Levonorgestrel pharmacokinetics in plasma and milk of lactating women who take 1.5 mg for emergency contraception

Hum Reprod. 2007 Jun;22(6):1578-84. doi: 10.1093/humrep/dem034. Epub 2007 Mar 2.

Abstract

Background: Progestin-only methods are among the contraceptive options available for breastfeeding women, however the doses of progestin used in emergency contraception (EC) have not been evaluated in nursing mothers. We therefore investigated the pharmacokinetics of 1.5 mg levonorgestrel (LNG) in lactating women.

Methods: Twelve healthy exclusively breastfeeding volunteers received 1.5 mg LNG. Women refrained from nursing for 72 h after dosing and fed their infants with milk frozen beforehand. Serial blood and milk samples were collected for 120 h and assayed for LNG and sex hormone binding globulin.

Results: LNG concentrations peaked in plasma and in milk 1-4 h and 2-4 h after dosing, respectively. Concentrations in milk (M) paralleled those in plasma (P) but were consistently lower (mean M:P ratio 0.28). Estimated infant exposure to LNG is 1.6 microg on the day of dosing (1 microg in the first 8 h), 0.3 microg on the second day and 0.2 microg on the third day.

Conclusions: Nursing mothers may need EC. These results suggest that to limit infant exposure to the period of maximum LNG excretion in milk, mothers should discontinue nursing for at least 8 h, but not more than 24 h, after EC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Breast Feeding
  • Contraception, Postcoital*
  • Contraceptives, Postcoital / blood*
  • Contraceptives, Postcoital / pharmacokinetics*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Lactation
  • Levonorgestrel / blood*
  • Levonorgestrel / pharmacokinetics*
  • Milk, Human / chemistry*
  • Sex Hormone-Binding Globulin / analysis

Substances

  • Contraceptives, Postcoital
  • Sex Hormone-Binding Globulin
  • Levonorgestrel