SWITCHING PILLS

Question 1

Additional precaution when switching from CHC to CHC

Answer 1

No additional precaution needed

Question 2

Additional precaution when switching from POP to CHC

Answer 2

7 days extra precaution needed

Question 3

Additional precaution when switching from LNG-IUD to CHC

Answer 3

7 days extra precaution needed

Question 4

Additional precaution when switching from Copper IUD or non-hormonal methods to CHC

Answer 4

• if started on upto day 5 of cycle then no additional precaution required
• if started after day 5 = 7 days of extra precaution

Question 5

switching from CHC to others week 1 (day 3-7 of hormone free interval) and no UPSI since start of HFI

CHC-> CU-IUD + POP + others

Answer 5

• CU-IUD = no extra precaution
• POP = 2DY precaution
• others = 7DY precaution

Question 6

switching from CHC to others week 1 (day 3-7 of hormone free interval) and UPSI since start of HFI

Answer 6

• carry on with CHC until 7 consecutive days
• then act as week 2/3

Question 7

switching from CHC to others week 2/3

Answer 7

no extra pre-caution required

Question 8

URGENT reasons to STOP CHC

Answer 8

• calf pain, swelling +/ redness (DVT)
• chest pain +/or breathlessness +/or coughing up blood (PE)
• loss of motor or sensory function (stroke)
• severe stomach pain (hepatotoxicity)
• v. high BP (haemorrhagic stroke)

Question 9

OTHER reasons to STOP CHC

e.g. during a medical review

Answer 9

• signs of breast cancer (lumps, nipple pain )
• 50+
• new onset of migraine
• persistent unscheduled vag bleed
• high BP
• high BMI >OR= 35
• DVT or PE
• blood clotting abnormal
• angina, heart attack, stroke or peripheral vascular disease
• AF
• cardiomyopathy