FSRH algorithms to help with deciding the best method of emergency contraception. (Reproduced under licence from FSRH. Copyright© Faculty of Sexual and Reproductive Healthcare 2011 to 2017)
A copper intrauterine device (IUD) is the most effective method of emergency contraception (EC) and should always be offered / considered. See
Contraception guidance and 7.3.4 Contraceptive devices
- Tablets 30mg (£14.05 per dose)
- Emergency contraception within 120 hours of unprotected intercourse
- One 30mg tablet is effective if taken within 120 hours of unprotected intercourse, the earlier it is taken the more likely ovulation is prevented
- Ulipristal acetate should be used with caution in patients with uncontrolled severe asthma.
- There is no evidence of harm to foetus from ulipristal acetate. Breast feeding should be avoided for at least 7 days.
- A routine method of hormonal contraception (e.g. CHC) is not advised to be started at the same time with ulipristal because the efficacy of ulipristal and the hormonal contraception may be reduced. Therefore, if a woman wishes to start or continue using hormonal contraception, she should be advised not to do so for at least 5 days and to use a reliable barrier method for 7 days after starting Combined Hormonal Contraceptive (CHC), 9 days for Qlaira (non-formulary) CHC or 2 days after Progesterone only pill. (FSRH guidance March 2017)
- If a woman has a BMI > 30kg/m2 the efficacy of ulipristal acetate may be impaired. See Contraception guidance for further information.
- Tablets 1.5mg (£5.20 per dose)
- Emergency contraception within 96 hours of unprotected intercourse
- One 1.5mg tablet effective if taken within 72 hours of unprotected intercourse, may also be used between 72 and 96 hours (unlicensed use) the earlier it is taken the more likely ovulation is prevented
- Practitioners supplying levonorgestrel under Patient Group Directive are constrained to supply within 72 hours of unprotected sexual intercourse. Therefore, GPs and contraceptive services may be approached by patients requesting emergency contraception outside the 72 hour period
- If a woman is over 70kg in weight or has a BMI > 26kg/m2, consider ulipristal acetate single dose or levonorgestrel double dose (unlicensed use). See Contraception guidance for further information.
- If a woman has a BMI > 30kg/m2 the efficacy of levonorgestrel may be impaired. See Contraception guidance for further information.
7. Obstetrics, gynaecology, and urinary-tract disorders >
7.3 Contraceptives >
7.3.5 Emergency contraception
- First line
- Second line