Levonorgestrel Nausea Prevention

Levonorgestrel contains progestin and is the main ingredient in a number of oral mini pills and intra-uterine (IUD) contraceptives. Both pills and IUD work to suppress ovulation, contain no estrogen and usually have a lower dose of progestin. Mild nausea can be a side effect. But when combined with an estrogen such as Ethinyl Estradiol, as in some contraceptives, Levonorgestrel-related nausea can become severe.

Levonorgestrel and Nausea

• Nausea is one of many possible side effects of Levonorgestrel when it is the active ingredient in a progestin-based 21-day cycle oral contraceptive, IUD or emergency contraceptive.

  Contraceptives that combine Levonorgestrel with Ethinyl Estradiol produce more side effects related to nausea and gastrointestinal distress because Ethinyl contains an synthetic estrogen, which your body can find hard to tolerate. Side effects of this combination include: abdominal cramps, bloating, nausea and vomiting.

Off Label Uses of Levonorgestrel and Ethinyl

• Off label uses of this drug combination include treating menorrhagia, endometriosis pain, endometrial hyperplasia, secondary amenorrhea, dysmenorrhea and dysfunctional uterine bleeding. Since nausea can be a significant side effect of many of these conditions, treating Levonorgestrel-related nausea also addresses nausea caused by the condition.

Starting Levonorgestrel

• You may experience nausea when you begin to take Levonorgestrel. It usually goes away in a few days to a month. If nausea becomes severe and/or does not go away, see your doctor, who may put you on a lower dose of Levonorgestrel, or on a progestin-only oral contraceptive. He may also recommend another method of contraception such as condoms or a diaphragm.

Taking Levonorgestrel at Night

• Levonorgestrel literature and your doctor both recommend you take the pill at the same time each day. Nausea is less likely if you take Levonorgestrel a half hour after dinner, or with a snack just before bedtime. Ginger tea and plain soda crackers are a snack that can help prevent nausea.

Taking Levonorgestrel in the Morning

• If you take Levonorgestrel in the morning, you are more likely to experience nausea, particularly if you skip breakfast, but you may feel nauseous in the morning even if you take the pill at night. Changes in your breakfast menu can help, in either case. Instead of coffee, have peppermint tea, plain toast with a small amount of jelly (no butter) and a soft-boiled egg. If you must have cereal, use soy-milk, which is easier to digest than regular milk. Do not have grapefruit, because it can increase both Levonogestrel and Ethinyl concentrations in your body and increase nausea.

Treating Nausea During the Day

• Carry a small bottle of oil of peppermint with you. If you feel nauseous, add a few drops to a glass of water and drink slowly. Candy peppermints also work, as long as they contain real oil of peppermint. Soda crackers and ginger-ale also help -- the baking soda in the crackers helps remove excess acid in your stomach, which contributes to nausea. For lunch and dinner, stay away from greasy, fatty, highly-spiced foods and eat lightly. Instead of three large meals, have smaller meals throughout the day, especially when you begin to feel nauseous.

Drug Interactions

• Drugs that may interact with Levonorgestrel and cause nausea and serious side effects include: insulin, blood-thinning agents such as Coumadin or aspirin therapy, and steroids such as prednisone, dexamethasone (Decadron), Nasonex and Advair. Grapefruit juice can increase Levonogestrel and Ethinyl concentrations in the body and the fruit's acid can increase nausea. Avoid herbs that have natural estrogens, such as donquai and black cohosh. Extra estrogen can contribute to nausea.