Logynon

Logynon is a triphasic combined oral contraceptive pill containing levonorgestrel and ethinylestradiol in three different dose combinations across each pack. Unlike monophasic pills where every active tablet contains the same hormone doses, Logynon varies the amounts of both progestogen and oestrogen across a 21-day cycle to more closely mimic the natural hormonal fluctuations of the menstrual cycle. Each pack contains 6 brown tablets, 5 white tablets, and 10 ochre tablets, each phase containing progressively adjusted hormone levels.

Triphasic Hormone Formulation

The first phase consists of 6 brown tablets, each containing levonorgestrel 50 micrograms and ethinylestradiol 30 micrograms. The second phase consists of 5 white tablets containing levonorgestrel 75 micrograms and ethinylestradiol 40 micrograms. The third and longest phase contains 10 ochre tablets, each providing levonorgestrel 125 micrograms and ethinylestradiol 30 micrograms. This stepped approach was designed to minimise the total hormone dose per cycle while maintaining reliable contraceptive efficacy, though in clinical practice the contraceptive efficacy and tolerability of triphasic and monophasic pills are broadly comparable.

How Logynon Prevents Pregnancy

Like all combined oral contraceptives, Logynon works through three mechanisms: suppression of ovulation by preventing the mid-cycle LH surge, thickening of cervical mucus to impede sperm penetration, and alteration of the endometrial lining to reduce receptivity. When taken correctly and consistently, Logynon is more than 99% effective at preventing pregnancy.

Who Logynon Is For

Logynon is suitable for healthy women of reproductive age who do not have contraindications to oestrogen-containing contraception. It is sometimes preferred for women who have experienced side effects such as breakthrough bleeding on a monophasic pill, as the varying hormone levels may suit some women better.

Logynon is taken over a 21-day cycle, followed by a seven-day tablet-free interval. It is essential that the tablets are taken in the correct order, starting with the brown tablets, then the white tablets, and finally the ochre tablets, following the arrows printed on the blister pack. Taking the tablets in the wrong sequence will result in incorrect hormone levels and may compromise contraceptive protection.

Starting Logynon

If Logynon is started on the first day of the menstrual period, contraceptive protection is immediate. If started on days two to five of the cycle, additional barrier contraception (such as condoms) should be used for the first seven days. After completing the 21 active tablets, a seven-day break follows, during which a withdrawal bleed typically occurs. The next pack must begin on day eight, whether or not the bleed has finished.

Missed Tablets

Logynon carries particular importance around missed tablets because the triphasic nature means each tablet in the pack contains a different dose. If a tablet is missed and fewer than 24 hours have elapsed since it should have been taken, the tablet should be taken immediately and the next one taken at the usual time. If more than 24 hours have passed, the missed tablet should be taken as soon as remembered (even if two tablets are taken in one day), and additional contraception used for the next seven days. If this seven-day period extends beyond the end of the pack, the next pack should be started without taking the usual break. The patient information leaflet contains detailed guidance for each phase of missed tablets.

Each Logynon pack contains 21 tablets in three colour-coded phases:

• Phase 1: 6 brown tablets (levonorgestrel 50mcg + ethinylestradiol 30mcg)
• Phase 2: 5 white tablets (levonorgestrel 75mcg + ethinylestradiol 40mcg)
• Phase 3: 10 ochre tablets (levonorgestrel 125mcg + ethinylestradiol 30mcg)

One tablet is taken daily in the correct sequence for 21 days, followed by 7 tablet-free days. The tablets must be taken in strict order and at approximately the same time each day.

No dose adjustment is applicable, as the product is a fixed triphasic formulation. Logynon is for use in women of reproductive age only. Mild to moderate renal or hepatic impairment does not routinely require dose adjustment, but severe liver disease or liver tumours are contraindications. If a pack is delayed or tablets are missed in any phase, the patient information leaflet should be consulted to determine whether additional contraception is needed.

Common Side Effects

• Nausea, especially in the first few weeks
• Breast tenderness or fullness
• Headache, including migraine
• Mood changes or low mood
• Decreased or altered libido
• Breakthrough bleeding or spotting between periods, particularly during dose phase transitions
• Changes in vaginal discharge
• Contact lens intolerance

Serious Side Effects

• Venous thromboembolism: DVT or pulmonary embolism, urgent medical attention required for sudden leg pain and swelling, chest pain, or breathlessness
• Arterial thromboembolic events: stroke or heart attack, particularly in women with hypertension, who smoke, or have other cardiovascular risk factors
• Hypertension: blood pressure should be monitored before and during treatment
• Liver tumours: rare benign or malignant liver tumours with long-term COC use; report persistent right upper abdominal pain
• Cervical cancer: long-term use associated with a modest increased risk

Logynon carries the standard warnings for combined oral contraceptives, and women should be assessed thoroughly before prescribing.

Thromboembolism and Cardiovascular Risk

All combined oral contraceptives increase the risk of venous thromboembolism. This risk is low in absolute terms for healthy young non-smoking women but rises substantially with additional risk factors such as obesity, smoking, prolonged immobility, a personal or family history of VTE, or known thrombophilia. Women with migraine with aura should not use combined oral contraceptives, as this combination is associated with an increased risk of ischaemic stroke. Blood pressure must be checked before prescribing Logynon and monitored during treatment. Women who smoke and are aged 35 or over must not use combined hormonal contraception, and women of any age who smoke heavily should be strongly advised to consider a progestogen-only alternative.

Drug Interactions and Other Considerations

Several medicines reduce the effectiveness of Logynon, including rifampicin, certain anticonvulsants (phenytoin, carbamazepine, phenobarbital, primidone, topiramate, oxcarbazepine), and St John's Wort. Women taking these medicines should use additional barrier contraception or consider a non-hormonal method. Logynon should be stopped immediately if a woman develops sudden severe headache, focal neurological symptoms, visual disturbances, chest pain, breathlessness, or severe abdominal pain, and urgent medical assessment obtained. Logynon provides no protection against sexually transmitted infections.

• Personal history of venous thromboembolism (DVT or pulmonary embolism)
• Known thrombophilia (e.g. Factor V Leiden, protein C or S deficiency, antiphospholipid syndrome)
• Migraine with aura (current or past history)
• History of or active arterial cardiovascular disease (stroke, angina, myocardial infarction)
• Uncontrolled hypertension
• Women aged 35 and over who smoke
• Breast cancer (current or within past five years)
• Severe or active liver disease, liver tumours
• Diabetes with vascular complications
• Hypersensitivity to any component
• Pregnancy or suspected pregnancy