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MHRA: Check if your patient needs a double dose of EHC

The MHRA has produced a new patient information sheet about the correct EHC dose

Women requiring the emergency contraceptive pill containing levonorgestrel may need a double dose if they are taking medication for certain conditions, the UK's medicines watchdog has reminded healthcare professionals.

Women seeking emergency contraception should tell their pharmacist if they are taking medicines to treat epilepsy, tuberculosis, HIV, or fungal infections – or are taking herbal remedies containing St John’s Wort – as these could reduce how well the pill works, the Medicines and Healthcare products Regulatory Agency (MHRA) said.

"To protect against unwanted pregnancies, women taking these medicines may need to take two packs of the emergency contraceptive in order for it to be effective," the watchdog said today (September 15).

The MHRA has produced a information sheet for pharmacists and prescribers to hand out to relevant patients, it said.

Dr Sarah Branch, deputy director of MHRA’s vigilance and risk management of medicines division, said this is "important new advice" for women who want to use the emergency contraceptive pill.

“Our new information sheet provides information on what types of medicines could interfere with how the emergency contraceptive works,” said Dr Branch. “It tells women what steps they need to take to ensure they receive the correct dose.”

Last week the Royal Pharmaceutical Society backed new guidance calling for healthcare professionals to alert women to the coil as an alternative to oral contraceptives. Read more here

What guidance do you give patients taking EHC?

J. Locum, Locum pharmacist

Can anyone explain how I can actually work with this in the community pharmacy. As far as I am aware the product licence for the OTC product has not changed so I cannot sell two packs and would refer the patient to their GP whose receptionist will probably not let the patient have an appointment within three weeks let alone three days. Telling the patient about IUD's would be good but even then five days is not time for an appointment. As for supplying under PGD, which most supplies are, that only allows me to give a second pill if there is a risk that the first dose was vomited up. Another issue which might require a double dose is BMI as there is some evidence that obese patients may recieve an inadequate dose with a single tablet. Perhaps CCG pharmacists would like to consider changes to PGD as a matter of urgency. We have concentrated on levonelle but doesn't ellaone have similar issues?

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