken within 72 hours after unprotected sex or when birth control fails.
- Lessina is a progestin. Progestins are hormones used in many birth control pills. Although Lessina and similar emergency contraception pills contain a higher dose of Lessina than birth control pills, they work in a similar way to prevent pregnancy, mainly by stopping the release of an egg from the ovary. Additionally, Lessina also may prevent fertilization of an egg (the uniting of the sperm with the egg) or prevent the attachment (implantation) of a fertilized egg to the uterus (womb).
- Emergency contraception pills do not work in women who are already pregnant and should not be taken during pregnancy.
- The FDA approved Lessina in July 1999.
- tell your doctor and pharmacist if you are allergic to Lessina, any other medications, or any of the ingredients in Lessina tablets. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements, you are taking or plan to take. Be sure to mention any of the following: barbiturates such as phenobarbital or secobarbital; bosentan (Tracleer); griseofulvin (Grifulvin V, Gris-PEG); certain medications used to treat HIV including atazanavir (Reyataz). darunavir (Prezista, in Prezcobix), delavirdine (Rescriptor), efavirenz (Sustiva), etravirine (Intelence), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), nevirapine (Viramune), rilpivirine (Edurant, in Complera), ritonavir (Norvir, in Kaletra), saquinavir (Invirase), and tipranavir (Aptivus); certain medications for seizures such as carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Oxtellar XR, Trileptal), phenytoin (Dilantin, Phenytek), and topiramate (Qudexy XR, Topamax, Trokendi XR, in Qsymia); and rifampin (Rifadin, Rimactane). Lessina may not work as well or may be more likely to cause side effects if it is taken with these medications.
- tell your doctor what herbal products you are taking, especially St. John's wort.
- tell your doctor if you have or have ever had any medical conditions.
- tell your doctor if you are pregnant. Do not take Lessina if you are already pregnant. Lessina will not end a pregnancy that has already begun.
- you should know that after you take Lessina, it is normal for your next menstrual period to begin up to a week earlier or later than expected. If your next menstrual period is delayed for longer than 1 week after the expected date, call your doctor. You may be pregnant and your doctor will probably tell you to have a pregnancy test.
First, your healthcare provider will examine your pelvis to find the exact position of your uterus. Your healthcare provider will then clean your vagina and cervix with an antiseptic solution, and slide a thin plastic tube containing the intrauterine device (IUD) into your uterus. Your healthcare provider will then remove the plastic tube, and leave the IUD in your uterus. Your healthcare provider will cut the threads to the right length. Placement takes only a few minutes during an office visit.
You may experience pain, bleeding or dizziness during and after placement. If these symptoms do not pass 30 minutes after placement, the IUD may not have been placed correctly. Your healthcare provider will examine you to see if the IUD needs to be removed or replaced.
You should check that the IUD is in proper position by feeling the removal threads. You should do this after each menstrual period. First, wash your hands with soap and water. Feel for the threads at the top of your vagina with your clean fingers. The threads are the only part of the IUD you should feel when it is in your uterus. Be careful not to pull on the threads. If you feel more than just the threads, the IUD is not in the right position and may not prevent pregnancy. Call your healthcare provider to have it removed. If you cannot feel the threads at all, ask your healthcare provider to check the IUD is still in the right place. In either case, use a non-hormonal birth control method (such as condoms or spermicide) until otherwise advised by your healthcare provider.
Call your healthcare provider if you have any questions or concerns. Otherwise, you should return to your healthcare provider for a follow-up visit 4 to 12 weeks after the IUD is placed to make sure that it is in the right position.
Tampons may be used with the IUD.
Call your healthcare provider if you have any concerns about this medication. Be sure to call if you:
What do I need to tell my doctor BEFORE I take Lessina?
This medicine may interact with other drugs or health problems.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Lessina (systemic) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
As a form of progesterone, Lessina exerts its actions on the hypothalamus through a negative feedback mechanism, which causes a decrease in the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Both LH and FSH normally stimulate ovulation. Thus, by reducing their secretion, Lessina serves to inhibit ovulation. The drug also inhibits implantation, the point when a fertilized egg embeds in the uterine wall, where it will grow and develop into an embryo. In addition, Lessina causes the mucus in the cervix to thicken, which blocks the ability of sperm to travel through the uterus and into the fallopian tubes, where fertilization of the egg by a sperm normally takes place.
In the early 1980s Lessina became w > Norplant. In this system Lessina was implanted beneath the skin of the upper arm in six Silastic (silicone-plastic) capsules, which prov > Norplant II (Jadelle), which uses a different synthetic progestogen, called etonogestrel, implanted under the skin in specially designed rods the size of matchsticks.
What is oral Lessina, and how does it work (mechanism of action)?
Pharmacologic class: Contraceptive, intrauterine device (Mirena); oral contraceptive, progestin-only pill (Plan B)
Therapeutic class: Contraceptive
Pregnancy risk category X (Mirena), NR (Plan B)
Lessina (Plan B One-Step, Next Choice One Dose, My Way) is a non-prescription (over-the-counter or OTC) drug used help prevent pregnancy when birth control methods fail or after unprotected sex. Side effects, drug interactions, storage, dosing, and pregnancy and breastfeeding safety should be reviewed prior to taking this medication.
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The Plan B package instructions state that you should take 1 white pill within 72 hours after unprotected sex and 1 more white pill 12 hours later. Each dose contains 0.75 mg of Lessina. The two pills are identical; it does not matter which pill you take first.
However, recent research indicates that both doses can be taken at the same time up to 120 hours after unprotected sex. The pills are more effective the sooner they are taken, so take 2 Plan B pills at the same time as soon as possible after unprotected intercourse.