EHC

Question 1

2 options

Answer 1

levonorgestrel

ulipristal acetate (Ella One)

Question 2

time when effective

Answer 2

LNG - up to 72hrs

ULP - up to 120hrs

Question 3

age restrictions

Answer 3

LNG - O16yrs

ULP - no minimum age

Question 4

levonorgestrel - licencing, vomiting, interactions, contraceptives

Answer 4

• 16yrs+
• take within 72hrs of UPSI
• vomiting within 2hrs, take another
• not rec in severe liver dysfunction
• interactions: enzyme inducers (CBZ, PHY, PRI, RIF, St John’s wort)
• can continue regular contraceptives after

Question 5

Ulipristal - licencing, vomiting, interactions, regular contraceptives

Answer 5

• licenced within 120hrs of UPSI (5 days)
• vomiting within 3 hrs, take another asap
• no rec for severe liver impairment or SEVERE ASTHMA ON GC
• interactions: enzyme inducers (CBZ, PHY, PRI, RIF, St John’s wort)
• can be used with regular contraceptives BUT reduces efficacy of COC/POP, use barrier until next period

Question 6

breastfeeding and EHC

Answer 6

LNG
- secreted into breast milk
- bf before taking
- avoid bf for at least 8hrs after

ULP
- excreted into breast milk
- bf not rec for 1 week after
- express and discard to stimulate lactation

Question 7

menstruation and EHC

Answer 7

menstruation can be delayed

LNG: pregnancy test if >5 days late

ULP: pregnancy test if >7 days late

Question 8

counselling

Answer 8

• take asap
• if vomit/diarrhoea within 3hrs (ULI) or 2hrs (LNG) repeat
• next period may be late/early
• if >7 days late, pregnancy test
• does not protect against STDs
• LT contraception
• LNG can be used while breastfeeding

Question 9

oral contraception referrals

Answer 9

• sudden severe chest pain
• sudden breathlessness
• unexplaned swelling/severe calf pain in 1 leg
• severe stomach pain
• unusual severe/prolonged headache
• sudden partial/complete vision loss
• sudden loss of hearing
  -> REFER ALL