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Levonorgestrel vs Drospirenone: side-by-side comparison

Levonorgestrel (Synthetic progestin (emergency contraception)) and Drospirenone (Progestogen with anti-mineralocorticoid and anti-androgen activity) belong to different therapeutic classes and are rarely substitutes for each other. The comparison is useful when a single patient is weighing both options for adjacent or overlapping needs.

Property Levonorgestrel Drospirenone
Therapeutic class Synthetic progestin (emergency contraception) Progestogen with anti-mineralocorticoid and anti-androgen activity
CAS 797-63-7 67392-87-4
ATC G03AC03 G03AA12
Molecular weight 312.5 g/mol 366.49 g/mol
Brands with this active ingredient 1 2

What they share

Levonorgestrel and Drospirenone share the common regulatory framework for prescription active ingredients, bioequivalence standards for generics, and pharmacist oversight. Beyond that, points in common are limited.

Key differences

Levonorgestrel acts by a different mechanism than Drospirenone, with indications that barely overlap. Comparing the two is useful when a clinician has mentioned both in the same context or the patient wants to understand why one was prescribed instead of the other.

Mechanisms compared

Levonorgestrel: In emergency contraception, levonorgestrel works primarily by delaying or inhibiting ovulation when taken before the LH surge. Drospirenone: Drospirenone activates progesterone receptors to suppress ovulation and produce the contraceptive effect when combined with an estrogen.

Indications compared

Levonorgestrel: Levonorgestrel is approved for emergency contraception (single 1.5mg dose), regular oral contraception (combined with ethinylestradiol or as progestin-only), and as the active component of hormonal intrauterine devices f… Drospirenone: Drospirenone in combination with ethinylestradiol is approved as combined oral contraception, treatment of moderate acne in women requesting contraception, and treatment of premenstrual dysphoric disorder.

Safety profile

Levonorgestrel: Common adverse effects of emergency contraceptive use include nausea, headache, fatigue, dizziness, breast tenderness and menstrual cycle changes. Drospirenone: Common adverse effects include menstrual irregularities, breast tenderness, headache, mood changes and nausea, mostly in the first 2–3 cycles.

Frequently asked questions

Is Levonorgestrel better than Drospirenone?

Levonorgestrel and Drospirenone are not "better or worse" — they treat different things. The sensible question is which fits your specific need.

Can Levonorgestrel and Drospirenone be combined?

Whether they can be combined depends on the indications and the interaction profile of each. If both are in a single prescription, the prescriber has weighed it; in self-medication they should never be combined.

Do they have the same side-effect profile?

No — they belong to different classes and have distinct side-effect profiles. Each has its own prescribing information.

Products with Levonorgestrel

Products with Drospirenone

The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.