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Emergency contraceptives

Emergency contraception methods are intended to prevent pregnancies after unprotected intercourse. There are two methods of emergency contraception: emergency contraceptive pills (ECPs) and copper-bearing intrauterine devices (IUDs).  Within ECP methods exists three types of emergency contraceptive pills: combined estrogen and progestin pills, progestin-only (Levornogestrel) pills, and antiprogestin (as mifepristone) pills[1]. In all cases, the action mechanism is related on delaying or preventing ovulation.  

Main difference between the two Emergency contraceptives methods is the effectiveness period after unprotected intercourse: About IUD regimen, experts still discussing. Some specialists stated IUD could prevent pregnancy if inserted up to 8 days after intercourse; at the same time latest WHO guidelines allow IUDs to be inserted up to day 12 days. However, many protocols recommend IUD insertion up to only 5 days.  Regarding ECP regimen, specialist sustains it may be initiated as soon as possible and no later than 5 days after unprotected intercourse[2].

Taking into account accessibility and capability of used of the emergency contraceptive methods, WHO recommended Levornogestrel 1.5mg in one single dose taken as the most standard.  Hence, WHO mention to be used within the five days (120 hours) of unprotected intercourse[3]. The original treatment posology (currently available) was one 0.75 mg dose within 72 hours after unprotected intercourse, and a second 0.75 mg dose 12 hours after the first dose. However, studies have shown that a single dose of 1.5 mg is as effective as two 0.75 mg doses[4].

Manufacture innovator of Levornogestrel 1500mg was Bayer, named as Levonelle 1500® or Postinor 1500® (depends on the country). First market commercial approval was awarded in June 2004[5].




[1] Gemzell-Danielsson, Kristina; Rabe, Thomas; Cheng, Linan "Emergency contraception: an update". Gynecological Endocrinology 29 (Supplement 1): 1–14 (March 2013).

[2]  J. Trussel, et all. Emergency Contraception: A last Chance to Prevent Unintended Pregnancy. Office of Population Research, Princeton University (2014)

[3] WHO Emergency contraception Fact sheet.  Fact sheet N°244 (July 2012)

[4] J. Trussel, et all. Emergency Contraception: A last Chance to Prevent Unintended Pregnancy. Office of Population Research, Princeton University (2014)

[5] Public Assessment Report Mutual Recognition Procedure Levonelle 1500 microgram Tablet. Medimpex UK Limited (2005)

 

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