Nebremel (Levonorgestrel)

Levonorgestrel, the active ingredient in Nebremel, is a progestogen presented as a tablet for oral use. It prevents pregnancy and can be used as emergency contraception in women of reproductive age.

GNH USA supplies Nebremel as a licensed, GDP-compliant international pharmaceutical supplier serving hospitals, pharmacies and clinics worldwide.

Levonorgestrel is a progestogen used in hormonal contraception to prevent pregnancy.

- Emergency contraception: prevents pregnancy after unprotected intercourse when taken within the recommended time frame. - Regular contraception: used as a progestin‑only method to inhibit ovulation and maintain contraceptive effect. - Menstrual cycle regulation: may be incorporated in regimens to help control irregular menstrual bleeding.

Levonorgestrel is generally well tolerated, but several adverse reactions have been reported.

Common Side Effects: - Nausea: mild to moderate stomach upset. - Headache: transient tension‑type headaches. - Breast tenderness: mild discomfort or swelling. - Menstrual changes: spotting, early or delayed periods. - Abdominal pain: cramping or mild discomfort. - Fatigue: feeling unusually tired.

Serious or Rare Side Effects: - Severe allergic reaction: rash, swelling, or difficulty breathing. - Thromboembolic events: rare blood clot formation. - Ectopic pregnancy: implantation outside the uterus. - Liver dysfunction: abnormal liver enzyme levels. - Persistent abdominal pain: may indicate serious gynecologic condition. - Severe vomiting: leading to dehydration.

Levonorgestrel should be used with awareness of specific safety considerations.

- Contraindicated in pregnancy: should not be taken if a confirmed pregnancy exists. - Liver disease: use with caution in patients with hepatic impairment. - Known hypersensitivity: avoid if allergic to levonorgestrel or any excipients. - Unexplained vaginal bleeding: seek medical evaluation before use. - Drug interactions: review concomitant medications that may reduce efficacy. - Store at room temperature: keep in the original packaging, protect from moisture and direct sunlight.

Levonorgestrel may interact with other medicines, affecting its contraceptive effectiveness.

Major Interactions (Avoid): - Rifampicin and other enzyme inducers: may markedly reduce levonorgestrel levels. - Certain antiretrovirals (e.g., efavirenz): can decrease contraceptive efficacy. - St. John’s wort: herbal inducer that lowers drug exposure.

Moderate Interactions (Monitor Closely): - Antifungal agents (e.g., ketoconazole): may increase levonorgestrel concentrations. - Certain antibiotics (e.g., ampicillin): potential modest reduction in effectiveness. - Hormonal therapies: concurrent use may require dosage adjustment or additional contraceptive methods.