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For further information, see CMDT Part 18-21: Contraception

Key Features

  • Information on clinics or individual clinicians providing emergency contraception in the United States may be obtained by calling 1-888-668-2528

  • All victims of sexual assault should be offered emergency contraception

Treatment

Medication

  • The following methods should be started within 120 h after unprotected coitus:

    • Levonorgestrel, 1.5 mg given orally in single dose

      • Has a 1% failure rate and is associated with less nausea and vomiting than ethinyl estradiol plus norgestrel

      • Available in the United States prepackaged as Plan B

    • Ethinyl estradiol, 50 mcg, with 0.5 mg norgestrel

      • Given twice in 12 hours

      • Available in the United States prepackaged as Preven

    • A comparable regimen includes four pills 12 h apart of Lo/Ovral, Nordette, or Levlen or the same regimen with the yellow pills of Triphasil or Tri-Levlen

      • Failure rate is approximately 3%

      • Anti-nausea medication should be provided

    • Ulipristal, 30 mg orally as a single dose

      • Has been shown to be more effective than levonorgestrel, especially when used between 72 and 120 hours, particularly among overweight women

      • It is available by prescription in the United States and western Europe

Intrauterine Devices

  • Copper-bearing intrauterine devices (IUDs) inserted within 5 days after one episode of unprotected midcycle coitus will prevent pregnancy

  • The disadvantage of this method is possible infection, especially in rape cases

  • The advantage is ongoing contraceptive protection if this is desired in a patient for whom the IUD is a suitable choice

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