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Levonorgestrel

Contraceptives, Oral, Synthetic
CATEGORIES

Contraceptives, Oral, Synthetic, Contraceptive Agents, Female, Contraceptive Agents


ALIASES

Abelonelle 28, Almina 28, Anastrella, Anastrella 28, Cyclabil®, Erlibelle, Evra, Follimin®, Follimin® 28, Follinett®, Follistrel®, Frivelle, Jadelle, Jadelle®, Jaydess, Kyleena, Leverette, Levesia, Levodonna, Levonorgestrel ABECE, Levonorgestrel Apofri, Levonorgestrel STADA, Levonorgestrel/Etinylestradiol Ebb, Levosert, Loette 28, Luadei, Mirena, Neovletta®, Neovletta® 28, NorLevo, Norplant®, Novogyn, Postinor, Postinor®, Prionelle, Prionelle 28, Rigevidon, Rigevidon 28, Rigevidoncont, Seasonique, Trinordiol, Trinordiol®, Trinordiol® 28, Trionetta, Trionetta®, Trionetta® 28, Triregol


SUBSTANCES

levonorgestrel


ENVIRONMENTAL CONCERN: HIGH
A synthetic progestational hormone with actions similar to those of progesterone and about twice as potent as its racemic or (+-)-isomer (norgestrel). It is used for contraception, control of menstrual disorders, and treatment of endometriosis. It is usually supplied in a racemic mixture (Norgestrel, 6533-00-2). Only the levonorgestrel isomer is active. Levonorgestrel is marketed mostly as a combination oral contraceptive under several brand names such as Alesse, Triphasil, and Min-Ovral.

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IN SCOPE
HIGH

REFERENCES

  1. Goodpoint. Prioritering av läkemedel med miljörisk inom SLL. Stockholm: Goodpoint; 2016. Rapport LS 2016–0634.
  2. Zeilinger J, Steger-Hartmann T, Maser E, Goller S, Vonk R, Länge R. Effects of synthetic gestagens on fish reproduction. Environ Toxicol Chem. 2009;28:2663-70.
  3. Fick J, Lindberg RH, Parkkonen J, Arvidsson B, Tysklind M, Larsson DG. Therapeutic levels of levonorgestrel detected in blood plasma of fish: results from screening rainbow trout exposed to treated sewage effluents. Environ Sci Technol. 2010;44:2661-6.
  4. Miguel-Queralt S, Hammond GL. Sex hormone-binding globulin in fish gills is a portal for sex steroids breached by xenobiotics. Endocrinology. 2008;149:4269-75.
  5. Friel PN, Hinchcliffe C, Wright JV. Hormone replacement with estradiol: conventional oral doses result in excessive exposure to estrone. Altern Med Rev. 2005;10:36-41.
  6. Fick J, Lindberg RH, Tysklind M, Larsson DG. Predicted critical environmental concentrations for 500 pharmaceuticals. Regul Toxicol Pharmacol. 2010;58:516-23.
  7. Fent K. Progestins as endocrine disrupters in aquatic ecosystems: Concentrations, effects and risk assessment. Environ Int. 2015;84:115-30.
  8. Runnalls TJ, Beresford N, Kugathas S, Margiotta-Casaluci L, Scholze M, Scott AP et al. From single chemicals to mixtures--reproductive effects of levonorgestrel and ethinylestradiol on the fathead minnow. Aquat Toxicol. 2015;169:152-67.
  9. Stockholms läns landsting. Förteckning över miljöbelastande läkemedel med åtgärdsförslag framtagen inom ramen för SLL:s miljöprogram 2017–2021.
  10. Fass.se för vårdpersonal
  11. Stockholms läns landsting. Kloka Listan 2018.
  12. Stockholm County Council. The Wise List 2015.
  13. Socialstyrelsen. Statistikdatabas för läkemedel.
  14. Stockholms läns landsting. Janusinfo: Läkemedelsuppföljning

SOURCES

  1. Drugbank, The DrugBank database is a unique bioinformatics and cheminformatics resource that combines detailed drug data with comprehensive drug target information.
  2. PubChem, PubChem is the world's largest collection of freely accessible chemical information. Search chemicals by name, molecular formula, structure, and other identifiers
  3. ECHA, The European Chemicals Agency (ECHA) is the driving force among regulatory authorities in implementing the EU's groundbreaking chemicals legislation for the benefit of human health and the environment as well as for innovation and competitiveness.
  4. EMA, The mission of the European Medicines Agency (EMA) is to foster scientific excellence in the evaluation and supervision of medicines, for the benefit of public and animal health in the European Union (EU).
  5. EU watch-list, Commission Implementing Decision (EU) 2018/840 of 5 June 2018 establishing a watch list of substances for Union-wide monitoring in the field of water policy pursuant to Directive 2008/105/EC of the European Parliament.
  6. Umweltbundesamt, Since its founding in 1974, the German Environment Agency (Umweltbundesamt – UBA) has been Germany’s main environmental protection agency.
  7. Naturvårdsverket, A public agency in Sweden that is responsible for environmental issues. The Agency carries out assignments on behalf of the Swedish Government relating to the environment in Sweden, the EU and internationally
  8. Läkemedelsverket, The Swedish Medical Products Agency (MPA) is the Swedish national authority responsible for regulation and surveillance of the development, manufacturing and marketing of drugs and other medicinal products.
  9. FASS, The Swedish environmental classification of pharmaceuticals at www.fass.se has now been running since October 2005. Since then a large amount of environmental information of pharmaceuticals has been published.
  10. Janusinfo, Janusinfo is providing drug information to support healthcare professionals in their everyday work. The website is the electronic means of communication of the Drug Therapeutic Committee and the Health and Medical Care Administration of the Stockholm County Council, Sweden.