Hormonal Emergency Contraception

Melissa Sanders Wanner, Pharm.D., Rachel L. Couchenour, Pharm.D.

Disclosures

Pharmacotherapy. 2002;22(1) 

In This Article

Summary

Emergency contraception has been studied and used for over 40 years. The quest for a highly effective and well-tolerated regimen has resulted in the discovery of the Yuzpe regimen (ethinyl estradiol plus progestin), a progestin-only regimen, and mifepristone. A plethora of evidence demonstrate that these regimens are very effective when initiated within 72 hours of unprotected intercourse.[47] The sooner the regimen is initiated, the greater the efficacy.[25] The most effective and well-tolerated regimen available to women in the U.S. is levonorgestrel, which may be administered as 20 Ovrette tablets/dose, or the marketed product Plan B.[10,27] Limited information is available in the literature about possible drug interactions with emergency contraceptives. According to the published literature on oral contraceptive pills, potential interactions with ethinyl estradiol or progestins do exist. Whether these same interactions exist for the brief high-dose regimens used in emergency contraception remains to be elucidated. Although public awareness and use of emergency contraceptives are low, accessibility has increased after FDA approval of two products specifically marketed for emergency contraception, the introduction of the emergency contraceptive hotline, and the collaborative drug therapy agreements established in Washington State. Until awareness is raised and access to those seeking emergency contraceptives improves, the impact of emergency contraception on the rate of unintended pregnancies will remain limited.

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