Product Brief: Caucus on New and Underused Reproductive Health Technologies- Emergency contraceptive pills

Publication date: 2011

PRODUC T BRIEF Caucus on New and Underused Reproductive Health Technologies Emergency contraceptive pills Description Emergency oral contraceptive pills are currently the most accessible, e!ective, post-coital contraceptive option. Low contraceptive-prevalence rates along with high levels of unmet need for family planning in many developing countries indicate a very high frequency of unprotected sexual relationships. As a result, many couples are at risk for an unplanned and/or unwanted pregnancy. #e most commonly available regimen involves a single dose, 1.5 mg levonorgestrel pill, which is taken up to 120 hours a$er unprotected sexual intercourse to prevent pregnancy, but is more e!ective the sooner it is taken. Also available is a two-pill regimen (0.75 mg each); both pills should be taken together, although some regimens include instructions to take one pill up to 72 hours a$er unprotected intercourse and the second one 12 hours later.1 More recently, a regimen containing 30 mg of the compound ulipristal acetate has been made available and can also be taken up to 120 hours a$er unprotected intercourse.2 Emergency contraceptive (EC) pills work mainly by either preventing or delaying ovulation; this is likely the only mechanism of action, although there is some evidence showing that they may prevent the sperm and egg from meeting by altering the cervical mucus. EC pills are more e!ective the sooner they are taken. Regular oral contraceptives taken in speci%c doses also can serve as EC. For general information on EC, visit: www. plannedparenthood.org/ec/. For a list of regular oral contraceptives that can be used for EC purposes, visit: http://ec.princeton.edu/worldwide/default.asp#country. Efficacy Depending on the formulation used and timing of use, EC can reduce a woman’s risk of becoming pregnant from a single act of intercourse between 75 and 89 percent. Current program/sector use EC is registered and available commercially in a number of countries. It is regulated as an over-the-counter or non-prescription product in many developed and developing countries. Still, many women are not aware of EC pills, and the pills o$en are not included in public-sector programs. For more information, visit: http://ec.princeton.edu/ Manufacturers/suppliers #ere are many manufacturers of EC pills. Please see the following for a list of manufacturers: http://ec.princeton.edu/questions/dedicated.html www.cecinfo.org/database/index.htm Registration status Dedicated EC pill formulations are registered in more than 140 countries. For a list of country registration, please go to the International Consortium for Emergency Contraception site at www.cecinfo.org/ database/index.htm. Public-sector price agreements Gedeon Richter, the manufacturer of Postinor-2, makes the product available to the public sector (government agencies) at a preferential price. Other manufacturers and distributors have demonstrated a willingness to provide a discounted price to public-sector agencies wishing to purchase their products. References 1 #e International Consortium for Emergency Contraception (ICEC). Policy Statement: Regimen Update. Washington, DC: ICEC; 2003. Available at: http://www.cecinfo.org/publications/ PDFs/policy/Dosage_Timing_English.pdf. 2 European Medicines Agency (EMEA)/Committee for Medicinal Products for Human Use (CHMP). CHMP Assessment Report for EllaOne. Doc.Ref.: EMEA/261787/2009. London: EMEA; 2009. This brief was last updated August 2010. For more information on the Caucus on New and Underused RH Technologies, please visit our web page at http://www.rhsupplies.org/working-groups/caucus-on-newunderused-rh-technologies.html. This publication forms part of a series of technical briefs, written by members of the Caucus on New and Underused Reproductive Health Technologies, a thematic group established under the auspices of the Reproductive Health Technologies Coalition. The Caucus’ aim is to broaden the discussion within the Coalition of reproductive health technologies that are not well integrated into the public or commercial health sectors. Responsibility for the selection and contents of the product briefs rests solely with the Caucus and does not imply endorsement by the Coalition or its wider membership. For additional information, please contact secretariat@rhsupplies.org.

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