Emergency contraception

Treatment

Progestin-Only Regimen

• First dose within 48 hours after unprotected intercourse followed by second dose 12 hours later
  • may take both at once
• Relative risk reduction of pregnancy = 89% (1% with vs 8% without)
• Side effects
  • Nausea (23%)
  • Vomiting (6%)
• No teratogenisis
• FDA approved regimens:
  • Plan B (marketed specifically for emergency contraception) - 1 pill (0.75 mg levonorgestrel) per dose
    • Plan B levonorgestrel 0.75mg po q12h x2

Yuzpe Regimen

(combination OCPs)

• Yuzpe ethinyl estradiol 100mcg po plus levonorgestral 0.5mg po; repeat in 12h

• First dose within 72 hours after unprotected intercourse followed by second dose 12 hours later
• May be given up to 120 hours later (but efficacy reduced)
• Reduces risk of pregnancy by 75% (2% with vs 8% without)
• Side effects
  • Nausea (50%)
  • Vomiting (20%)
• Safety
  • No teratogenic effect
• Contraindications
  • Pregnancy
• FDA approved regimens:
  • Ovral, Ogestrel - 2 pills (100 ug ethiny estradiol/0.5 mg levonorgestrel) per dose
  • Alesse, Aviane, Levlite - 5 pills (100 ug ethiny estradiol/0.5 mg levonorgestrel) per dose
  • Levlen, Levora, Lo/Ovral, Low-Ogestrel - 4 pills (120 ug ethiny estradiol/0.6 mg levonorgestrel) per dose
  • Triphasil, Tri-Levlen, Trivora - 4 pills (120 ug ethiny estradiol/0.5 mg levonorgestrel) per dose