I PILL-IS IT SAFE? USES, SIDE EFFECTS, DOSAGE

What is I Pill?

I Pill is an emergency contraceptive pill used to prevent pregnancy after an episode of unprotected intercourse. Commonly known as the “morning after pill”, it should be consumed within 72 hours (3 days) of unprotected sex to be effective.

The tablet is available in oral form and is manufactured by a leading pharmaceutical company called Piramal Healthcare.

I PILL-IS IT SAFE? USES, SIDE EFFECTS, DOSAGE

What is the Generic name(s)?
What is its composition?
How does it work?
What are its uses?
Who should not use I pill?
How effective is this medicine?
Is it addictive?
What is the dosage?
How to use I pill?
What if I miss a dose?
What to do in case of overdosage?
Can I drive after taking it?
Can it be taken on an empty stomach?
Can it be taken with food?
Can it be taken with alcohol?
What are the side effects?
Does this medicine has any drug interactions?
What are the precautions I need to take?
Is it safe to use if I am pregnant?
Is it safe to use if I am breastfeeding?
Can this medicine be given to children and infants?
Is this medicine available as over the counter product?
Frequently asked questions
Reference

What is the Generic name(s)?

The generic name of is Levonorgestrel.

What is its composition?

The active ingredient is

Levonorgestrel – 1.5 mg 

How does it work?

Levonorgestrel is a synthetic Progestogen which is a form of the hormone progesterone. It prevents pregnancy by delaying the phase of ovulation and preventing the release of the egg. The active ingredient will thicken the cervical fluid making it difficult for the sperm to reach the egg. Therefore when no egg will be released, fertilization by sperm will not be possible and pregnancy will not take place. It also prevents the sperm to reach and fertilize the egg in the Fallopian tube. It causes alterations in the uterus to stop implantation even after the sperm and the egg have already undergone fertilization.

However, if implantation has already happened, the pill will most likely not work.

What are its uses?

The pill is very commonly used to prevent unwanted pregnancy after unprotected sex.

It has other indications also where the pill is available in different strengths. But is rarely used for those as its effectiveness is not well established. These are:

• Prevention of pregnancy for up to 3 years
• To reduce or stop short duration changes in menopause

Who should not use I pill?

This pill is to be avoided strictly in patients with:

• Hypersensitivity to the pill or its active ingredient
• Porphyria
• Severe arterial disease
• Adenoma
• History of liver impairment
• History of cancer of the breast
• Undiagnosed vaginal bleeding

How effective is this medicine?

As stated above, this tablet is only effective within 72 hours of unprotected sex.

The sooner the tablet is consumed, more effective it will be in preventing pregnancy.

No pill can guarantee 100% required outcome. But when taken following proper guidelines and in the stipulated time, this pill has a good success rate.

• When taken within 24 hours of unprotected intercourse, protection from pregnancy is 95%
• If taken within 25-48 hours of unprotected intercourse, the protection will be 85%.
• Finally if taken between 48-72 hours of sex, the effectiveness will be only 58%.
• If taken after that, the tablet may or may not be effective.
• If fertilization has already occurred, the medicine will most likely not work.

 Is it addictive?

It does not pose any risk of addiction in any individual.

What is the dosage?

Within 3 days of unprotected intercourse, take one tablet orally with water.

How to use I pill?

• Use exactly as directed by the doctor or pharmacist or by the instructions printed on the label.
• Take only one pill of I Pill after unprotected sex or if there is concern that pregnancy can result after intercourse. It would be most beneficial if taken within 12 hours of intercourse. But do not take it any later than 72 hours.
• Do not crush, chew or bite the tablet. It has to be swallowed directly.
• If after consuming the tablet, vomiting results within 3 hours, immediately take another pill.

What if I miss a dose?

It is an emergency contraceptive and therefore is taken once only. It does not have a schedule of dosage that can be missed.

What to do in case of overdosage?

If many tablets are taken at a time, the effectiveness will not increase and the pill might actually not work properly. There have not been any harmful or serious side effects reported. Commonly nausea, vomiting and vaginal bleeding can occur in case of overdose.

This medicine is sold in packaging with one tablet with an accurate strength. Here, overdose is not likely to happen. At a time, do not consume more than one tablet.

Can I drive after taking it?

Pills like these do not usually affect your ability to drive. But if the side effects of consuming this medicine like dizziness, fall in heart rate and tiredness result, it will be unsafe to drive a vehicle.

Can it be taken on an empty stomach?

It can be consumed with or without food but it is recommended to take after food to prevent stomach upset and vomiting.

Can it be taken with food?

As stated above, this pill can be taken after food will prevent vomiting and stomach upset.

 Can it be taken with alcohol?

Alcohol does not have the capability to decrease the effectiveness of the medicine. But the pill can increase intoxication caused by alcohol more than already present. The side effects of this pill like drowsiness will be intensified and the alcohol will have an impact on the behaviour and judgment of the individual. Thus it is advised to not drink alcohol along with this pill.

What are the side effects?

Side effects will not be seen in every individual who has taken this medicine. These effects are not usually adverse and are mild plus temporary.

Very common side effects are (found in more than 1 in 10 people):

• Tiredness (fatigue)
• Headache/migraine
• Nausea
• Irregular bleeding (usually till the next period)
• Pain in the lower stomach region

Common side effects are (found in 1 out of 10 people):

• Tenderness in breasts
• Dizziness
• Emesis
• Diarrhoea

Rarely seen side effects are:

• Unexpected spotting or bleeding
• Mood swings
• Weight gain
• Flu syndrome
• Vaginal Haemorrhage
• Hormonal imbalance
• Genital discharge
• Acne
• Very rarely, allergic reaction to the pill or its active ingredient Levonorgestrel can manifest. It will affect only 1 in 10,000 people. The symptoms will be skin rashes, difficulty in breathing, pain in hips, swelling of throat, tongue, face (facial oedema) and lips, itching (pruritus) and hives (urticaria). Call for medical help immediately if these signs are recognized,

Does this medicine has any drug interactions?

This pill may have interactions with following products and drugs which can decrease its effectiveness. These are:

• Drugs used in the treatment of seizures like Barbiturates, Phenytoin, Carbamazepine, Topiramate, Felbamate, Primidone, etc.
• Bosentan
• Herbal products containing St. John’s wort like Hypericum perforatum.
• Modafinil
• HIV drugs like Nevirapine, Nelfinavir, Ritonavir, Efavirenz, etc.
• Medicines used to treat fungal infections like Griseofulvin.
• Oxcarbazepine
• Rifamycins used for tuberculosis such as Rifabutin, Rifampin, etc.

What are the precautions I need to take?

• I pill as an emergency contraceptive is not for regular use. It is not to be used routinely as birth control. Use oral contraceptive pills (OCP’s) for that.
• Read the label carefully before using and check the expiry of the tablet.
• Ask the pharmacist or doctor to advice when taking other medications after using this pill.
• After 3 weeks of using the pill, consult with the gynaecologist to confirm that pregnancy has not resulted and there are no harmful effects in the body after taking this pill.
• After using the pill, if your period is delayed for more than a week, use a pregnancy test or consult a gynaecologist.
• Report to a doctor immediately if any unexplained side effects are seen especially unexplained vaginal bleeding.
• The active ingredient Levonorgestrel contains lactose. So if the individual has lactose intolerance, it is advised to contact your doctor first and then take it.
• This tablet does not provide any protection against AIDS/HIV or other sexually transmitted diseases (STD’s). Only a condom can protect against these diseases.
• If pregnancy is confirmed even after using this pill, it might be an ectopic pregnancy (implantation outside the womb) and has to be confirmed by the doctor.
• It is always advised by gynaecologists to not take this pill for more than two times in six months even though it is proved to be safe and reliable.

Is it safe to use if I am pregnant?

Emergency contraceptive does not usually affect pregnancy or fetus. It is non-teratogenic and when a woman accidentally takes the contraceptive when she doesn’t know that she is pregnant, there are no harmful effects. There are no birth defects also. Even in the case of ectopic pregnancy, there are no harmful effects on a fetus found. In a study of emergency contraceptives involving 6000 pregnant women, after taking this pill, no negative outcomes on birth were found.

 Is it safe to use if I am breastfeeding?

There are no harmful effects stated as of yet when a woman takes this medicine while breastfeeding. The quality or the quantity if the milk remains unaltered. However, it has been found that when consumed orally, some dose of the tablet passes into the breast milk of the lactating women. This is not harmful to the nursing baby. But to be on the safer side, take the medicine just after breastfeeding and drain the residual milk using a breast pump. Do this till 6 hours after consuming the pill. This will reduce the amount of medicine entering the child. Otherwise, if possible do not breastfeed for 3 days after taking this medicine.

Can this medicine be given to children and infants?

This medicine is a contraceptive and not meant for children or infants.

Is this medicine available as over the counter product?

Yes. I pill is available in medical stores.

Frequently asked questions

Q: Can this medicine be used for teenagers?

This medicine is meant for women of age 25-45 years. There are no risks found in teenagers but there are no studies to support its safety too as their reproductive organs are still maturing. Consult with a physician or gynaecologist first and only then take this pill.

Q: When can I use regular birth control again?

If this pill is taken after missing birth controls pills, which is more than three times successively, from the very next day onward the regular pills can be continued like before.

Q: What I still get pregnant after taking I pill?

• Even though this pill is very 95-98% effective and is recommended by many experts, it sometimes cannot prevent pregnancy. There is a 5% chance of pregnancy even if it is taken just after having unprotected intercourse.
• When proper guidelines are not followed by the individual, the pill might not work.
• In cases when the woman is already pregnant or implantation happened outside the womb, this pill will not be effective.

Q: Will my periods be affected after taking this pill?

Regular menses can come a few days early or can be delayed. There can be little interruption and change in the menstrual cycle/s after consuming I pill. If periods do not come even after 3 weeks of stipulated time, get a pregnancy test. Usually, using this pill once in isolation will not affect the regular menstrual cycle but continuous and prolonged use can cause damage to the regular cycle.

Q: Will this pill work differently for obese women?

There are few pieces of evidence proving that it is not very effective in overweight women to some extent. In women weighing more than 165 pounds (74.54 kg), this pill loses some of its effectiveness. In women with weight more than 176 pounds (79.83 kg), the pill doesn’t work at all.

Q: Can I pill cause weight gain?

Yes. This pill and other estrogens can rarely cause rapid weight gain which depends on the dose and the duration of the drug. If there is concern regarding weight gain, consult your gynaecologist or health care provider.

Q: Can I pill cause abortion?

I pill is used to prevent fertilization from taking place. This is for prevention of pregnancy in the first place. In already pregnant women, it does not terminate the pregnancy. Therefore it cannot cause abortion.

Q: Why am I bleeding after few days of taking I pill?

There is bleeding observed after 3-4 days of consuming I pill. This is commonly known as ‘withdrawal bleeding’. It is absolutely normal. If the bleeding is in time of your regular menses, the blood is because of your period. If you miss your period and you see spotting or light bleeding, get a pregnancy test.

Q: Can I pill cause infertility?

I pill cannot affect the fertility of a female nor it has any effect on the future pregnancies. This pill can only shake the natural cycle of the body. However, using this drug more than twice in six months will cause the menstrual cycle to be disrupted and lead to irregular periods. The ovulation period will become unpredictable. The flow of periods also change and become either heavier or lighter.

Q: How to store I pill?

• Keep the pill out of sight and reach from children.
• Make sure that the pill is not past its expiry date.
• Keep away from extreme heat and moisture.

Q: What is the cost of this pill?

One packet of I pill contains one tablet only. Its cost is 110 INR.

Reference

Wikipedia page on Birth control

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