5.1 Client instructions
•
ECPs should be taken as early as convenient to ensure better efficacy.
• the common minor adverse effects should
be explained. She should also be instructed to report back for repeat
dose of ECP if she has vomiting within 2 hours of ECP intake.
• any irregular bleeding or spotting which
can happen after ECP use should not be misunderstood as periods.
Next menstrual periods may occur one week prior or later than expected
time.
• ECPs do not prevent pregnancy from sexual
acts after treatment. Client should be told to avoid exposure or
use condom during further sexual acts, till the next period.
• EC is a good ‘back-up’ method for regular
contraceptive failures and not as ongoing contraceptive method.
The health-care provider should take it as an opportunity for discussing
regular contraceptive use and how to use the chosen method correctly.
• the client to report back if menses are
delayed for more than one week after the expected date.
• client should be warned about the possibility
of pregnancy and higher failure rates if she has multiple unprotected
sexual acts and the first act is more than 120 hours away from the
date of prescription of EC.
• ECPs do not protect against HIV/AIDs and
STIs. The unprotected intercourse that prompted the request for
ECP may have put her at risk of these infections. She should also
be advised where to obtain evaluation and treatment for STIs and
how to reduce her risk of acquiring these in future.
Important tips for prescription
+
Tablets are to be swallowed with sips of water.
+
There is no difference in side-effects or efficacy whether the
pills are taken on empty or full stomach.
+
The treatment should not be delayed unnecessarily as the efficacy
declines over time.
+ A single dose
of (1.5mg) of LNG i.e. 2 tablets of 0.75mg together is as effective
as two divided dose (0.75mg each) 12 hrs. apart.
+
The ideal interval between 2 doses is 12 hours. however, it is
permissible to take the second dose between 10-24 hours of the
first dose.
+
Do not prescribe extra pills to women with undue anxiety. More
pills will not make it more effective, but will increase the risk
of nausea and vomiting.
5.2 Record-keeping
Record
is to be kept on a simple proforma (see annexure
II ).
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