Última actualización: 15 de Febrero de 2016

Levonorgestrel

Riesgo muy bajo para la lactancia


Compatible.
Sin riesgo para la lactancia y el lactante.

Anticonceptivo progestágeno utilizado como producto único por vía oral, implante subcutáneo, dispositivo intrauterino (DIU), o en la anticoncepción de emergencia.
También se comercializa asociado al etinilestradiol

El LEVONORGESTREL es un progestágeno, isómero y metabolito activo del norgestrel, ambos derivados de la nortestosterona. Se excreta en leche materna en cantidad clínicamente no significativa y no se han observado problemas en lactantes cuyas madres la tomaban. Los niveles en plasma de dichos lactantes fueron muy bajos.

El levonorgestrel y los progestágenos en general se consideran los antoconceptivos de elección durante la lactancia ya que no alteran la cantidad ni composición de la leche ni provocan efectos secundarios ni afectan al crecimiento de los lactantes ni a la duración de la lactancia.
Se ha publicado protección contra la pérdida de masa ósea materna con el uso de anticonceptivos de sólo progestágenos.

Las primeras 6 semanas posparto los métodos anticonceptivos no hormonales son de primera elección. Hay discusión sobre si ocurre disminución de producción de leche cuando se utilizan progestágenos antes de que la lactancia esté bien establecida .

Academia Americana de Pediatría: medicación usualmente compatible con la lactancia.
Listado de medicamentos esenciales OMS 2002: compatible con la lactancia a partir de la 6ª semana tras el parto.

Alternativas

No se muestran alternativas porque Levonorgestrel tiene un nivel de riesgo muy bajo.

Las recomendaciones de e-lactancia las realizan pediatras y farmacéuticas de APILAM y están basadas en publicaciones científicas recientes.
Estas recomendaciones no pretenden reemplazar la relación con su médico, sino complementarla.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Tu aportación es fundamental para que este servicio siga existiendo. Necesitamos la generosidad de personas como tú que creen en las bondades de la lactancia materna.

Gracias por ayudar a seguir salvando lactancias.

José María Paricio, creador de e-lactancia.

Otros nombres

Levonorgestrel también se conoce como


Levonorgestrel en otros idiomas o escrituras:

Grupo

Levonorgestrel pertenece a la siguiente familia o grupo:

Marcas comerciales

Principales marcas comerciales de diversos países que contienen Levonorgestrel en su composición:

Farmacocinética

Variable Valor Unidad
Biodisponibilidad 100 %
Peso Molecular 312 daltons
Unión proteínas 97 %
Tmax 1 - 2 horas
T1/2 24 - 45 horas
Índice L/P 0,4 -
Dosis Teórica 0,00005 - 0,00015 mg/Kg/d
Dosis Relativa 0,1 - 1 %

Bibliografía

  1. Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, Simmons KB, Pagano HP, Jamieson DJ, Whiteman MK. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. CDC - MMWR Recommendations & Reports. 2016 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
  2. Department of Reproductive Health and Research World Health Organization. Medical Eligibility Criteria for Contraceptive Use. WHO/RHR/15.07. 2015 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
  3. WHO. Medical eligibility criteria for contraceptive use. 5th ed. Who Library. 2015 Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
  4. Phillips SJ, Tepper NK, Kapp N, Nanda K, Temmerman M, Curtis KM. Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception. 2015 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
  5. Berens P, Labbok M; Academy of Breastfeeding Medicine. Protocolo clínico de la ABM n.º 13: Anticoncepción durante la lactancia, revisado en 2015. Breastfeed Med. 2015 Texto completo (enlace a fuente original)
  6. Berens P, Labbok M; Academy of Breastfeeding Medicine. ABM Clinical Protocol #13: Contraception During Breastfeeding, Revised 2015. Breastfeed Med. 2015 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
  7. OMS. Criterios médicos de elegibilidad para el uso de anticonceptivos Quinta edición. Who Library. 2015 Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
  8. Mwalwanda CS, Black KI. Immediate post-partum initiation of intrauterine contraception and implants: a review of the safety and guidelines for use. Aust N Z J Obstet Gynaecol. 2013 Resumen
  9. Bahamondes L, Bahamondes MV, Modesto W, Tilley IB, Magalhães A, Pinto e Silva JL, Amaral E, Mishell DR Jr. Effect of hormonal contraceptives during breastfeeding on infant's milk ingestion and growth. Fertil Steril. 2013 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
  10. Polakow-Farkash S, Gilad O, Merlob P, Stahl B, Yogev Y, Klinger G. Levonorgestrel used for emergency contraception during lactation-a prospective observational cohort study on maternal and infant safety. J Matern Fetal Neonatal Med. 2013 Resumen
  11. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
  12. Shaaban OM, Hassen SG, Nour SA, Kames MA, Yones EM. Emergency contraceptive pills as a backup for lactational amenorrhea method (LAM) of contraception: a randomized controlled trial. Contraception. 2013 Resumen
  13. Costa ML, Cecatti JG, Krupa FG, Rehder PM, Sousa MH, Costa-Paiva L. Progestin-only contraception prevents bone loss in postpartum breastfeeding women. Contraception. 2012 Resumen
  14. Chen BA, Reeves MF, Creinin MD, Schwarz EB. Postplacental or delayed levonorgestrel intrauterine device insertion and breast-feeding duration. Contraception. 2011 Resumen Texto completo (en nuestros servidores)
  15. Centers for Disease Control and Prevention (CDC). U S. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR Recomm Rep. 2010 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
  16. Aisien AO, Enosolease ME. Haemostatic function in Norplant (levonorgestrel) users: a 3-year prospective experience in Benin-City, Nigeria. Niger Postgrad Med J. 2009 Resumen
  17. Graesslin O, Korver T. The contraceptive efficacy of Implanon: a review of clinical trials and marketing experience. Eur J Contracept Reprod Health Care. 2008 Resumen
  18. Gainer E, Massai R, Lillo S, Reyes V, Forcelledo ML, Caviedes R, Villarroel C, Bouyer J. Levonorgestrel pharmacokinetics in plasma and milk of lactating women who take 1.5 mg for emergency contraception. Hum Reprod. 2007 Resumen Texto completo (en nuestros servidores)
  19. Shaamash AH, Sayed GH, Hussien MM, Shaaban MM. A comparative study of the levonorgestrel-releasing intrauterine system Mirena versus the Copper T380A intrauterine device during lactation: breast-feeding performance, infant growth and infant development. Contraception. 2005 Resumen
  20. Faculty of Family Planning & Reproductive Health Care. FFPRHC Guidance (July 2004): Contraceptive choices for breastfeeding women. J Fam Plann Reprod Health Care. 2004 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
  21. Truitt ST, Fraser AB, Grimes DA, Gallo MF, Schulz KF. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev. 2003 Resumen
  22. Díaz S. Contraceptive implants and lactation. Contraception. 2002 Resumen
  23. Bassol S, Nava-Hernandez MP, Hernandez-Morales C, Trujillo-Macias AM, Lopez-Lozano MR, Recio R. Effects of levonorgestrel implant upon TSH and LH levels in male infants during lactation. Int J Gynaecol Obstet. 2002 Resumen
  24. Halderman LD, Nelson AL. Impact of early postpartum administration of progestin-only hormonal contraceptives compared with nonhormonal contraceptives on short-term breast-feeding patterns. Am J Obstet Gynecol. 2002 Resumen
  25. Schiappacasse V, Díaz S, Zepeda A, Alvarado R, Herreros C. Health and growth of infants breastfed by Norplant contraceptive implants users: a six-year follow-up study. Contraception. 2002 Resumen
  26. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
  27. Kunz J. [Levonorgestrel releasing intrauterine spiral--contraception and therapeutic indications]. Praxis (Bern 1994). 2001 Resumen
  28. Harwood B, Mishell DR Jr. Contraceptive vaginal rings. Semin Reprod Med. 2001 Resumen
  29. Meckstroth KR, Darney PD. Implant contraception. Semin Reprod Med. 2001 Resumen
  30. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
  31. Dórea JG. Oral contraceptives do not affect magnesium in breast milk. Int J Gynaecol Obstet. 2000 Resumen
  32. Meckstroth KR, Darney PD. Implantable contraception. Obstet Gynecol Clin North Am. 2000 Resumen
  33. Dorea JG, Miazaki ES. The effects of oral contraceptive use on iron and copper concentrations in breast milk. Fertil Steril. 1999 Resumen
  34. Dorea JG, Myazaki E. Calcium and phosphorus in milk of Brazilian mothers using oral contraceptives. J Am Coll Nutr. 1998 Resumen
  35. Coukell AJ, Balfour JA. Levonorgestrel subdermal implants. A review of contraceptive efficacy and acceptability. Drugs. 1998 Resumen
  36. Díaz S, Zepeda A, Maturana X, Reyes MV, Miranda P, Casado ME, Peralta O, Croxatto HB. Fertility regulation in nursing women. IX. Contraceptive performance, duration of lactation, infant growth, and bleeding patterns during use of progesterone vaginal rings, progestin-only pills, Norplant implants, and Copper T 380-A intrauterine devices. Contraception. 1997 Resumen
  37. Kelsey JJ. Hormonal contraception and lactation. J Hum Lact. 1996 Resumen
  38. [No authors listed] Progestogen-only contraceptives during lactation: II. Infant development. World Health Organization, Task Force for Epidemiological Research on Reproductive Health; Special Programme of Research, Development, and Research Training in Human Reproduction. Contraception. 1994 Resumen
  39. Patel SB, Toddywalla VS, Betrabet SS, Kulkarni RD, Patel ZM, Mehta AC, Saxena BN. At what 'infant-age' can levonorgestrel contraceptives be recommended to nursing mothers? Adv Contracept. 1994 Resumen
  40. [No authors listed] Progestogen-only contraceptives during lactation: I. Infant growth. World Health Organization Task force for Epidemiological Research on Reproductive Health; Special Programme of Research, Development and Research Training in Human Reproduction. Contraception. 1994 Resumen
  41. Gellén J, Borthaiser Z, Nyári T, Földesi I. [Changes in serum levels of lipid and lipoprotein fractions during breast feeding under the effect of hormonal contraceptives]. Orv Hetil. 1992 Resumen
  42. Shaaban MM. Contraception with progestogens and progesterone during lactation. J Steroid Biochem Mol Biol. 1991 Resumen
  43. McCann MF, Moggia AV, Higgins JE, Potts M, Becker C. The effects of a progestin-only oral contraceptive (levonorgestrel 0.03 mg) on breast-feeding. Contraception. 1989 Resumen
  44. [No authors listed] Effects of hormonal contraceptives on breast milk composition and infant growth. World Health Organization (WHO) Task Force on Oral Contraceptives. Stud Fam Plann. 1988 Resumen
  45. Betrabet SS, Shikary ZK, Toddywalla VS, Toddywalla SP, Patel D, Saxena BN. ICMR Task Force Study on hormonal contraception. Transfer of norethisterone (NET) and levonorgestrel (LNG) from a single tablet into the infant's circulation through the mother's milk. Contraception. 1987 Resumen
  46. Shikary ZK, Betrabet SS, Patel ZM, Patel S, Joshi JV, Toddywala VS, Toddywala SP, Patel DM, Jhaveri K, Saxena BN. ICMR task force study on hormonal contraception. Transfer of levonorgestrel (LNG) administered through different drug delivery systems from the maternal circulation into the newborn infant's circulation via breast milk. Contraception. 1987 Resumen
  47. Shikary ZK, Betrabet SS, Toddywala WS, Patel DM, Datey S, Saxena BN. Pharmacodynamic effects of levonorgestrel (LNG) administered either orally or subdermally to early postpartum lactating mothers on the urinary levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (T) in their breast-fed male infants. Contraception. 1986 Resumen
  48. Shaaban MM, Odlind V, Salem HT, Abdullah KA, Gomaa AA. Levonorgestrel concentrations in maternal and infant serum during use of subdermal levonorgestrel contraceptive implants, Norplant, by nursing mothers. Contraception. 1986 Resumen
  49. Affandi B, Karmadibrata S, Prihartono J, Lubis F, Samil RS. Effect of Norplant on mothers and infants in the postpartum period. Adv Contracept. 1986 Resumen
  50. Shikary ZK, Betrabet SS, Toddywala WS, Patel DM, Datey S, Saxena BN. Pharmacodynamic effects of levonorgestrel (LNG) administered either orally or subdermally to early postpartum lactating mothers on the urinary levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (T) in their breast-fed Contraception. 1986 Resumen
  51. Díaz S, Herreros C, Juez G, Casado ME, Salvatierra AM, Miranda P, Peralta O, Croxatto HB. Fertility regulation in nursing women: VII. Influence of NORPLANT levonorgestrel implants upon lactation and infant growth. Contraception. 1985 Resumen
  52. Abdulla KA, Elwan SI, Salem HS, Shaaban MM. Effect of early postpartum use of the contraceptive implants, NORPLANT, on the serum levels of immunoglobulins of the mothers and their breastfed infants. Contraception. 1985 Resumen
  53. Shaaban MM, Salem HT, Abdullah KA. Influence of levonorgestrel contraceptive implants, NORPLANT, initiated early postpartum upon lactation and infant growth. Contraception. 1985 Resumen
  54. Prema K. Duration of lactation and return of menstruation in lactating women using hormonal contraception and IUDs. Contracept Deliv Syst. 1982 Resumen
  55. Heikkilä M, Haukkamaa M, Luukkainen T. Levonorgestrel in milk and plasma of breast-feeding women with a levonorgestrel-releasing IUD. Contraception. 1982 Resumen
  56. Heikkilä M, Luukkainen T. Duration of breast-feeding and development of children after insertion of a levonorgestrel-releasing intrauterine contraceptive device. Contraception. 1982 Resumen
  57. Cumming FJ. Effect of oral contraceptive use on ascorbic acid and vitamin A in lactation. J Hum Nutr. 1981 Resumen
  58. Nilsson S, Nygren KG, Johansson ED. d-Norgestrel concentrations in maternal plasma, milk, and child plasma during administration of oral contraceptives to nursing women. Am J Obstet Gynecol. 1977 Resumen
  59. Saxena BN, Shrimanker K, Grudzinskas JG. Levels of contraceptive seroids in breast milk and plasma of lactating women. Contraception. 1977 Resumen

Visitas totales

186.131

Ayúdanos a mejorar esta ficha

Cómo citar esta ficha

¿Necesitas más información o no encontraste lo que buscabas?

   Escríbenos a elactancia.org@gmail.com

e-lactancia es un recurso recomendado por Asociación Española de Bancos de Leche Humana de España

¿Quieres recomendar el uso de e-lactancia? Escríbenos al correo corporativo de APILAM