Levest is a combined oral contraceptive pill used to prevent pregnancy, commonly referred to as ‘the pill’. Levest contains man-made versions of the hormones oestrogen and progesterone. Each pill contains 150mcg of levonorgestrel (progestogen) and 30mcg of ethinylestradiol (oestrogen).

Levest is taken every day for 21 days followed by a 7-day pill-free break if you take it with a break. During the pill-free break, you should have a ‘withdrawal bleed’ similar to a period. Levest has some added benefits, including:

• lighter, less painful periods
• clearer skin
• fewer premenstrual symptoms (PMS)

Levest combines 2 synthetic versions of the female hormones oestrogen and progesterone. Together these work to prevent pregnancy in 3 ways:

• preventing an egg from leaving the ovaries (ovulation)
• making the mucus in the cervix thicker, making it harder for sperm to reach an egg
• thinning the lining of the womb, stopping an egg from implanting itself

How effective is Levest?

If used correctly Levest is over 99% effective in preventing pregnancy.

The actual figure is more likely to be closer to 92% due to common reasons, like forgetting to take the pill or illness, particularly sickness and diarrhoea which can prevent the pill being absorbed properly if it happens soon after you take it.

Research also shows that combined pills that contain levonorgestrel and ethinylestradiol are effective against acne. In one study, a levonorgestrel and ethinylestradiol pill effectively managed acne and excessive hair growth (hirsutism) compared to levonorgestrel alone.

Combined pills containing levonorgestrel can also improve heavy periods and may result in a better quality of life for women who have heavy or painful menstrual bleeding.

Levest comes in blister strips of 21 pills. Each pill has a day of the week marked above it, corresponding to the day of the week it should be taken.

Taking Levest:

• Take the pill that relates to the day of the week you are on. If it is Monday, take the first pill in the strip marked ‘Mon’.
• You should take 1 pill around the same time every day for 21 days. Swallow each pill whole with a glass of water, if needed.
• Follow the direction of the arrows, until you have finished all 21 pills.
• Then, have a 7-day break. Take no pills for 7 days.
• Within a few days, you should have a ‘withdrawal bleed’, similar to a period. If you have taken your pill correctly, you will not need to use extra contraception during your break. Some people don’t bleed between pills, so don’t be worried if you don’t have a bleed every time.
• After 7 days, start a new strip of Levest, even if you are still bleeding.

If you would prefer not to bleed you can continue to take the pill with no breaks at all. You can find full instructions about how to take Levest with or without a 7-day break in the patient information leaflet supplied with your medication.

When to take Levest

You should start taking Levest on the first day of your period. If you start the combined pill on days 1 to 5 of your period, you will be immediately protected against pregnancy. If you start Levest on any other day, you will need to use extra contraception, like condoms, for 7 days.

For information on taking Levest in other situations, such as after having a baby or coming off another pill, read the patient information leaflet or ask your doctor for advice.

How often to take Levest

Take 1 pill daily at the same time until the strip is complete (21 days) then:

• take a pill-free break for seven days then begin a new strip

Or if you do not want to bleed:

• begin a new strip on the next day following your completed strip

How long do you need to take Levest for?

You should continue taking Levest for as long as you don’t want to become pregnant. If you do want to try for a baby, you can stop taking Levest at any time.

It is recommended to use another method of contraception, such as condoms, until you have had a proper period after stopping your pill. That’s because it will help your doctor or midwife tell you when your baby is due, but it will not harm your baby if you become pregnant straight away.

What should I do if I forget to take the pill?

If you have missed a pill and it is:

• less than 12 hours late: Take your missed pill as soon as you remember, this may mean taking 2 pills on the same day. Your protection against pregnancy should not be reduced.
• more than 12 hours late or you have missed more than 1 pill: You may not be protected against pregnancy. Take the most recently missed pill as soon as you remember and leave any earlier missed pills. Continue taking your pill as usual, even if this means taking 2 pills in 1 day. You will need to use a non-hormonal form of contraception, like condoms, for 7 days to stop you from becoming pregnant.

Some people find it helpful to use an alarm to remind them to take their pills. You can also choose to take your pill at the same time as completing a daily task, such as brushing your teeth, to remind you to take your pill.

Levest is a prescription-only medication so you will need to get a doctor’s approval for it. You can request Levest from a reputable online service like Superdrug Online Doctor. You can do this online without the need for a face-to-face appointment, saving you valuable time. Alternatively, it may be available on the NHS.

Can I buy Levest online?

Yes, you can request Levest quickly and easily from Superdrug Online Doctor. It is very important to purchase any form of medication from reliable and trusted services that are regulated by the Care Quality Commission.

To request Levest from Superdrug Online Doctor:

1. Fill out a brief health and lifestyle questionnaire.
2. Order your preferred treatment and make payment.
3. One of our doctors will review your order and questionnaire answers.
4. If approved, your treatment will be posted to your address or made available for collection at your local Superdrug Pharmacy.
5. If your order is not approved, one of our doctors will contact you via your account with other treatment options.

Can I buy Levest over the counter?

No, because Levest is a prescription-only medication you cannot buy it over the counter.

Can I get Levest on the NHS?

You may be able to obtain Levest on the NHS but you will need to make an appointment to see your GP.

Our doctors at Superdrug Online Doctor use the same criteria as the NHS to assess if the medication is suitable for you.

As with all medication, there is a risk that you could experience side effects, however, not everyone does.

Common side effects (may affect up to 1 in 10 people)

• feeling sick (nausea)
• stomach pain
• weight gain
• headaches
• mood swings or feeling depressed
• painful or sore breasts

Uncommon side effects (may affect up to 1 in 100 people)

• being sick (vomiting)
• upset stomach
• fluid retention
• migraine
• loss of interest in sex
• enlarged breasts
• itchy skin rash

Rare side effects (may affect up to 1 in 1000 people)

• low tolerance for contact lenses
• weight loss
• increased libido
• breast or vaginal discharge
• allergic reactions, some of which can be severe with swelling skin and/or mucous membranes (erythema nodosum & erythema multiforme)

You can find a full list of potential Levest side effects in the patient information leaflet.

How long do Levest side effects last for?

Mild side effects should clear up within the first few months of taking Levest as your body gets used to the hormonal changes taking place.

Although these side effects should be temporary and go away on their own, if you are concerned, you should contact your doctor, nurse, or pharmacist.

What to do if you get Levest side effects?

If you are experiencing any side effects that you cannot tolerate or are finding difficult to manage, you should talk to your doctor, nurse, or pharmacist.

If you experience any of the following serious side effects, you should go to A&E or call 999 immediately:

• swollen face, lips, tongue, or throat
• difficulty swallowing
• difficulty breathing
• hives and difficulty breathing

These are signs of a severe allergic reaction called anaphylaxis.

Do not take Levest if you:

• are allergic to levonorgestrel, ethinylestradiol, or any other ingredients in this medication
• have or have ever had a blood clot in your legs, lungs, or any other organs
• have a blood clotting disorder
• need an operation or are going to be off of your feet for a while
• have ever had a heart attack or stroke
• have or have ever had angina pectoris or a transient ischaemic attack (TIA)
• have high blood pressure
• experience migraine with aura
• have a high level of fat in your blood
• have or have ever had breast cancer or liver tumours
• have or have ever had severe liver disease
• have a condition called hyperhomocysteinemia
• have hepatitis C and take medications containing ombitasvir, paritaprevir, ritonavir, dasabuvir, glecaprevir, pibrentasvir, sofosbuvir, velpatasvir, voxilaprevir

Some medications can interfere with Levest and may stop it from working as it should. Tell your doctor if you are taking any prescribed, over-the-counter, or herbal remedies, including:

• epilepsy medications
• HIV and hepatitis C medications
• griseofulvin
• some antibiotics
• certain sedatives
• St. John’s Wort

If you think you may have any of the following, see a doctor straight away. You may need to stop taking Levest:

Harmful blood clots in a vein or artery, for example:

• in your leg or foot (DVT)
• in your lung (PE)
• heart attack
• stroke
• mini-stroke or stroke-like symptoms known as transient ischaemic attack (TIA)
• blood clots in the kidney, liver, stomach, intestine, or eye

Your risk of developing a blood clot will increase if you have any other condition that could increase this risk.

Signs of breast cancer:

• dimpling of the skin
• changes in the nipple
• any lumps you can see or feel.

Signs of cancer of the cervix:

• vaginal discharge that smells or contains blood
• unusual vaginal bleeding
• pelvic pain
• painful sex

Signs of severe liver problems:

• severe pain in your upper abdomen
• yellow skin or eyes (jaundice)
• inflammation of the liver (hepatitis)
• your whole body starts itching

Levest and pregnancy

If you are pregnant, do not take Levest. If you think you might be or are planning to get pregnant while taking Levest, speak to your doctor or pharmacist for advice.

Levest and breastfeeding

It is not advisable to use Levest while you are breastfeeding. If you need hormonal contraception while you are breastfeeding you should tell your doctor. They will be able to advise on suitable options while breastfeeding.

Levest and lactose and sucrose

Levest contains lactose and sucrose. If you have been advised that you have an intolerance to some sugars, speak to a doctor before taking Levest.

Levest may not be suitable for everyone and there are many different contraception methods available to prevent pregnancy.

Depending on your preferences, you may choose a hormonal or non-hormonal contraceptive method.

Combined pills

Combined pills contain man-made versions of oestrogen and progesterone to prevent pregnancy. Some examples include:

• Microgynon 30
• Gedarel
• Yasmin

Mini pills

Mini pills or the progesterone-only pill (POP) only contain progesterone. It is a suitable alternative for anyone who can’t or chooses not to take oestrogen. Common examples include:

• Cerelle
• Cerazette
• Hana

Other hormonal contraceptives include:

• Contraceptive patch: Evra patch
• Vaginal ring: NuvaRing
• Contraceptive injection
• Contraceptive implant
• Intrauterine system (IUS) (the coil)

Non-hormonal contraception

• Condoms (male and female)
• Diaphragms
• Copper coil (intrauterine device)

Can Levest cause acne?

Acne is listed as a side effect for Levest because one of the active ingredients, levonorgestrel, can increase male hormone levels and cause oily skin. However, a combination of levonorgestrel and ethinylestradiol can improve acne. If you are concerned about your skin, we can provide acne treatments.

Is Levest the same as Microgynon?

Levest and Microgynon contain the same ingredients, in the same doses, and work in the same way. The only difference is the brand name.

Does Levest make you gain weight?

Although weight gain is listed as a common Levest side effect, there is no conclusive evidence that the combined contraceptive pill makes you gain weight.