Z30.0/Z30.4
Emergency contraception is indicated to prevent pregnancy after unprotected intercourse in women not using contraception or where contraception is likely to be ineffective:
- forgotten tablets (See Missed pills )
- slipped or broken condom
- injectable contraception given > 2 weeks late
- sexual assault
- Levonorgestrel 1.5 mg, oral, as a single dose as soon as possible after unprotected intercourse, and not later than 5 days.
- If the woman vomits within 2 hours, repeat the dose.
Advise women that their period should be on time; very rarely it is delayed but it should not be more than 7 days late. If this occurs, they should come back for a pregnancy test.
OR
- Copper IUCD, e.g.:
- Cu T380A, inserted as soon as possible after unprotected intercourse and not later than 5 days.
CAUTION
Emergency contraceptive tablets must be taken as soon as possible, preferably within 72 hours of unprotected intercourse, and not later than 5 days.
Enzyme inducers (including efavirenz and carbamazepine) cause a significant reduction in levonorgestrel concentrations. Women on these medicines should preferably have copper IUCD inserted or alternatively double the dose of levonorgestrel. Women > 80 kg or BMI ≥ 30 should also be given double the standard dose.
REFERRAL
Women in need of emergency contraception must be referred for HIV counselling and testing and PEP.