L11 Pharmacist prescribing of the ECP and OC

Under section 44(m) of the Med Regs, pharmacists can supply a prescription medication at the request of a patient in an emergency. It must have been previously prescribed by a NZ prescriber in last ❌ months. It can be 72 hours worth or the minimum ❌ size ie 1 month's for COC.

Fertility:
• Sperm survival – maximum ❌
• Egg survival – ❌
• Full suppression of ovulation with COC, if the hormone free week is extended – risk of ovulation after about ❌

Copper intrauterine device (IUD)
• The copper IUD is the most ❌ form of emergency contraception (almost 100% effective)
• Works up to ❌ days after unprotected intercourse
• Efficacy is not affected by body mass index or ❌
• Copper IUD has ❌ contraindications
• Can be left in situ to provide future contraception
• Must be fitted by an expert (GP or family planning clinic)

Emergency contraceptive pill (ECP)
• Postinor-1 is the funded brand – contains ❌
• Does not provide ❌ contraception
• may delay next period
• can cause ❌ in some users (rare)
• Efficacy is similar up to day for but only registered up to ❌

ECP Counselling…
• If adverse effects occur, generally ❌ & will subside within 24 hrs.
• Repeat the dose if ❌ within 3 hrs of taking ECP.
• Next period may be early or late.
• Increased pregnancy ❌ post-ECP as it can delay ovulation.
• Seek medical attention ASAP if any lower abdominal pain occurs b/c this could be an ectopic pregnancy.
• Perform a pregnancy test in ❌ wks, if the next menstrual bleed is abnormally light, heavy or brief, or is absent, or if she is otherwise concerned.
• Refer for STI counselling, continuous contraception, sexual assault?