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If EC given because of UPSI:
- advise condom use for remainder of cycle. PT in 3 weeks advisable.
- discuss ongoing contraception and provide method for future use
- after LNG-EC use: consider ‘quick-starting’ (starting method at time of giving LNG-EC) ongoing hormonal contraception plus condoms for 7 days.
- after UPA-EC use: start ongoing hormonal contraception after 5 days plus condoms for 7 days or at next period.
If EC given because hormonal contraception failure:
- effectiveness of UPA-EC may be reduced. Avoid pill/patch/vaginal ring for 5 days after UPA-EC use before restarting method. Additional condom should be used for the 5 days plus a further 1 week after restarting the method. PT in 3 weeks advisable.
- after LNG-EC, continue with the hormonal method with additional condom use for 1 week. PT in 3 weeks advisable.
If current or recent (past 4 weeks) enzyme-inducing drug use:
- copper-IUD most effective EC. If declined, give double dose (3mg) of LNG-EC*. Don’t use UPA-EC (SPC advice).
If breast feeding:
- avoid breast-feeding for 1 week after UPA-EC use. Can use LNG-EC.
If BMI > 26 Kg/M2 or weight >70Kg
- may be reduced efficacy of LNG-ED. Re-consider Copper IUD or Give UPA-EC or double dose LNG-EC
|All EC methods
- full consultation, including side-effects, action to be taken if vomiting within 2 to 3 hours (hormonal EC only)
- provide written information
- accurate documentation
- consider STI testing
- follow-up as appropriate.
The Faculty of Sexual & Reproductive Healthcare Guideline to Emergency Contraception