Pharmacodynamics and pharmacokinetics
Escapelle is a means of emergency post-coital contraception. There is no exact data on how the drug works.
The action of levonorgestrel is aimed at inhibiting ovulation and reducing the risk of egg fertilization in the preovulatory phase, when the likelihood of becoming pregnant is considered the highest.
By acting on the lining of the uterus , the substance changes it in such a way that a fertilized egg cannot penetrate into it. However, in cases where implantation of the embryo into the endometrium has already begun, the pills are ineffective.
The use of Escapel after unprotected sexual intercourse can prevent pregnancy in approximately 84% of cases. At the same time, the drug does not cause clinically significant disorders of carbohydrate and lipid metabolism and does not provoke a violation of vascular-platelet (cellular) and plasma hemostasis .
After taking p/os, levonorgestrel is well absorbed from the gastrointestinal tract. Its bioavailability is close to 100%. The maximum concentration of the substance in the blood plasma after a single dose of 0.75 mg is observed after approximately 1.6 hours (+/- 0.7 hours). As a rule, it is 6.4-21.8 ng/ml.
In blood serum, the levonorgestrel that enters the body is bound to the protein albumin , another 47.5% of the substance is bound to the protein SHBG ( androgen-binding globulin ).
Levonorgestrel undergoes biotransformation in the liver, the resulting metabolic products are pharmacologically inactive.
The half-life is 19.1-29.7 hours. Levonorgestrel and its metabolites are excreted primarily in the urine and in small quantities in the intestinal contents.
When breastfeeding, approximately 0.1% levonorgestrel , therefore, in cases where Escapelle is used to prevent pregnancy in a nursing woman, it is recommended to stop lactation for 36 hours.
Pharmacological properties of the drug Escapelle
At a dose of 1.5 mg, levonorgestrel acts mainly by inhibiting ovulation and preventing fertilization if sexual intercourse took place in the preovulatory phase of the menstrual cycle, that is, at the time of the greatest likelihood of fertilization. In addition, changes in the endometrium under the influence of taking pills prevent the implantation of a fertilized egg. Once implantation has begun, the drug is ineffective. Prevents pregnancy in 82% of cases. The effectiveness of the drug is significantly lower when taken between the 96th and 120th hour after sexual intercourse than when taken before 96 hours. Recommended doses of levonorgestrel do not have a significant effect on blood clotting factors, fat and carbohydrate metabolism. Levonorgestrel is absorbed quickly and almost completely. After taking 1 tablet of Escapelle, the maximum concentration of levonorgestrel in the blood serum (average 18.5 ng/ml) is achieved after 2 hours, after which its concentration decreases. The half-life is about 26 hours. Levonorgestrel is excreted from the body only in the form of metabolites, with urine and feces, in equal proportions. The biotransformation of levonorgestrel is similar to that of steroids. Levonorgestrel is hydroxylated in the liver, and its metabolites are excreted in the form of conjugates with glucuronic acid. Pharmacologically active metabolites have not been identified for levonorgestrel. Levonorgestrel binds to plasma proteins, mainly albumin and sex hormone-binding globulin. Only 1.5% of the administered dose is in the form of free steroid in the blood serum, and 65% is specifically bound to sex hormone binding globulin. Absolute bioavailability is almost 100%. About 0.1% of the administered dose passes into breast milk.
Indications for use
Escapelle contraceptive pills are intended for emergency contraception. The pill after an unprotected act, as well as in situations where there is reason to consider the main method of contraception to be insufficiently reliable, should be taken within the first 72 hours.
In particular, it is advisable to take the drug in case of violation of the integrity of the condom, skipping a contraceptive pill for regular use, after rape or forced sexual intercourse, as well as in situations where spontaneous sexual intercourse took place.
REMEMBER about ESCAPE after sex
Escapelle delays the release of the egg from the ovary (prevents ovulation) using the same hormone levonorgestrel, which is contained in many conventional contraceptives, preventing pregnancy during the period when it is not yet possible to establish it. Escapelle will be effective if you are not yet pregnant (within 3 days after intercourse), and will not harm an already established pregnancy. The sooner you take Escapelle tablet after unprotected sex, the more effective its effect will be.
After using Escapelle, as a rule, normal menstruation occurs at the usual time. Sometimes the arrival of menstruation may occur earlier or later than usual. Bleeding may also be less or more severe. Or you may experience light spotting before your next period. Some women have experienced a delay of more than 5 days in their menstrual cycle after taking emergency contraceptive pills. If your menstrual cycle is more than 5 days late, you will need to consult your doctor.
Is Escapelle an “abortion pill”?
No, definitely not. Escapelle is an emergency contraceptive pill containing levonorgestrel: a common female sex hormone. This hormone prevents pregnancy by delaying the maturation of the egg or preventing ovulation (the release of an egg from the ovary), and thus preventing fertilization of the egg. Emergency contraceptives containing levonorgestrel do not prevent implantation and do not terminate pregnancy (by any definition of the onset of pregnancy), which means they do not have an abortifacient effect, do not terminate an existing pregnancy, and do not harm the fetus.
Abortion pills (called “medical abortion”) are completely different from emergency contraceptive pills. Abortion pills are taken later, their mechanism of action is different from emergency contraceptive pills: they stop the development of pregnancy after it has begun. The abortion pill stops the development of an existing pregnancy and then initiates the removal of products of conception from the uterus. The use of these drugs is permitted for early abortions, but not in all countries. Abortion pills are much more regulated than emergency contraceptive pills. Unlike emergency contraceptive pills, abortion pills are never sold in pharmacies without a prescription.
Related Content
FAQ
Contraindications
In the instructions for the drug, the manufacturer warns that taking Escapel should be avoided:
- in cases where hypersensitivity to levonorgestrel ;
- patients with lactose intolerance (including impaired absorption of glucose and galactose , galactosemia , lactase deficiency );
- with severe functional liver failure;
- girls under 16 years of age.
intestinal malabsorption syndrome should take Escapelle with caution .
Side effects of Escapel
Taking Escapelle tablets may be accompanied by a number of side effects, which are most often expressed as:
- manifestations of allergies (including swelling of the eyelids and cheeks, the appearance of a rash on the body, scabies, etc.);
- disorders of the function of the digestive system (the most common disorders are retching and/or vomiting, diarrhea );
- migraine-like headaches;
- coordination disorders;
- discomfort in the lower abdomen;
- the appearance of bleeding after taking the pill (and this discharge is not associated with menstrual bleeding);
- discomfort in the mammary glands;
- failure of the menstrual cycle (the delay after Escapelle is usually from 5 to 7 days).
It is believed that side effects of Escapelle occur much less frequently in women who lead an active, healthy lifestyle and play sports.
Research by Russian scientists has established that the use of the drug is effective in 97% of cases. In the remaining 3% of cases, patients took the pill later than 90 hours after unprotected sexual intercourse.
It was experimentally possible to determine that in about a third of the subjects, menstruation after taking Escapel did not begin at the usual time, but 7-14 days later. In 14% of subjects, menstrual bleeding after taking the pill was significantly heavier than usual.
In 16% of subjects, menstruation began earlier than expected; the urge to vomit occurred in 11%, vomiting in 3%, and tenderness of the mammary glands in 3% of women taking the drug in the experiment. In general, some side effects were observed in 17% of the participants in the experiment.
Instructions for use Escapela (Method and dosage)
According to the instructions for Escapelle, the tablets should be taken orally with a sufficient amount of drinking water.
The tablet can be taken without reference to meal times, and on any day of the cycle (provided that the previous menstrual bleeding was normal), but as soon as possible after unprotected sexual intercourse. The maximum permissible interval between sexual intercourse and taking the pill is 72 hours.
If a woman vomits within 3 hours after taking the drug, she must take another tablet.
After using Escapel, barrier contraceptives .
Menstruation after taking the drug usually begins at the usual time, but the possibility of a slight cycle disruption cannot be ruled out (bleeding can begin either a few days earlier or a few days later).
How often can I take the drug? The instructions for Escapelle indicate that it is considered optimal to take no more than 1 tablet during one menstrual cycle. To avoid negative consequences, it is recommended to drink Escapelle no more than once every 3-6 months.
You should be aware that the use of the drug does not eliminate the need to use additional means of protection against sexually transmitted diseases.
Instructions for use ESCAPELLE®
This drug is intended solely for emergency contraception and does not replace regular hormonal contraception. Repeated use of Escapelle® during one menstrual cycle is not recommended.
Emergency contraception does not prevent pregnancy in all cases.
If the time of sexual intercourse is unknown or more than 72 hours have passed since unprotected sexual intercourse, pregnancy may occur. In this regard, the use of Escapelle® after the second sexual intercourse may be ineffective. If menstruation is delayed by more than 5 days, if there is a change in the nature of menstruation that occurred on time, or if pregnancy is suspected for any other reason, pregnancy should be excluded. If pregnancy occurs after using Escapelle®, you should be aware of the possibility of ectopic pregnancy.
The absolute risk of ectopic pregnancy appears to be low because levonorgestrel prevents ovulation and fertilization. Ectopic pregnancy can develop despite the appearance of uterine bleeding. In this regard, levonorgestrel is not recommended for use in the presence of risk factors for ectopic pregnancy (salpingitis or a history of ectopic pregnancy).
Escapelle® is not recommended for use in patients with severe liver failure.
In case of severe intestinal absorption disorders (for example, Crohn's disease), the effectiveness of Escapelle® may be reduced.
After taking Escapel®, normal menstruation usually occurs at the expected time. Sometimes your period may start a few days earlier or later than expected. It is recommended to consult a doctor to select or adjust regular contraception. If Escapel® was used against the background of regular hormonal contraception, and menstruation does not occur during the subsequent 7-day break in taking the contraceptive, pregnancy must be excluded.
Repeated use of the drug during the same menstrual cycle is not recommended due to the possibility of its disruption.
There is limited evidence that requires further confirmation that the contraceptive effectiveness of Escapelle may decrease with increasing body weight or BMI. All women, regardless of their weight and BMI, should take emergency contraception as soon as possible after unprotected intercourse.
The drug contains lactose monohydrate (142.5 mg). Patients with congenital galactose or lactose intolerance or glucose-galactose malabsorption syndrome are not recommended to take the drug.
Escapelle® is not effective as regular contraception and can only be used as an emergency contraceptive. Women who regularly use emergency contraception should consult their doctor to select a method of permanent contraception.
The use of emergency contraception does not eliminate the need to protect against sexually transmitted diseases.
Impact on the ability to drive vehicles and operate machinery
Studies have not been conducted to identify the possible effect of the drug on the ability to drive a car and operate machinery.
Preclinical safety data
In animal experiments, virilization of female fetuses was observed when high doses of levonorgestrel were used.
Preclinical studies have not identified any specific potential harm to humans other than those presented elsewhere in the product summary.
Interaction
The simultaneous use of the drug with liver enzyme inducers provokes increased metabolism of levonorgestrel .
A decrease in the contraceptive effect of Escapel is facilitated by taking the drug in combination with: barbiturates ( Carbamazepine , Primidone , Phenytoin ); products containing St. John's wort (St. John's wort); Amprenavir , Oxycarbazepine , Lanzoprazole , Topiramate Rifampicin , Nevirapine , Tacrolimus , Tretinoin , tetracycline and ampicillin group , Ritonavir , Griseofulvin , Rifabutin .
In turn, the tablets reduce the effectiveness of anticoagulants and hypoglycemic drugs , increase the plasma concentration of glucocorticosteroids and increase the risk of cyclosporine by suppressing its metabolism.
special instructions
Repeated use of the drug during one cycle should be avoided, as this is associated with a high likelihood of menstrual dysfunction.
Regular use of contraception provokes an increase in the incidence of side effects and a decrease in the effectiveness of the pills.
If a woman does not have a period after taking Escapela tablet (this applies to cases where menstrual bleeding does not begin a week after using the drug), it is necessary to undergo examination to exclude pregnancy.
Reasons to consult a doctor are also changes in the nature of discharge, the appearance of pain in the lower abdomen, and fainting. Similar symptoms may be a sign of ectopic (ectopic) pregnancy .
If uterine bleeding , a gynecological examination is necessary.
In adolescence (up to 16 years), emergency contraception using Escapel is possible in exceptional cases (for example, rape) and only when the attending physician approves it.
Special instructions for the use of the drug Escapelle
The drug is used only in emergency cases. Taking Escapelle tablet is not a contraindication to continuing regular use of oral hormonal contraceptives. The drug does not replace regularly used contraceptives. Emergency contraception does not prevent pregnancy in all cases. If menstruation is delayed by more than 5 days, pregnancy must be excluded. In the case when the time of sexual intercourse is not known exactly or when more than 96 hours have passed since the moment of sexual intercourse unprotected by contraception, the likelihood of fertilization is high. Using the Escapelle tablet after the second sexual intercourse does not lead to the desired effect. If menstruation is delayed by more than 5 days, as well as in cases where menstruation that occurs on time is unusual or there is a suspicion of pregnancy, a gynecological examination should be performed to exclude pregnancy. While taking Escapelle tablets, it is possible to develop an ectopic pregnancy. If there is pain in the lower abdomen, fainting, a history of ectopic pregnancy, surgery on the pelvic organs or their inflammation, ectopic pregnancy should be excluded. The use of Escapelle tablets is not recommended for severe liver dysfunction. Severe malabsorption disorders (eg Crohn's disease) may reduce the effectiveness of Escapelle tablets . After using the drug, menstruation usually appears at the usual time and proceeds normally. In isolated cases, it may appear several days earlier or later. After using the drug, it is recommended to conduct a medical examination to decide on the use of a regular method of contraception. In cases where the drug Escapelle was used due to an error in regular hormonal contraception and there is no menstruation during the subsequent 7-day break, pregnancy should be excluded. Repeated use of Escapel within the same menstrual cycle is not recommended due to the possibility of menstrual irregularities. If a woman frequently needs to use an emergency contraceptive method, she should be advised to use a regular method of contraception. Compared to hormonal contraceptives used regularly, Escapelle tablets are less effective. The use of emergency contraception does not eliminate the need for protection against sexually transmitted diseases. Escapelle tablets should not be taken during pregnancy; the drug does not terminate an existing pregnancy. Epidemiological studies have not revealed a teratogenic effect when pregnancy occurs after the use of progestogens. Levonorgestrel passes into breast milk. The potential effect of levonorgestrel on the baby can be reduced if the woman takes the tablet immediately after feeding and refrains from breastfeeding after taking it. Studies have not been conducted to identify the possible effect of Escapelle on the ability to drive vehicles or operate potentially dangerous machinery.
Analogs
Level 4 ATX code matches:
Eskinor-F
Microlute
Exluton
Postinor
Implanon NKST
Charosetta
Lactinet
Structural analogues of Escapel are the drugs Postinor and Eskinor-F
The drug belongs to the same pharmacological subgroup with such drugs as Implanon , Charozetta , Laktinet , Exluton , Implanon NKST , MODELL MAM .
Genale or Escapelle - which is better?
The main difference between the drugs is their composition. The action of Escapel is due to the activity of levonorgestrel ; Genale mifepristone as an active substance - a synthetic steroid that does not have gestagenic activity and is capable of blocking the action of progesterone at the level of gestagen receptors.
Mifepristone in gynecology is used for medical termination of an existing pregnancy (however, for this purpose, the drug is used in a dose significantly higher than the 10 mg of mifepristone Zhenale ).
Levonorgestrel , on the contrary, is ineffective in cases where the fertilized egg has already implanted itself in the uterine wall.
It is important to know that if pregnancy continues Zhenale
If the pregnancy continues after using Escapel, it can continue to be carried to term (provided that the ovum is located normally), since the drug does not have a negative effect on the development of the fetus.
Gynepristone or Escapelle - which is better?
Ginepristone antihormone mifepristone as an active substance . That is, like its analogue Zhenale , the drug is a non-hormonal emergency contraception .
Like Zhenale , Ginepristone at a dose of 10 mg can inhibit ovulation for an average of 4 days (sometimes more). Thus, before it takes place, all sperm entering the genital tract simply die.
The action of levonorgestrel is similar to that of progesterone . Therefore, if Escapelle is taken after sexual intercourse that took place a day or two before ovulation, it loses up to 68% in effectiveness. If the pill is taken on the day of ovulation or after ovulation, the drug often does not give the desired effect at all.
Antigestagenic drugs Zhenale and Ginepristone are equally effective in any phase of the menstrual cycle: before ovulation, mifepristone suppresses it, after it prevents the adhesion of the egg in the uterine mucosa.
Therefore, antigestagens are considered more effective in comparison with levonorgestrel if taken on fertile days.
Another important difference between Ginepristone and Zhenale from Escapel is that their effectiveness does not depend on the woman’s weight: experts say that drugs containing levonorgestrel have a less pronounced effect if a woman is overweight (especially if she suffers from obesity).
Unwanted pregnancy remains a serious problem for women. An alternative to terminating pregnancy is to prevent it. To prevent unwanted pregnancy, there are many methods of contraception, including emergency ones.
Emergency contraception was first used as a means of preventing unwanted pregnancies among rape victims in the mid-1960s. Since then, the range of indications for its use has expanded, and emergency contraception is recommended for women who are at risk of pregnancy as a result of unprotected sex (when no contraceptive method was used or when protection has failed, such as when a condom breaks). An emergency contraception method is considered acceptable if it can be used within a few days after unprotected sexual intercourse.
Despite its important role in preventing pregnancy, emergency contraception is not widely used, due to a lack of information about this method among women and sometimes among doctors.
As already stated, emergency contraception should be recommended as an emergency measure to protect against unwanted pregnancy in women who have been raped; if there are doubts about the effectiveness of contraception (displacement of the diaphragm during sexual intercourse, etc.); during expulsion of intrauterine devices (IUD); if you miss taking oral contraceptives; in cases where the planned methods of contraception cannot be used for some reason. Patients who are rarely sexually active and in whom an unwanted pregnancy may occur after sexual intercourse without the use of contraceptives also need to be prescribed postcoital contraception [2, 3].
The mechanism of action of emergency hormonal contraception is to suppress or delay the ovulation process, disrupt the fertilization process, transport the fertilized egg and its implantation.
The risk of pregnancy after unprotected intercourse ranges from 0 to 26% throughout the entire menstrual cycle and from 7 to 30% during the peri- or ovulatory period of the menstrual cycle [7]. Considering that the viability of sperm in a woman’s reproductive tract lasts from 3 to 7 days, and that of an unfertilized egg for 24–72 hours, it is advisable to carry out emergency contraception in the first three days after sexual intercourse [7].
For emergency hormonal contraception, mainly estrogen-gestagen and gestagen-containing drugs are used.
Until recently, one of the common methods of emergency contraception was the use of increased doses of oral contraceptives - the so-called Yuzpe method (named after the Canadian doctor who first used it). The method consists of twice using 200 mcg of ethinyl estradiol and 1 mg of levonorgestrel within 72 hours after sexual intercourse, with a break of 12 hours. The advantage of this method is that for the purpose of emergency contraception, you can use any combined contraceptives, including low-dose ones, while the number of tablets varies depending on their composition and doses of hormones. However, it has been proven that the effectiveness of this method is reduced if unprotected intercourse occurs immediately before ovulation. In addition, the incidence of side effects such as headaches, nausea, vomiting, and menstrual dysfunction occurred in 21.3% of cases, i.e., in almost every fourth patient [1, 3].
Contraindications to the use of the Yuzpe method are determined mainly by the presence of an estrogen component in the tablets. These include a history of thrombolism, severe liver disease, breast and endometrial cancer. Its use is also undesirable for women over 35 years of age, heavy smokers (more than 15 cigarettes per day), as well as women who have been subjected to sexual violence, against which complications often develop.
Currently, one of the most common effective and affordable methods of emergency contraception is the use of gestagens. The most commonly used testosterone derivatives are divided into levonorgestrel and norethisterone derivatives. Their chemical structure is close to natural progesterone. From this group of drugs, the Hungarian drug Postinor is widely known in our country, containing 0.75 mg of levonorgestrel in one tablet, which is recommended for use according to the following scheme: one tablet no later than 72 hours after sexual intercourse, another one 12 hours after the first.
Levonorgestrel is a synthetic compound, structurally similar to norethisterone, binds strongly and selectively to progesterone receptors and exhibits biological activity without any preliminary transformations. This is the most active substance in the series of 19-norsteroids. Levonorgestrel has the longest half-life because it does not have a first-pass effect through the liver, which makes its biological activity maximum.
Levonorgestrel has no estrogenic effect and has a slight androgenic effect on the woman's body. It is characterized by the greatest affinity for progesterone receptors, which explains such a pronounced progestational effect of levonorgestrel, in particular on the endometrium.
Gestagens suppress the mitotic activity of endometrial cells, initiate their early secretory activity, and cause early secretory transformation of the endometrium, which prevents the implantation of a fertilized cell. In addition, gestagens help reduce contractile activity and the threshold of excitability of muscle cells, which explains one of the mechanisms of emergency contraception - disruption of egg transport. Gestagens have an inhibitory effect on the secretion of gonadotropic hormones and, as a result, prevent ovulation.
In 1998, a randomized controlled trial of levonorgestrel versus the Yuzpe method was conducted under the auspices of WHO. 1998 healthy women with a regular menstrual cycle were examined in 21 centers in different countries: 997 of them were prescribed the Yuzpe method, 1001 - levonorgestrel. The analysis of the study results was carried out based on data from 979 women who used the Yuze method according to the standard method, and 976 who received 0.75 mg of levonorgestrel no later than 72 hours after unprotected intercourse with a repeat dose after 12 hours. The effectiveness of levonorgestrel was higher than that of the Yuzpe method - 98.9 and 96.8%, respectively. In terms of tolerability, levonorgestrel was also superior to the Yuzpe method: nausea was observed in 23.4 and 50.5% of women, respectively, vomiting in 5.6 and 18.8%, dizziness in 11.2 and 16.7%, fatigue in 16 .9 and 28.5% (the differences are statistically significant). Differences in the incidence of other side effects (headache, mastalgia, lower abdominal pain, intermenstrual bleeding) were not statistically significant. Thus, the efficacy of levonorgestrel was higher and the tolerability was better than that of the Yuzpe method.
According to the authors of the study, this is due to the peculiarities of the interaction of estrogens and gestagens, as well as a lower dose of levonorgestrel when using the Yuzpe method. The following conclusion was drawn: the Yuzpe method can be replaced by the use of levonorgestrel, which is more effective and has a lower incidence of side effects. Severe menstrual irregularities with the use of levonorgestrel, which were previously noted in other studies, were not observed in this study [4, 8, 11].
Given the increased interest in emergency contraception methods, which is explained by a number of biological and social factors (early puberty, early onset of sexual activity), the development of effective methods and regimens for taking hormonal drugs has continued in recent years. In mid-1998, a large multicenter, randomized, double-blind study was initiated to compare the efficacy and side effects of 10 mg mifepristone and two regimens of levonorgestrel (0.75 mg twice or 1.5 mg once) for emergency contraception within 120 hours of unprotected use. sexual intercourse. Based on the studies conducted, a new regimen of levonorgestrel was developed - 1.5 mg once [18, 19].
This became the basis for the creation of the drug Escapelle, containing 1.5 mg of levonorgestrel in one tablet, which provides an excellent contraceptive effect and provides greater reliability in preventing pregnancy. Escapelle can be effectively used as a first-choice drug for emergency contraception as an alternative to abortion. Currently, Escapelle has appeared in Russia.
The effectiveness and safety of a single dose of 1.5 mg of levonorgestrel, the dose contained in Escapelle, was confirmed by the results of a WHO study in which more than 4,000 women from 14 countries took part. The Emergency Contraception Consortium recommends this regimen as the first choice [17–19].
If the recommended dosage regimen is followed, levonorgestrel does not significantly affect blood clotting factors, fat and carbohydrate metabolism [16]. When taken orally, it is quickly and completely absorbed from the gastrointestinal tract. The maximum concentration of levonorgestrel in the blood serum after taking 1 tablet of Escapel is achieved after 2 hours. At the recommended dose, levonorgestrel causes inhibition of ovulation if sexual intercourse occurs in the preovulatory phase of menstruation. In addition, the drug-induced regression of endometrial proliferation prevents blastocyst implantation. The effectiveness of contraception decreases as the time elapses between sexual intercourse and taking the drug increases.
If the time of sexual intercourse is unknown or more than 96 hours have passed since unprotected sexual intercourse, the likelihood of pregnancy is high. If menstruation is delayed by more than 7 days, as well as when menstruation that occurs on time is unusual or pregnancy is suspected for some other reason, a gynecological examination should be performed to exclude pregnancy.
If vomiting occurs within 3 hours after taking the Escapel tablet, the effectiveness of the drug is reduced, in which case barrier contraceptives (for example, a condom) should be used until the next menstruation. Repeated use of Escapella tablets during the same menstrual cycle should be avoided to avoid cycle disturbances.
In women with a history of ectopic pregnancy or pelvic inflammatory disease, the use of levonorgestrel may serve as an additional risk factor for ectopic pregnancy. The latter should be excluded if there is pain in the lower abdomen, fainting and the above-mentioned anamnestic data. The use of Escapel, as a rule, does not interfere with the regularity and nature of menstruation. In cases where this drug was used due to an error in regular hormonal contraception and subsequent
There is a 7-day break, there is no menstruation, pregnancy should be excluded. It must be remembered that emergency contraception does not protect against sexually transmitted diseases.
Thus, it should be emphasized that emergency contraception is a one-time measure aimed at preventing unplanned pregnancy. Emergency contraception cannot be recommended for chronic use. However, in certain situations, emergency contraception is the only option to prevent unwanted pregnancy and is an alternative to abortion.
Reviews about Escapelle
The reviews about Escapelle left by customers are quite varied: some praise the product for its high effectiveness, others criticize it for causing a lot of side effects, and sometimes it doesn’t help at all.
The consequences of Escapel - and reviews of this drug are proof of this - are often quite pronounced: in some women, the pill taken caused nausea, headaches, vomiting, severe abdominal pain, someone noted the appearance of white discharge after using the drug and severe weakness, and in some cases, Escapelle became the cause of quite serious hormonal imbalances.
Gynecologists in reviews of this drug indicate that the drug is considered one of the most effective and safe today.
Moreover, once in the body, Escapelle is completely eliminated from it within 24 hours. This property allows it to be used even during lactation (a mandatory condition is its temporary cessation for 36 hours).
Reviews from doctors about Escapelle, compiled on the basis of research data, indicate that the use of levonorgestrel in a dose of 1.5 mg is tolerated by women quite well, and side effects develop only in every sixth case. Moreover, in most cases they are similar to the sensations that women experience in the first weeks of pregnancy.
Experts believe that the main advantage of the drug is that it can be taken without preliminary examinations or tests. In addition, when used, there is no cumulative effect at all, and the recommended doses do not affect blood clotting factors and do not provoke serious disorders of carbohydrate and lipid metabolism .
Escapella price, where to buy
The drug is produced by only one pharmaceutical company, so how much it costs at the Escapelle pharmacy depends on the cost of its transportation and the pricing features of a particular retail chain.
The price of Escapel in Russia is from 230 to 420 rubles. The price of Escapelle tablets in Ukraine varies from 152 to 335 UAH.
You can buy the drug both in regular and online pharmacies.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
Pharmacy Dialogue
- Escapelle (tab. 1.5 mg No. 1) Gedeon-Richter
576 rub. order
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Pharmacy24
- Escapel 1.5 mg No. 1 tablets VAT "Gedeon Richter", Ugorshchina
206 UAH. order
PaniPharmacy
- Escapel tablets Escapel tablets. 1.5 mg No. 1 Hungary, Gedeon Richter
219 UAH. order
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