Comparative Pharmacology
Head-to-head clinical analysis: LEVONEST versus NORTREL 0 5 35 28.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LEVONEST versus NORTREL 0 5 35 28.
LEVONEST vs NORTREL 0.5/35-28
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Levonorgestrel is a synthetic progestin that inhibits ovulation by suppressing luteinizing hormone (LH) surge, alters cervical mucus to impede sperm penetration, and induces endometrial changes that inhibit implantation.
Norethindrone and ethinyl estradiol are a combination hormonal contraceptive. Norethindrone suppresses gonadotropin release (FSH and LH) from the pituitary, inhibiting ovulation. Ethinyl estradiol stabilizes the endometrium and enhances the contraceptive effect by inhibiting gonadotropin secretion.
One tablet (levonorgestrel 1.5 mg) orally as a single dose within 72 hours of unprotected intercourse.
1 tablet orally once daily for 28 days (21 active tablets containing 0.5 mg norethindrone and 35 mcg ethinyl estradiol, followed by 7 placebo tablets).
None Documented
None Documented
The terminal elimination half-life is approximately 24-30 hours. This relatively long half-life supports once-daily dosing and allows for stable plasma concentrations within 5-7 days of continuous use.
Norethindrone: 7.2-9.2 hours; Ethinyl estradiol: 13-27 hours. Clinical context: Steady state reached in 5-7 days; half-life supports once-daily dosing.
Renal excretion of conjugated metabolites accounts for approximately 60-80% of an administered dose; fecal elimination via bile accounts for 20-40%.
Renal: ~40% as metabolites; Biliary/Fecal: ~60% as metabolites; <5% unchanged.
Category C
Category C
Oral Contraceptive
Oral Contraceptive