contraindications to the morning after pill

Last reviewed 03/2021

Contraindications to the Yuzpe method e.g. Schering PC4:

• Absolute contraindications include:
• history of thrombosis
• active acute porphyria
• current severe liver disease
• focal migraine at the time of presentation

• Relative contraindications include breast feeding - this is because a small amount of oestrogen may pass into the breast milk. This may result in a harmless withdrawal bleed in female baby who is breast-fed

Contraindications to the Levonorgestrel method include:

• contraindicated in pregnancy or suspected pregnancy
• this method is not suitable for women with active acute porphyria or current severe liver disease

Contraindications to Ulipristal acetate include:

• contraindicated in pregnancy or suspected pregnancy, as well as in those with a hypersensitivity to any of the excipients
• in the absence of specific studies to monitor safety, ulipristal is not recommended in those with severe hepatic impairment, nor is it recommended in women with severe asthma insufficiently controlled by oral glucocorticoids as it is not known whether ulipristal is excreted in breast milk, breastfeeding women are advised not to breastfeed for 36 hours after treatment

Hormonal emergency contraception should not be given if menstrual bleeding is overdue or if unprotected intercourse occurred more than 72 hours previously.

Notes:

• Guidance has been given regarding the use of emergency contraception and enzyme inducing drugs (1)
  • women who request oral EC while using enzyme-inducing drugs or within 28 days of stopping them, should be advised to take a total of 3 mg LNG (two 1.5 mg tablets) as a single dose as soon as possible and within 120 hours of unprotected sexual intercourse (UPSI) (use of LNG >72 hours after UPSI and double dose are outside the product licence)
  • Ulipristal acetate (UPA) is not advised in women using enzyme-inducing drugs or who have taken them within the last 28 days women should be advised that UPA has the potential to reduce the efficacy of hormonal contraception. Additional precautions are advised for 14 days after taking UPA (9 days if using or starting the POP, 16 days for Qlaira®)

Please check the respective summary of product characteristics before prescribing any of the drugs mentioned.

Reference:

• Faculty of Sexual & Reproductive Healthcare Clinical Guidance. Drug Interactions with Hormonal Contraception.Clinical Effectiveness Unit; January 2011.