Patient Counselling
Intended Benefit
§ Levonorgestrel emergency contraception is intended for use as birth control after having unprotected sex or when another method of birth control fails.
§ Patients should be advised that levonorgestrel is not an abortifacient.
§ Patients should also be advised that levonorgestrel provides no protection against HIV infection and other sexually transmitted diseases.
Dose and Dose Timing
§ Two tablets of Levonorgestrel (0.75 mg tablets, total dose 1.5 mg) should be taken at the same time orally, as soon as possible or within 72 hours of having unprotected coitus.
§ The sooner levonorgestrel is taken, the more effective it is. Approximately 7 out of 8 women will not become pregnant after administration of levonorgestrel within the recommended time interval.
Potential Side Effects
§ Nausea, abdominal pain, fatigue, headache, vomiting and changes in bleeding are the most common adverse events reported.
§ The patient should be instructed to contact a healthcare provider if she vomits within the first 2 hours of administration. An additional dose may be administered at this time, based on the clinical decision of the healthcare professional.
Contraindications
§ Women with known or suspected pregnancy should not take this drug.
§ Patients with undiagnosed abnormal vaginal bleeding should also be advised to avoid levonorgestrel.
Other
§ The patient should be counselled on abstaining or using an alternative method of contraception until the next menstrual cycle.
§ If the patient’s menstrual period is delayed beyond 1 week of the expected due date, the patient’s pregnancy status should be confirmed with a pregnancy test and she should follow-up with her doctor.
§ If the pharmacist determines that the patient is a repeat user of emergency contraception (more than once a month) or if levonorgestrel has been used in the past cycle, he or she should discuss other contraceptive methods and the prevention of sexually transmitted diseases with the patient.
Storage
Store levonorgestrel between 15 and 30 °C. Protect from high humidity (avoid the bathroom cabinet).
References
1. Belanger D. Emergency Contraception (Birth Control) Patient Information. Patient Self Care. 1st Edition. 2002. Canadian Pharmacists Association. Ottawa, ON. Chapter 49. Page 669.
2. Levonorgestrel [product monograph]. e-therapeutics. Last Updated: June 10, 2010. Accessed at: https://www-e-therapeuticsca.proxy.lib.uwaterloo.ca/cps.select.preliminary Filter.action?simplePreliminaryFilter =levonorgestrel# on June 27, 2012.
3. Zieman M. Emergency Contraception. UptoDate. Last Updated: March 6, 2012. Accessed at: http://www.uptodate.com/contents/emergency-contraception-morning-after-pill-beyond-the-basics#H4 on June 27, 2012.
Intended Benefit
§ Levonorgestrel emergency contraception is intended for use as birth control after having unprotected sex or when another method of birth control fails.
§ Patients should be advised that levonorgestrel is not an abortifacient.
§ Patients should also be advised that levonorgestrel provides no protection against HIV infection and other sexually transmitted diseases.
Dose and Dose Timing
§ Two tablets of Levonorgestrel (0.75 mg tablets, total dose 1.5 mg) should be taken at the same time orally, as soon as possible or within 72 hours of having unprotected coitus.
§ The sooner levonorgestrel is taken, the more effective it is. Approximately 7 out of 8 women will not become pregnant after administration of levonorgestrel within the recommended time interval.
Potential Side Effects
§ Nausea, abdominal pain, fatigue, headache, vomiting and changes in bleeding are the most common adverse events reported.
§ The patient should be instructed to contact a healthcare provider if she vomits within the first 2 hours of administration. An additional dose may be administered at this time, based on the clinical decision of the healthcare professional.
Contraindications
§ Women with known or suspected pregnancy should not take this drug.
§ Patients with undiagnosed abnormal vaginal bleeding should also be advised to avoid levonorgestrel.
Other
§ The patient should be counselled on abstaining or using an alternative method of contraception until the next menstrual cycle.
§ If the patient’s menstrual period is delayed beyond 1 week of the expected due date, the patient’s pregnancy status should be confirmed with a pregnancy test and she should follow-up with her doctor.
§ If the pharmacist determines that the patient is a repeat user of emergency contraception (more than once a month) or if levonorgestrel has been used in the past cycle, he or she should discuss other contraceptive methods and the prevention of sexually transmitted diseases with the patient.
Storage
Store levonorgestrel between 15 and 30 °C. Protect from high humidity (avoid the bathroom cabinet).
References
1. Belanger D. Emergency Contraception (Birth Control) Patient Information. Patient Self Care. 1st Edition. 2002. Canadian Pharmacists Association. Ottawa, ON. Chapter 49. Page 669.
2. Levonorgestrel [product monograph]. e-therapeutics. Last Updated: June 10, 2010. Accessed at: https://www-e-therapeuticsca.proxy.lib.uwaterloo.ca/cps.select.preliminary Filter.action?simplePreliminaryFilter =levonorgestrel# on June 27, 2012.
3. Zieman M. Emergency Contraception. UptoDate. Last Updated: March 6, 2012. Accessed at: http://www.uptodate.com/contents/emergency-contraception-morning-after-pill-beyond-the-basics#H4 on June 27, 2012.