Plan B (Levonorgestrel)

Introduction

Plan B is an emergency contraceptive pill that contains the synthetic progestin levonorgestrel (1.5 mg). It is classified as a hormonal contraceptive and is intended for short-term use after contraceptive failure or unprotected sexual intercourse. The medication works by preventing or delaying ovulation and, if ovulation has already occurred, by impairing fertilization or implantation. Levonorgestrel is also the active ingredient in other oral contraceptives and is marketed under brand names such as Plan B One-Step, Next Choice One Dose, and Levonelle. The pill is supplied as a single-dose tablet and is available without a prescription in many countries.

What is Plan B?

Plan B is a single-tablet emergency contraceptive that delivers 1.5 mg of levonorgestrel orally. Levonorgestrel is a second-generation progestin originally developed in the s for use in combined oral contraceptives. The emergency-use formulation was first approved by the U.S. Food and Drug Administration (FDA) in 1999 and has since been adopted worldwide. Various manufacturers produce the product, and it is sold under several brand names, including the well-known Plan B One-Step and Next Choice One Dose. The medication belongs to the hormonal emergency-contraception group, distinct from copper-IUD or ulipristal-acetate options.

How Plan B Works

Levonorgestrel exerts its contraceptive effect primarily by inhibiting the luteinizing hormone (LH) surge that triggers ovulation. When taken within 72 hours of intercourse, the drug can delay follicular rupture, thereby preventing the release of an oocyte. If ovulation has already occurred, levonorgestrel may alter tubal motility and endometrial receptivity, reducing the probability of fertilization or implantation. The onset of action is rapid-plasma concentrations peak within 2-3 hours after ingestion. Levonorgestrel has a half-life of about 24 hours and is largely cleared via hepatic metabolism and renal excretion within 4 days.

Conditions Treated with Plan B

• Prevention of pregnancy after unprotected intercourse - The only FDA-approved indication. When administered promptly (ideally within 12 hours and no later than 72 hours), Plan B reduces the risk of pregnancy by 75-89 % compared with no intervention.
• Contraceptive failure - Includes missed or delayed doses of combined oral contraceptives, condom breakage, or slippage. The drug restores contraceptive protection without requiring a full course of a regular birth-control method.

The effectiveness of Plan B declines as the interval between intercourse and dosing lengthens; therefore, early use is strongly recommended.

Off-Label and Investigational Uses of Plan B

• Management of abnormal uterine bleeding (AUB) - Small case series have reported that a single dose of levonorgestrel can transiently reduce heavy menstrual bleeding, but evidence is limited and the indication is not approved.
• Adjunct in early-termination protocols - Some clinicians have explored levonorgestrel as part of a medical abortion regimen for pregnancies ≤ 49 days, although mifepristone + misoprostol remains the standard and levonorgestrel alone is not recommended.

These applications are not authorized by the FDA, EMA, or other regulatory agencies. Patients should only consider such uses under direct supervision of a qualified healthcare professional.

Is Plan B the Right Medication for You?

Plan B is appropriate for individuals who:

• Have had unprotected vaginal intercourse or experienced contraceptive failure within the past 72 hours.
• Are not currently pregnant and have a functional uterus.
• Have no contraindications to progestin use (e.g., known hypersensitivity to levonorgestrel or any tablet excipient).

Situations where Plan B is not advised include:

• Confirmed pregnancy (the product does not terminate an established pregnancy).
• Severe hepatic impairment, as metabolism may be compromised.
• Ongoing use of medications that significantly induce hepatic enzymes (e.g., rifampin, carbamazepine), which can reduce levonorgestrel efficacy.

Patients with a history of thromboembolic disorders, estrogen-dependent cancers, or unexplained vaginal bleeding should discuss alternative emergency-contraception options with a clinician.

Risks, Side Effects, and Interactions

Common

• Nausea, abdominal cramping, and mild headache.
• Fatigue, dizziness, or transient breast tenderness.
• Irregular menstrual bleeding (spotting or early onset of the next period).

Rare

• Vomiting within 2 hours of ingestion; if this occurs, a second dose should be taken after an additional 12 hours.
• Allergic reactions such as rash, itching, or hives.

Serious

• Anaphylaxis (extremely rare) - immediate medical attention required.
• Deep-vein thrombosis or pulmonary embolism - risk is low but higher in women with pre-existing clotting disorders.

Drug-Drug Interactions

• Enzyme inducers (rifampin, phenytoin, carbamazepine, St. John’s wort) may lower levonorgestrel plasma levels, decreasing efficacy.
• Certain anticonvulsants (phenobarbital, topiramate) have similar inducing effects.
• No clinically significant interactions have been reported with most over-the-counter medications, but concomitant use of hormonal contraceptives may increase menstrual irregularities.

Food and Lifestyle Interactions

• Taking the tablet with food does not affect absorption; however, excessive alcohol may exacerbate nausea.
• Operating heavy machinery is not restricted, but caution is advised if dizziness occurs.

Use: Dosing, Missed Dose, Overdose

• Standard dose: One tablet containing 1.5 mg levonorgestrel taken orally as soon as possible after the qualifying event. No second dose is required.
• Missed dose: If the tablet is vomited within 2 hours of ingestion, repeat the dose after an additional 12 hours. If vomiting recurs, seek medical advice.
• Overdose: Symptoms may include prolonged nausea, vomiting, or severe abdominal pain. Ingesting more than the recommended 1.5 mg does not increase efficacy and may increase side-effect risk. Supportive care is the mainstay; activated charcoal is rarely indicated.
• Precautions: The tablet can be taken with or without food. Alcohol does not interfere with efficacy but may worsen gastrointestinal upset. Women should avoid extra hormonal contraception for 5 days after taking Plan B to prevent hormonal interference.

FAQ

• What is the shelf life of a Plan B tablet?

  The product typically remains stable for 2 years when stored at room temperature (15-30 °C) in its original packaging. Expiration dates are printed on the blister pack.

• Can I take Plan B while breastfeeding?

  Levonorgestrel passes into breast milk in very low concentrations. The FDA considers emergency contraception compatible with lactation, but mothers may wish to monitor infant feeding patterns.

• Does Plan B affect future fertility?

  No. Levonorgestrel does not cause lasting changes to ovarian function or fertility. Regular menstrual cycles usually resume within 1 month.

• How does Plan B differ from ulipristal acetate (Ella)?

  Ulipristal acetate is a selective progesterone receptor modulator with a longer efficacy window (up to 120 hours). Levonorgestrel is a progestin with a 72-hour window and may be slightly less effective when taken later.

• Is a pregnancy test needed before taking Plan B?

  Not required, but if a user suspects an existing pregnancy, a test can confirm that emergency contraception is appropriate.

• Can I use Plan B if I have a copper IUD already inserted?

  The copper IUD is itself an emergency contraceptive with > 99 % effectiveness; additional levonorgestrel offers no extra benefit.

• Will Plan B cause my next period to be early or late?

  Both outcomes are possible. The pill may cause the subsequent menstrual bleed to occur up to 7 days earlier or later than expected.

• Does Plan B interact with herbal supplements such as ginkgo or garlic?

  Current evidence does not show a clinically relevant interaction, but high-dose herbal products that affect liver enzymes could theoretically reduce effectiveness.

• Can I take Plan B while on hormonal birth control pills?

  Yes. Plan B can be used in addition to regular contraceptive pills after a contraceptive failure; however, continue the regular pill schedule unchanged.

• What temperature extremes can affect Plan B’s potency?

  Exposure to temperatures above 40 °C or below °C for prolonged periods may degrade the active ingredient. Store the tablet in a dry, temperature-controlled environment.

Glossary

Progestin

A synthetic compound that mimics the action of the natural hormone progesterone, used in many hormonal contraceptives.

Luteinizing hormone (LH) surge

A rapid increase in LH that triggers ovulation; preventing this surge stops the release of an egg.

Enzyme inducer

A substance that increases the activity of liver enzymes responsible for drug metabolism, potentially lowering the efficacy of co-administered medications.

Emergency contraception

A method used after unprotected sex or contraceptive failure to prevent pregnancy, distinct from routine birth-control methods.

Buying Plan B from Our Online Pharmacy

Plan B can be obtained conveniently through our online pharmacy. We source the generic levonorgestrel tablet from licensed, verified suppliers who meet international quality standards, ensuring that every package contains the correct dosage and formulation. By purchasing through us, patients benefit from near-manufacturer pricing, which reduces out-of-pocket costs without sacrificing safety.

Our fulfillment network provides discreet packaging and reliable shipping options, including express delivery (typically 7 days) and standard airmail (approximately 3 weeks). Because we operate as a pharmacy-broker service, we can bring internationally sourced medications to regions where local availability may be limited or where insurance coverage does not include over-the-counter emergency contraception.

Privacy is a core priority-all orders are processed with secure, encrypted data handling, and parcels are sent without identifying markings. This approach allows individuals to protect their personal health information while accessing a proven, effective emergency contraceptive.

Disclaimer

The information presented about Plan B is intended for general educational purposes and does not replace professional medical advice. Treatment decisions, including any off-label applications, should be made under the direct supervision of a qualified healthcare provider. Readers are presumed to be responsible adults capable of informed health choices. Our online pharmacy supplies Plan B for individuals who may encounter limited access through conventional pharmacies or insurance channels and who seek cost-effective generic options. Always consult a clinician before initiating, modifying, or discontinuing any medication.