levonorgestrel

=Levonorgestrel=

How it works
Emergency contraception (EC) is a dose of progestogen (levonorgestrel) taken after sexual intercourse to reduce the risk of pregnancy. It’s sometimes wrongly called the morning-after pill, because it can be taken for up to five days after unprotected sex, although it’s more effective the sooner it’s taken. //Progestogen is a hormone which works by: - stopping the release of an egg by the ovary (ovulation) - making the mucus at the entrance of the uterus thicker so sperm can’t get through - changing the lining of the uterus so a fertilised egg can’t grow//

Questions to Ask
//Refer to [|Supply Protocol] and [|Checklist]// - In women taking enzyme-inducing drugs (particularly rifamycins), a copper IUD is preferred for emergency contraception - If sexual assault is suspected, you may ask if the sexual intercourse was consensual. - Unexplained vaginal bleeding and current breast cancer are contraindications - Levonorgestrel for EC should not be used if the patient is already pregnant. However, pharmacists should note this contraindication reflects a lack of benefit rather than any risk to the pregnancy nor will it terminate an existing pregnancy - The use of levonorgestrel for EC is unlikely to be of concern for nursing mothers

How to take
Take the two tablets immediately. //As stated in the product information, EC can be taken as two separate doses 12 hours apart, but recent research shows that EC works just as well if you take both pills at once// It is important to take it again if you have had further unprotected sex and you want to reduce the risk of pregnancy. If you vomit within two hours of taking the pills you will need to take another dose of EC.

Side effects
- nausea (23%): usually does not last longer than 12 hours after the last dose - vomiting (5-6%): if within two hours of taking the pills you will need to take another dose of EC. - breast pain (tenderness): usually disappear within 48hrs - dizziness - tiredness - headaches: usually disappear within 48hrs - spot bleeding: may occur after a few days, but is not a normal period

//rare:// - ectopic pregnancy: unusual pain in lower abdomen within the month of taking the pill - immediately seek treatment (inform that EC has been used)

Other advice?
- The EC pill is 90-95% effective in the first 24 hours, 85% within 48 hours and 58% within 72 hours. It can be taken within 5 days. - It is more likely to fail if you have already had unprotected sex after your last period, if you vomit within 2 hours of taking the pill, or if you have unprotected sex after taking the pill - Most women have a period within 3 weeks after taking the pills, but most can expect around the normal time (up to 30% occur a week late) - If your period is over one week late or lighter than usual, see your doctor or clinic for a pregnancy test - If you choose to use the oral contraceptive pill, the first course can be taken 24 hours after the last EC pill

CMI
[|PSA - Supply Protocol]: January 2006 [|PSA - Checklist]: January 2006 [|PSA - Leaflet]: January 2006 [|SHine SA: Emergency Contraception]