Under which condition is Levonorgestrel (Plan B) contraindicated?

• A. In the presence of known or suspected pregnancy
• B. In a woman who is breastfeeding
• C. In the presence of psychiatric illness
• D. In women with intrauterine fibroids

Answer: (A)

Levonorgestrel, commonly known as Plan B, is a form of emergency contraception that works primarily by preventing ovulation or fertilization if taken shortly after unprotected sex. Its use is contraindicated in the presence of known or suspected pregnancy because its primary mechanism does not terminate an established pregnancy. Instead, it is designed to prevent pregnancy before it occurs. Administering it in cases of suspected pregnancy could be unnecessary and misleading, as the intention behind its use is to prevent conception rather than to interrupt an existing one.

When considering other conditions listed, Levonorgestrel can generally be used in breastfeeding women, as it is considered safe with minimal transfer to breast milk. Similarly, having a psychiatric illness does not inherently contraindicate its use, as the medication does not have significant neuropsychiatric effects that would present risks in those populations. Additionally, women with intrauterine fibroids can also use Levonorgestrel, as fibroids do not affect the efficacy or safety of emergency contraceptive methods.