Emergency Contraception

Question 1

What are features of levonorgestrel?

Answer 1

Must be taken within 72 hours of UPSI- after this decreased efficacy
Single dose 1.5mg
- dose double if BMI >26 or weight 70kg or if enzyme inducing drugs (prefer IUD in this case)
If vomiting occurs within 3 hours then dose repeated
Can be used more than once in a menstrual cycle
Hormonal contraception can be start immediately after using

Question 2

What are features of Ulipristal?

Answer 2

Primary MoA- inhibition of ovulation
Must be taken within 120 hours- 30mg
Can reduce effectiveness of hormonal contraception- should restart 5 days after taking
Caution if severe asthma
Breastfeeding should be delayed for one week after taking
Can be taken more than once in menstrual cycle

Question 3

What are features of IUD?

Answer 3

Most effective method and should be first line and offered to all eligible women
Insert within 5 days of UPSI or 5 days after the likely ovulation date
Can inhibit fertilisation or implantation
Give prophylactic abx if high risk of STI
Can also provide long term contraception
99% effective