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5.0 Prescription Details

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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