Emergency Contraception

Question 1

Ulipristal (EllaOne)

Answer 1

• inhibits ovulation
  -can be used more than once in same cycle
• if already taken levonorgesterol should not be taken in following 5 days
• 30 mg taken ASAP after UPSI no later than 120hrs after (5 days)
• may reduce effectiveness of hormonal contraception (pill/patch/ring restated 5 days after ulipristal)..barrier methods used in between
• caution in PTS with severe asthma
• BREASTFEEDINgG should be delayed for 1 week after taking ulipristal….no restriction if levonorgesterol used

Question 2

Levonorgesterol (Levonelle)

Answer 2

• stops ovulation and inhibits implantation
• take ASAP
• must be taken within 72hrs UPSI (3 days)
• 1.5mg (a progesterone) DOSE doubled if BMI over 26 /wt over 70kg
• 84% effective if used within 72hrs
• if vomiting occurs within 3hrs then dose should be repeated
• can be used more than one in menstrual cycle if required
• hormonal contraception can be started IMMEDIATELY after for emergency contraception

Question 3

IUD

Answer 3

• most effective form of emergency contraception - should be offered to all women who meet the criteria
• must be inserted within 5 days of UPSI …or if a woman presented 5 days after then IUD can be inserted after likely ovulation date
• prophylactic ABx given it high risk of STI
  99% effective
• left in situ as long term contraception …if client wishes for it to be removed…should be kept in at least until next period