{"id":16555,"date":"2021-12-11T10:42:23","date_gmt":"2021-12-11T10:42:23","guid":{"rendered":"https:\/\/zeepedia.com\/?p=16555"},"modified":"2021-12-13T09:12:18","modified_gmt":"2021-12-13T09:12:18","slug":"leverette-21","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/leverette-21\/","title":{"rendered":"Leverette 21 &#8211; Levonorgestrel \/ Ethinyl estradiol Levetiracetam uses, dose and side effects"},"content":{"rendered":"\n<p>150 micrograms \/ 30 micrograms&nbsp;film-coated tablets<br>levonorgestrel \/ ethinyl estradiol<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Leverette 21 is and what it is used for<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Leverette 21 is a&nbsp;birth control pill&nbsp;and is used to prevent pregnancy.<\/li><li>Each tablet contains a small amount of two different female sex hormones, namely levonorgestrel and ethinyl estradiol.<\/li><li>Birth control pills that contain two&nbsp;hormones&nbsp;are called combined&nbsp;birth control pills&nbsp;.<\/li><\/ul>\n\n\n\n<p>Levonorgestrel and Ethinyl estradiol contained in Leverette 21 may also be approved for the treatment of other conditions not mentioned in this product information.\u00a0Ask your doctor, pharmacist, or other healthcare professional if you have any further questions, and always follow their instructions.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What you need to know before taking Leverette 21<\/h2>\n\n\n\n<p><strong>Generally<\/strong><\/p>\n\n\n\n<p>Before using Leverette 21, read the information on blood clots in section 2. You must read the information on the symptoms of blood clots &#8211; see section 2, \u201cBlood clots\u201d.<\/p>\n\n\n\n<p>Before you can start taking Leverette 21, your doctor will ask you some questions about your personal and immediate relatives&#8217; medical history.\u00a0Your doctor will also measure your\u00a0blood pressure\u00a0and possibly do some other tests, depending on your situation.<\/p>\n\n\n\n<p>This leaflet describes several situations when you should stop taking Leverette 21, or when the protective effect of the contraceptive pill may be reduced.\u00a0In these situations, you should not have intercourse or you should use additional protection in the form of a non-hormonal contraceptive, e.g.\u00a0condom or another\u00a0barrier method.\u00a0Do not use &#8220;safe periods&#8221; based on the menstrual cycle or temperature changes.\u00a0Such methods can be unreliable because Leverette 21 disrupts the normal changes in body temperature and cervical\u00a0mucosa\u00a0during the menstrual cycle.<\/p>\n\n\n\n<p><strong>Like other&nbsp;pill&nbsp;protects Leverette 21 not against&nbsp;HIV&nbsp;&#8211;&nbsp;infection&nbsp;(&nbsp;AIDS&nbsp;) and other sexually transmitted diseases.<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Do not take Leverette 21<\/h2>\n\n\n\n<p>Do not use Leverette 21 if you have any of the conditions listed below.&nbsp;If you have any of these conditions, you need to tell your doctor.&nbsp;The doctor will discuss what other type of contraception may be more appropriate.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>If you have (or have had) a blood clot in a blood vessel in your legs (deep&nbsp;vein thrombosis&nbsp;, DVT), in your lungs (&nbsp;pulmonary embolism&nbsp;) or any other organ.<\/li><li>If you know you have a disease that affects blood clotting &#8211; e.g.&nbsp;protein&nbsp;C deficiency,&nbsp;protein&nbsp;S deficiency, antithrombin III deficiency, factor V Leiden or antiphospholipid antibodies.<\/li><li>If you need to have an operation or if you stay in bed for a long period of time (see section &#8220;Blood clots&#8221;).<\/li><li>If you have (or have had) a heart attack or a&nbsp;stroke&nbsp;.<\/li><li>If you have (or have had) angina (a condition that causes severe chest pain and may be a first sign of a heart attack) or&nbsp;transient&nbsp;ischemic attack (&nbsp;TIA&nbsp;&#8211; transient stroke symptoms).<\/li><li>If you have any of the following conditions that may increase the risk of a blood clot in your arteries:<ul><li>severe&nbsp;diabetes&nbsp;with damaged blood vessels<\/li><li>very high&nbsp;blood pressure<\/li><li>a very high level of fat in the blood (&nbsp;cholesterol&nbsp;or&nbsp;triglycerides&nbsp;)<\/li><li>a condition called hyperhomocysteinemia.<\/li><\/ul><\/li><\/ul>\n\n\n\n<ul class=\"wp-block-list\"><li>If you have (or have had) a type of&nbsp;migraine&nbsp;called &#8220;migraine with aura&#8221;.<\/li><li>If you have (or have had) a liver disease and your liver values \u200b\u200bare still not normal.<\/li><li>If you have (or have had) a&nbsp;tumor&nbsp;in your liver.<\/li><li>If you have (or have had) or are suspected of having breast or genital cancer.<\/li><li>If you have unexplained vaginal bleeding.<\/li><li>If you are allergic to ethinyl estradiol, levonorgestrel or any of the other ingredients of this medicine (listed in section 6).&nbsp;An&nbsp;allergic reaction&nbsp;can cause&nbsp;itching&nbsp;, rash or swelling.<\/li><li>If you have&nbsp;hepatitis&nbsp;C and are being treated with medicines containing ombitasvir \/ paritaprevir \/ ritonavir, dasabuvir, glekaprevir \/ pibrentasvir andsofosbuvir \/ velpatasvir \/ voxilaprevir (see also section \u201cOther medicines and Leverette 21\u201d).<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings and cautions<\/h2>\n\n\n\n<p>When should you contact a doctor?<\/p>\n\n\n\n<p><strong>Seek medical attention immediately<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you notice signs of a blood clot that may indicate that you have a blood clot in your leg (ie deep&nbsp;vein thrombosis&nbsp;), a blood clot in your lung (ie&nbsp;pulmonary embolism&nbsp;), a heart attack or a&nbsp;stroke&nbsp;(see section \u201cBlood clots\u201d below).<\/li><\/ul>\n\n\n\n<p>The symptoms of these serious&nbsp;side effects&nbsp;are described in more detail in the section \u201cHow to recognize a blood clot\u201d below.<\/p>\n\n\n\n<p><strong>Tell your doctor if any of the following apply to you.<\/strong><\/p>\n\n\n\n<p>If any of the following occur or occur while using Leverette 21, consult a physician.\u00a0In some situations, you may need to be especially careful when using Leverette 21 or any other combined\u00a0pill, and you may need to be examined regularly by a doctor.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>If a close relative has or has had breast cancer.<\/li><li>If you have a disease of the liver or gallbladder.<\/li><li>If you have&nbsp;diabetes&nbsp;.<\/li><li>If you have depression.&nbsp;Some women who use hormonal contraceptives, including Leverette 21, have reported depression or depression.&nbsp;Depression can be a serious condition and can sometimes lead to suicidal thoughts.&nbsp;If you notice mood swings and depressive symptoms, you should contact a doctor for medical advice as soon as possible.<\/li><li>If you have&nbsp;Crohn&#8217;s disease&nbsp;or&nbsp;ulcerative colitis&nbsp;(&nbsp;chronic&nbsp;inflammatory&nbsp;bowel disease).<\/li><li>If you have systemic lupus erythematosus (&nbsp;SLE&nbsp;&#8211; a disease that affects your natural immune system).<\/li><li>If you have&nbsp;hemolytic uremic syndrome&nbsp;(HUS &#8211; a disorder of blood coagulation that leads to&nbsp;kidney failure&nbsp;).<\/li><li>If you have&nbsp;sickle cell anemia&nbsp;(a hereditary disease of the red&nbsp;blood cells&nbsp;).<\/li><li>If you have high blood fats (&nbsp;hypertriglyceridemia&nbsp;) or a hereditary condition of this condition.&nbsp;Hypertriglyceridemia&nbsp;has been linked to an increased risk of developing&nbsp;pancreatitis&nbsp;(inflammation of the pancreas).<\/li><li>If you need to have an operation or stay in bed for a longer period (see section 2 &#8220;Blood clots&#8221;).<\/li><li>If you have just given birth, the risk of getting a blood clot is higher.&nbsp;Ask your doctor how soon after giving birth you can start using Leverette 21.<\/li><li>If you have&nbsp;inflammation&nbsp;of the veins under the skin (superficial&nbsp;thrombophlebitis&nbsp;).<\/li><li>If you have varicose veins.<\/li><li>If you have&nbsp;epilepsy&nbsp;(see section \u201cOther medicines and\u201d Leverette 21 \u201d).<\/li><li>If you have a condition that first appeared during pregnancy or previous use of sex hormones (eg, hearing loss, a blood disease called&nbsp;porphyria&nbsp;, skin rash with blisters during pregnancy (&nbsp;herpes&nbsp;gestationis), a nerve disease that causes sudden body movements (Sydenhams korea) ).<\/li><li>If you have or have had chloasma (yellow-brown pigment spots, especially on the face or neck, so-called pregnancy spots).&nbsp;If this is the case, you should avoid direct sunlight or ultraviolet radiation.<\/li><li>Contact a doctor immediately if you experience symptoms of&nbsp;angioedema&nbsp;, such as swelling of the face, tongue and \/ or throat and \/ or difficulty swallowing or&nbsp;hives&nbsp;, possibly with difficulty breathing.&nbsp;Products containing&nbsp;estrogen&nbsp;can cause or worsen the symptoms of hereditary or acquired&nbsp;angioedema&nbsp;.<\/li><\/ul>\n\n\n\n<p><strong>BLOOD CLOTS<\/strong><\/p>\n\n\n\n<p>Using combined hormonal contraceptives such as Leverette 21 increases the risk of blood clots compared to if you do not use such drugs.&nbsp;In rare cases, a blood clot can block the blood vessels and cause serious problems.<\/p>\n\n\n\n<p>Blood clots can form<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>in the veins (called venous&nbsp;thrombosis&nbsp;, venous&nbsp;thromboembolism&nbsp;or VTE)<\/li><li>in&nbsp;artery&nbsp;engines (called&nbsp;arterial&nbsp;thrombosis&nbsp;,&nbsp;arterial&nbsp;thromboembolism&nbsp;or ATE).<\/li><\/ul>\n\n\n\n<p>It is not always possible to fully recover from blood clots.&nbsp;In rare cases, they can have serious lasting effects and, in very rare cases, be fatal.<\/p>\n\n\n\n<p><strong>It is important to remember that the overall risk of a dangerous blood clot due to Leverette 21 is small.<\/strong><\/p>\n\n\n\n<p><strong>HOW to DO YOU\u00a0IGE\u00a0N Emboli<\/strong><\/p>\n\n\n\n<p>Seek medical attention immediately if you notice any of the following signs or symptoms. <a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=20190225000061#\" rel=\"noopener\">Show larger<\/a><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Do you experience any of these signs?<\/td><td>What could it be due to?<\/td><\/tr><tr><td>Swelling of a leg or along a vein in the leg or foot, especially if you also get: pain or tenderness in the leg that is only felt when you stand or walk increased heat in the affected leg altered skin color of the leg, e.g.\u00a0pale, red or blue.<\/td><td>Deep&nbsp;vein thrombosis<\/td><\/tr><tr><td>Sudden unexplained shortness of breath or rapid breathing sudden cough for no apparent reason that could cause you to cough up blood severe chest pain that may increase with deep breathing severe instability or dizziness fast or irregular heartbeat severe pain in the abdomen. If you are not sure, talk to a doctor because some of these symptoms, e.g.\u00a0cough and shortness of breath, can be mistakenly interpreted as a milder condition such as a respiratory infection (such as a common cold).<\/td><td>Pulmonary embolism<\/td><\/tr><tr><td>Symptoms most common in one eye: immediate loss of vision or blurred vision without pain that can lead to vision loss.<\/td><td>Retinal&nbsp;venous thrombosis&nbsp;(blood clot in the eye)<\/td><\/tr><tr><td>Chest pain, discomfort, pressure, heavinesspressure or feeling of fullness in the chest, arm, or below the sternum feeling full, indigestion or suffocationdiscomfort in the upper body that radiates to the back, jaw, neck, arm, and abdomen\u00a0sweating, nausea, vomiting or dizziness extreme weakness, anxiety or shortness of breath fast or irregular heartbeat.<\/td><td>Myocardial infarction<\/td><\/tr><tr><td>Sudden weakness or numbness in the face, arms, or legs, especially on one side of the body sudden confusion, difficulty speaking or understanding sudden vision problems in one or both eyes sudden difficulty walking, dizziness, loss of balance or coordination Sudden, severe or prolonged headache for no known reason consciousness or fainting with or without seizures. The symptoms of a\u00a0stroke\u00a0can sometimes be short-lived with almost immediate or complete recovery, but you should still seek medical attention immediately as you are at risk of having a new\u00a0stroke.<\/td><td>Stroke<\/td><\/tr><tr><td>Swelling and slight blue discoloration of an arm or leg severe pain in the abdomen (\u00a0acute\u00a0abdomen).<\/td><td>Blood clots that block other blood vessels<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><strong>BLOOD CLOTS IN A FRIEND<\/strong><\/p>\n\n\n\n<p><strong>What can happen if a blood clot forms in a vein?<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The use of combined hormonal contraceptives has been associated with an increased risk of a blood clot in a vein (venous&nbsp;thrombosis&nbsp;).&nbsp;However, these&nbsp;side effects&nbsp;are rare.&nbsp;They usually occur during the first year of using a combined hormonal contraceptive.<\/li><li>If a blood clot forms in a vein in the leg or foot, it can lead to deep&nbsp;vein thrombosis&nbsp;(DVT).<\/li><li>If a blood clot moves from the bone and gets stuck in the lung, it can lead to a&nbsp;pulmonary embolism&nbsp;.<\/li><li>In very rare cases, a blood clot can form in a vein in another organ such as the eye (&nbsp;retinal&nbsp;venous thrombosis&nbsp;).&nbsp;<\/li><\/ul>\n\n\n\n<p><strong>When is the risk of developing a blood clot in a vein greatest?<\/strong><\/p>\n\n\n\n<p>The risk of developing a blood clot in a vein is greatest during the first year that you use combined hormonal contraceptives for the first time.&nbsp;The risk can also be higher if you start again with a combined hormonal contraceptive (same product or another product) after a break of 4 weeks or longer.<\/p>\n\n\n\n<p>After the first year, the risk decreases, but it is always slightly higher than if you had not used a combined hormonal contraceptive.<\/p>\n\n\n\n<p>When you stop using Leverette 21, the risk of a blood clot returns to normal within a few weeks.<\/p>\n\n\n\n<p><strong>How big is the risk of developing a blood clot?<\/strong><\/p>\n\n\n\n<p>The risk depends on your natural risk of VTE and the type of combined hormonal contraceptive you are taking.<\/p>\n\n\n\n<p>The overall risk of a blood clot in the leg or lung with Leverette 21 is small.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Of 10,000 women who do not use a combined hormonal contraceptive and who are not pregnant, about 2 develop a blood clot over a 1-year period.<\/li><li>Of the 10,000 women who use a combined hormonal contraceptive that contains levonorgestrel, such as Leverette 21, approximately 5-7 develop a blood clot over a 1-year period.<\/li><li>The risk of getting a blood clot varies depending on your personal medical history (see &#8220;Factors that increase the risk of a blood clot&#8221; below).<\/li><\/ul>\n\n\n\n<p><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=20190225000061#\" rel=\"noopener\">Show larger<\/a><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><\/td><td><strong>Risk of developing a blood clot over 1 year<\/strong><\/td><\/tr><tr><td>Women who\u00a0<strong>do not use<\/strong>\u00a0combined contraceptive pills\/patches \/ contraceptive rings and who are not pregnant\u00a0<\/td><td>About 2 out of 10,000 women<\/td><\/tr><tr><td>Women using combined&nbsp;oral contraceptives&nbsp;containing&nbsp;<strong>levonorgestrel<\/strong>such as Leverette 21<\/td><td>About 5-7 out of 10,000 women<\/td><\/tr><tr><td>Women using Leverette 21<\/td><td>About 5-7 out of 10,000 women<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><strong>Factors that increase the risk of a blood clot in a vein<\/strong><\/p>\n\n\n\n<p>The risk of a blood clot with Leverette 21 is small, but certain circumstances increase the risk.&nbsp;The risk is higher:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you are severely overweight (body mass index or&nbsp;BMI&nbsp;over 30 kg \/ m&nbsp;<sup>2<\/sup>&nbsp;)<\/li><li>if a close relative has had a blood clot in the bone, lung or other organ at a young age (eg under about 50 years);&nbsp;in that case, you may have a hereditary blood clotting disease<\/li><li>if you need to undergo surgery, or stay in bed for an extended period of time due to injury or illness, or if your leg is plastered.&nbsp;The use of Leverette 21 may need to be discontinued for several weeks before surgery or while you are less mobile.&nbsp;If you have to stop taking Leverette 21, ask your doctor when you can start taking it again.<\/li><li>with increasing age (especially if you are over about 35 years old)<\/li><li>if you gave birth a few weeks ago.<\/li><\/ul>\n\n\n\n<p>The risk of developing a blood clot increases the more of these conditions that exist.<\/p>\n\n\n\n<p>Air travel (over 4 hours) can temporarily increase the risk of a blood clot, especially if you have any of the other factors listed here.<\/p>\n\n\n\n<p>You must tell your doctor if any of these circumstances apply to you, even if you are unsure.\u00a0Your doctor may decide that you must stop taking Leverette 21.<\/p>\n\n\n\n<p>Talk to your doctor if any of the above circumstances change while you are using Leverette 21, e.g.&nbsp;if a close relative suffers from a blood clot for an unknown reason or if you gain a lot of weight.<\/p>\n\n\n\n<p><strong>BLOOD CLOTS IN AN&nbsp;ART<\/strong><\/p>\n\n\n\n<p><strong>What can happen if a blood clot forms in an\u00a0artery?<\/strong><\/p>\n\n\n\n<p>In the same way as a blood clot in a vein, a clot in an\u00a0artery\u00a0can lead to serious problems.\u00a0Such a blood clot can e.g.\u00a0cause a heart attack or\u00a0stroke.<\/p>\n\n\n\n<p><strong>Factors that increase the risk of a blood clot in an&nbsp;artery<\/strong><\/p>\n\n\n\n<p>It is important to know that the risk of a heart attack or&nbsp;stroke&nbsp;due to the use of Leverette 21 is very small but may increase:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>with increasing age (after about 35 years of age)<\/li><li><strong>if you smoke.&nbsp;<\/strong>When using combined hormonal contraceptives such as Leverette 21, you should stop smoking.&nbsp;If you can not stop smoking and are over 35 years old, your doctor may advise you to use another type of contraceptive.<\/li><li>if you are overweight<\/li><li>if you have high&nbsp;blood pressure<\/li><li>if a close relative has had a heart attack or&nbsp;stroke&nbsp;at a young age (younger than 50 years).&nbsp;In such a case, you may also be at greater risk of a heart attack or&nbsp;stroke&nbsp;.<\/li><li>if you or a close relative have high blood fat levels (&nbsp;cholesterol&nbsp;or&nbsp;triglycerides&nbsp;)<\/li><li>if you have migraine attacks, especially&nbsp;migraines&nbsp;with&nbsp;aura<\/li><li>if you have heart problems (valve disease, a heart rhythm disorder called&nbsp;atrial fibrillation&nbsp;)<\/li><li>if you have&nbsp;diabetes&nbsp;.<\/li><\/ul>\n\n\n\n<p>If more than one of the above circumstances applies to you or if any of them are particularly serious, the risk of developing a blood clot can be even greater.<\/p>\n\n\n\n<p>Talk to your doctor if any of the above circumstances change when you use Leverette 21, e.g.\u00a0if you start smoking, a close relative suffers from\u00a0thrombosis\u00a0of unknown cause, or if you gain a lot of weight.<\/p>\n\n\n\n<p><strong>Leverette 21 and cancer<\/strong><\/p>\n\n\n\n<p>Breast cancer is diagnosed somewhat more often in women who use combined&nbsp;contraceptive pills,&nbsp;but it is not known if this is due to the treatment.&nbsp;For example, it may be that more&nbsp;tumors&nbsp;are detected in women who use&nbsp;birth control pills&nbsp;because they are examined more often.<\/p>\n\n\n\n<p>The incidence of breast tumors gradually decreases after discontinuation of combined hormonal contraceptives.\u00a0You must be examined by a doctor if you feel a lump.<\/p>\n\n\n\n<p>In rare cases, benign liver tumors and, even more rarely, malignant liver tumors have been reported in birth control pill users.&nbsp;Contact a doctor immediately if you have unusually severe pain in the abdominal region.<\/p>\n\n\n\n<p>Cervical cancer has been observed somewhat more frequently in long-term&nbsp;contraceptive&nbsp;users compared to non-users, but it is unclear to what extent this is related to sexual behavior and other factors, such as human papillomavirus (HPV).<\/p>\n\n\n\n<p><strong>Intermittent bleeding<\/strong><\/p>\n\n\n\n<p>During the first months of taking Leverette 21, you may experience unexpected bleeding (bleeding at times other than during the tablet-free period).\u00a0If such bleeding occurs for more than a few months or only occurs after a few months, talk to your doctor to find out what is wrong.<\/p>\n\n\n\n<p><strong>What to do if you do not experience any bleeding during the tablet-free period<\/strong><\/p>\n\n\n\n<p>If you have taken all the tablets correctly, have not vomited, or had severe diarrhea and you have not taken any other medicines, it is highly unlikely that you are pregnant.<\/p>\n\n\n\n<p>If the expected bleeding does not occur twice in a row, you may be pregnant.&nbsp;Contact a doctor immediately.&nbsp;Do&nbsp;<strong>not start<\/strong>&nbsp;with the next tablet card until you are sure you are not pregnant.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other medicines and Leverette 21<\/h2>\n\n\n\n<p>Always tell the doctor\/midwife who prescribes Leverette 21 if you are taking, have recently taken, or might take any other medicines, including (traditional) herbal medicines and herbal remedies.\u00a0Also, tell other doctors or dentists who prescribe other medicines (or the pharmacy staff) that you are taking Leverette 21. They may tell you if you need to use additional contraceptives (eg condoms) and if so, for how long.<\/p>\n\n\n\n<p>Do not use Leverette 21 if you have\u00a0hepatitis\u00a0C and are taking medicines containing ombitasvir\/paritaprevir \/ ritonavir, dasabuvir, glekaprevir \/ pibrentasvir and<\/p>\n\n\n\n<p>sofosbuvir \/ velpatasvir \/ voxilaprevir, as treatment with these products, may lead to elevated liver values \u200b\u200b(elevated levels of the liver enzyme\u00a0ALT\u00a0).<\/p>\n\n\n\n<p>Your doctor will prescribe another contraceptive before starting treatment with these medicines.<\/p>\n\n\n\n<p>Leverette 21 can be started again about 2 weeks after the end of treatment.&nbsp;See section &#8220;Do not use Leverette 21&#8221;.<\/p>\n\n\n\n<p>Some medicines can affect the levels of Leverette 21 in the blood and can reduce the protection against pregnancy or cause unexpected bleeding.&nbsp;These include:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>drugs for the treatment of:<ul><li>epilepsy&nbsp;(eg primidone,&nbsp;phenytoin&nbsp;,&nbsp;barbiturates&nbsp;, carbamazepine, oxcarbazepine)<\/li><li>tuberculosis&nbsp;(eg rifampicin)<\/li><li>HIV&nbsp;and&nbsp;hepatitis&nbsp;C virus infections (so-called&nbsp;protease inhibitors&nbsp;and non-nucleoside reverse transcriptase inhibitors, such as ritonavir, nevirapine, efavirenz)<\/li><li>fungal infections (eg griseofulvin)<\/li><li>arthritis&nbsp;,&nbsp;osteoarthritis&nbsp;(eg etoricoxib)<\/li><li>high&nbsp;blood pressure&nbsp;in the blood vessels of the lungs (&nbsp;bosentan&nbsp;)<\/li><\/ul><\/li><li>(traditional) herbal medicines containing&nbsp;St. John&#8217;s wort&nbsp;.<\/li><\/ul>\n\n\n\n<p>Leverette 21 may affect the effectiveness of other medicines, for example:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>medicines containing ciclosporin<\/li><li>the epilepsy drug lamotrigine (this may lead to an increased number of epileptic seizures)<\/li><li>theophylline (for the treatment of respiratory problems)<\/li><li>tizanidine (for the treatment of muscle pain and \/ or muscle cramps).<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Leverette 21 with food and drink<\/h2>\n\n\n\n<p>Leverette 21 can be taken with or without food, if necessary with a little water.<\/p>\n\n\n\n<p><strong>Laboratory samples<\/strong><\/p>\n\n\n\n<p>If you need to take a blood test, tell your doctor or laboratory staff that you are taking&nbsp;birth control pills&nbsp;as hormonal contraceptives may affect certain test results.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy and breastfeeding<\/h2>\n\n\n\n<p>If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor\/midwife or pharmacist for advice before taking this medicine.<\/p>\n\n\n\n<p><em>Pregnancy<\/em><\/p>\n\n\n\n<p>Do not take Leverette 21 if you are pregnant.\u00a0If you become pregnant while taking Leverette 21,\u00a0<strong>stop<\/strong>\u00a0taking the contraceptive pill\u00a0immediately\u00a0and contact a doctor\/midwife.\u00a0If you want to get pregnant, you can stop taking the contraceptive pill at any time (see also &#8220;If you want to stop taking Leverette 21&#8221;).<\/p>\n\n\n\n<p><em>Breast-feeding<\/em><\/p>\n\n\n\n<p>The use of Leverette 21 is generally not recommended for breastfeeding women.\u00a0If you want to use\u00a0birth control pills\u00a0while you are breastfeeding, contact your doctor\/midwife.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving and using machines<\/h2>\n\n\n\n<p>There is no information to suggest that the use of Leverette 21 affects the ability to drive or use machines.<\/p>\n\n\n\n<p>You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires sharpened attention.\u00a0One of the factors that can affect your ability in these respects is the use of drugs due to their effects and\/or\u00a0side effects.\u00a0Descriptions of these effects and\u00a0side effects\u00a0can be found in other sections.\u00a0Therefore, always read all the information in this leaflet for guidance.\u00a0If you are not sure, talk to your doctor\/midwife or pharmacist.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Leverette 21 contains lactose<\/h2>\n\n\n\n<p>This medicine contains\u00a0lactose.\u00a0If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How to take Leverette 21<\/h2>\n\n\n\n<p>Always take this medicine exactly as your doctor\/midwife has told you.\u00a0If you are not sure, talk to your doctor\/midwife or pharmacist.<\/p>\n\n\n\n<p>Remember to take Leverette 21 according to the instructions as forgotten tablets may reduce the effect of the medicine.<\/p>\n\n\n\n<p><strong>How and when to use Leverette 21:<\/strong><\/p>\n\n\n\n<p>Each tablet map contains 21 tablets.<\/p>\n\n\n\n<p>Take a Leverette 21 tablet every day, if necessary with a little water.&nbsp;You should take the tablets at about the same time each day.<\/p>\n\n\n\n<p>The day of the week that the tablet is to be taken is printed next to each tablet.\u00a0Start by taking a tablet from the first row marked with the current day of the week.\u00a0For example, if you start on a Wednesday, take a tablet with &#8220;ONS&#8221; next to it.\u00a0Follow the direction of the arrows until you have taken all 21 tablets.\u00a0You should then not take any tablets for the next seven days.\u00a0During these seven tablet-free days (also called tablet-free or tablet-free weeks), you should experience menstrual-like bleeding.\u00a0This so-called dropout bleeding usually begins on the second or third day of the tablet-free week.<\/p>\n\n\n\n<p>On the eighth day after the last Leverette 21 tablet (ie after the 7-day tablet pause), start with the next tablet chart, whether or not the bleeding has stopped.&nbsp;This means that you should start each tablet chart&nbsp;<strong>on the same day of the week<\/strong>&nbsp;and the bleeding should occur on the same days each month.<\/p>\n\n\n\n<p>If you use Leverette 21 in this way, you are protected against pregnancy even during the 7 days when you do not take any tablets.<\/p>\n\n\n\n<p><strong>When you can start taking Leverette 21<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>If you have not used any hormonal contraceptives in the previous month<\/strong>Start taking Leverette 21 on the first day of the menstrual cycle (ie the first day of bleeding).&nbsp;If you start with Leverette 21 on the first day of menstruation, you are immediately protected against pregnancy.&nbsp;You can also start on day 2\u20115 of the cycle, but then you must use additional contraceptives (eg condoms) for the first 7 days.<\/li><li><strong>If you change from a combined&nbsp;contraceptive pill&nbsp;,&nbsp;vaginal ring&nbsp;or contraceptive&nbsp;patch<\/strong>You should preferably start taking Leverette 21 on the day after the last active tablet (the last tablet containing active substances) of your previous&nbsp;pill&nbsp;and no later than the day after stopping the tablet with your previous&nbsp;pill&nbsp;).If you change from a&nbsp;vaginal ring&nbsp;or contraceptive&nbsp;patch&nbsp;, follow the doctor&#8217;s \/ midwife&#8217;s advice.<\/li><li><strong>If you change from a contraceptive with only&nbsp;progestogens&nbsp;(mini-pills, contraceptive&nbsp;syringe&nbsp;,&nbsp;contraceptive pill&nbsp;or IUD)<\/strong>You can change from&nbsp;mini-pills&nbsp;any day (from the IUD or IUD the same day the IUD is removed, and from the IUD)&nbsp;gun&nbsp;the day you would get the next&nbsp;injection&nbsp;).&nbsp;In all these cases, you must use additional contraceptives (eg condoms) during the first 7 days of Leverette 21.<\/li><li><strong>If you have had a miscarriage<\/strong>Follow the doctor&#8217;s \/ midwife&#8217;s advice.<\/li><li><strong>After childbirth<\/strong>You can start taking Leverette 21 between 21 and 28 days after delivery.&nbsp;If you start later than day 28, use a&nbsp;barrier method&nbsp;(eg condom) for the first 7 days.If you have had intercourse after giving birth before taking Leverette 21, you must be sure that you are not pregnant or wait until the next period before taking this medicine.<\/li><li><strong>During breastfeeding<\/strong>If you are breast-feeding and want to start taking Leverette 21 again after having a baby, read the section \u201cPregnancy and breast-feeding\u201d.<\/li><\/ul>\n\n\n\n<p>Ask your doctor\/midwife if you are unsure when to start taking Leverette 21.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you take more Leverette 21 than you should<\/h2>\n\n\n\n<p>No serious adverse effects have been reported after taking too many Leverette 21 tablets.&nbsp;If you have taken several tablets at the same time, you may experience nausea or vomiting.&nbsp;Young girls may experience vaginal bleeding.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Possible side effects<\/h2>\n\n\n\n<p>Like all medicines, this medicine can cause\u00a0side effects,\u00a0although not everybody gets them.\u00a0Talk to your doctor if you get a\u00a0side effect, especially if it is serious or persistent, or if your health changes and you think it may be due to Leverette 21.<\/p>\n\n\n\n<p><strong>Serious&nbsp;side effects&nbsp;are<\/strong><\/p>\n\n\n\n<p>Contact a doctor immediately if you experience any of the following symptoms of angioedema: swelling of the face, tongue, and\/or throat and\/or difficulty swallowing,\u00a0hives, possible nausea, and difficulty breathing (see also section &#8220;Warnings and precautions&#8221;).<\/p>\n\n\n\n<p>All women who use combined hormonal contraceptives have an increased risk of blood clots in the veins (venous\u00a0thromboembolism, VTE), or blood clots in the\u00a0arteries\u00a0are (\u00a0arterial\u00a0thromboembolism, ATE).\u00a0For more information on the different risks of using combined hormonal contraceptives, see section 2: \u201cWhat you need to know before taking Leverette 21\u201d).<\/p>\n\n\n\n<p>Listed below are&nbsp;side effects&nbsp;that have been linked to the use of Leverette 21:<\/p>\n\n\n\n<p><strong>Common&nbsp;side effects&nbsp;are<\/strong>&nbsp;(may affect up to 1 in 10):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>nausea<\/li><li>abdominal pain<\/li><li>weight gain<\/li><li>headache<\/li><li>Depression<\/li><li>mood change<\/li><li>sore breasts<\/li><li>chest pain.<\/li><\/ul>\n\n\n\n<p><strong>Less common&nbsp;side effects&nbsp;are<\/strong>&nbsp;(may affect up to 1 in 100):&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>vomiting<\/li><li>diarrhea<\/li><li>fluid retention<\/li><li>migraine<\/li><li>decreased sexual desire<\/li><li>breast augmentation<\/li><li>rash<\/li><li>hives&nbsp;(&nbsp;urticaria&nbsp;).<\/li><\/ul>\n\n\n\n<p><strong>Rare&nbsp;side effects&nbsp;are<\/strong>&nbsp;(may affect up to 1 in 1000 people):&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>contact lens intolerance (difficulty wearing contact lenses)<\/li><li>hypersensitivity<\/li><li>weight loss<\/li><li>increased sexual desire<\/li><li>fluid secretion from the breasts<\/li><li>discharge from the vagina<\/li><li>a type of dermatitis that causes reddish, painful, sore lumps (erythema nodosum)<\/li><li>a skin condition that causes red, target-like spots or sores (erythema multiforme)<\/li><li>dangerous blood clots in a vein or&nbsp;artery&nbsp;, eg:<ul><li>in one leg or foot (ie DVT)<\/li><li>in a lung<\/li><li>myocardial infarction<\/li><li>stroke<\/li><li>ministroke or transient stroke-like symptoms, a so-called&nbsp;transient&nbsp;ischemic attack (&nbsp;TIA&nbsp;)<\/li><li>blood clots in the liver, stomach \/ intestines, kidneys or eye.<\/li><\/ul><\/li><\/ul>\n\n\n\n<p>The risk of getting a blood clot may be greater if you have another condition that increases this risk (section 2 contains more information on factors that increase the risk of blood clots and the symptoms of a blood clot).<\/p>\n\n\n\n<p>The following serious&nbsp;side effects&nbsp;have been reported somewhat more frequently in women taking&nbsp;oral contraceptives&nbsp;but it is unclear whether this is due to treatment (see section 2: \u201cWarnings and precautions\u201d):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>high&nbsp;blood pressure<\/li><li>liver tumors or breast cancer.<\/li><\/ul>\n\n\n\n<p><strong>The following conditions have also been associated with combined oral contraceptives:<\/strong><\/p>\n\n\n\n<p>Crohn&#8217;s disease,\u00a0ulcerative colitis,\u00a0epilepsy,\u00a0migraine,\u00a0endometriosis,\u00a0porphyria\u00a0(metabolic disease that causes abdominal pain and mental disorders), systemic lupus erythematosus (in which the body attacks and damages its organs and\u00a0tissues\u00a0),\u00a0herpes\u00a0late in pregnancy, Sydenham&#8217;s chorea (rapid involuntary jerky and jerky movements),\u00a0hemolytic uremic syndrome\u00a0(a condition that occurs after diarrhea caused by the bacterium E.coli), liver problems that manifest as jaundice, gallbladder disease or gallstone formation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How to store Leverette 21<\/h2>\n\n\n\n<p>Keep this medicine out of the sight and reach of children.<\/p>\n\n\n\n<p>Do not store above 30 \u00b0 C.<\/p>\n\n\n\n<p>Do not use this medicine after the expiry date which is stated on the carton and tablet carton after \u201cEXP\u201d.&nbsp;The expiration date is the last day of the specified month.<\/p>\n\n\n\n<p>Medicines should not be disposed of via wastewater or household waste.&nbsp;Ask your pharmacist how to dispose of medicines no longer required.&nbsp;These measures will help to protect the environment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Contents of the pack and other information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Content declaration<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>The active substances are levonorgestrel and ethinyl estradiol.&nbsp;Each tablet contains 150 micrograms levonorgestrel and 30 micrograms ethinyl estradiol.<\/li><li>Other ingredients are:Tablet core:&nbsp;lactose monohydrate&nbsp;, povidone, crospovidone and magnesium stearate.Coating: polyvinyl alcohol, titanium dioxide (E171), macrogol, talc (E553b) and yellow iron oxide (E172)<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">What the medicine looks like and contents of the pack<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Each tablet map with Leverette 21 contains 21 yellow film-coated tablets.<\/li><li>The Leverette 21 tablets are film-coated.&nbsp;The tablets are yellow, round and have a diameter of 6 mm and are approximately 4 mm thick.<\/li><li>Leverette 21 is available in packs of 1, 3, 6 or 13 tablet cards with 21 tablets on each card.&nbsp;Not all pack sizes may be marketed.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorization Holder and Manufacturer<\/h2>\n\n\n\n<p><strong>Marketing Authorisation Holder<\/strong><\/p>\n\n\n\n<p>Exeltis Healthcare SL<\/p>\n\n\n\n<p>Avenida Miralcampo 7<\/p>\n\n\n\n<p>Poligono Industrial Miralcampo<\/p>\n\n\n\n<p>19200 Azuqueca de Henares, Guadalajara<\/p>\n\n\n\n<p>Spain<\/p>\n\n\n\n<p><strong>Manufacturer<\/strong><\/p>\n\n\n\n<p>Leon Farma Laboratories, SA<\/p>\n\n\n\n<p>C \/ La Vallina s \/ n, Pol.&nbsp;Ind.&nbsp;Navatejera<\/p>\n\n\n\n<p>24008 &#8211; Navatejera, Le\u00f3n.<\/p>\n\n\n\n<p>Spain<\/p>\n\n\n\n<p><strong>This medicinal product is authorized under the European Economic Area under the names\u00a0<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Denmark:<\/td><td>Leverette 21<\/td><\/tr><tr><td>Iceland:<\/td><td>Melva<\/td><\/tr><tr><td>Netherlands:<\/td><td>Levonorgestrel \/ Ethinylestradiol Sandoz BV 150\/30 micrograms, film-coated tablets<\/td><\/tr><tr><td>Norway:<\/td><td>Melva<\/td><\/tr><tr><td>UK:<\/td><td>Amelina 150\/30 microgram film-coated tablets<\/td><\/tr><tr><td>Sweden:<\/td><td>Leverette 21 150 micrograms \/ 30 micrograms, film-coated tablets<\/td><\/tr><tr><td>Germany:<\/td><td>Asumate 30 0.15 mg \/ 0.03 mg Film tablets<\/td><\/tr><\/tbody><\/table><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Leverette 21 is a birth control pill and is used to prevent pregnancy<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2200,15579],"tags":[3375,3378,5385,15736,15740,15739,2424,2427,12055,15735,3919,15737,12053,15738,12054],"class_list":["post-16555","post","type-post","status-publish","format-standard","hentry","category-medicines","category-l","tag-ethinyl-estradiol","tag-ethinyl-estradiol-side-effects","tag-ethinyl-estradiol-tablet","tag-leverette-21","tag-leverette-21-side-effects","tag-leverette-21-tablet","tag-levonorgestrel","tag-levonorgestrel-side-effects","tag-levonorgestrel-tablet","tag-what-ethinyl-estradiol-is-used-for","tag-what-is-ethinyl-estradiol","tag-what-is-leverette-21","tag-what-is-levonorgestrel","tag-what-leverette-21-is-used-for","tag-what-levonorgestrel-is-used-for"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/16555","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=16555"}],"version-history":[{"count":4,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/16555\/revisions"}],"predecessor-version":[{"id":16580,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/16555\/revisions\/16580"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=16555"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=16555"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=16555"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}