Emergency Contraception Products Research Articles

Population Geography and Emergency Contraception Access in Louisiana.

We assessed the same-day availability of oral emergency contraception (EC) in five Louisiana communities, and evaluated this data for relationships between availability and local population demographics. Researchers called all retail pharmacies in five municipalities of varying sizes in order to inquire about the same-day stockage of EC products and their availability to teens. Individual pharmacies were then geolocated to a census tract, and call data was analyzed against neighborhood census data regarding population size, income, gender, race, family structure, and educational level. A multivariable logistic regression model was performed to predict the same-day availability of emergency contraception. EC was available on the same day in 66% of all pharmacies. The same-day availability of EC decreased with the local population size (p < 0.001), and the availability increased with higher levels of educational attainment (p = 0.0015). The largest census level predictor of access to same-day EC was the city population, with the availability increasing by 6.6% for every 10,000 person increase in population. Despite changing to over-the-counter sales in 2013, EC is still not widely available in all geographic areas. Its availability is partially predictable by local population demographics, and this difference may represent a health disparity for teens and women seeking EC.

Emergency contraception in Jordan: Assessing retail pharmacists’ awareness, opinions, and perceptions of need

ObjectivesJordan has a robust contraceptive method mix in both the public and private sectors and oral contraceptive pills and the copper-T intrauterine device are widely available. However, Jordan remains one of only a few countries in the world without a registered dedicated product for emergency contraception (EC). We aimed to explore retail pharmacists’ knowledge of and attitudes toward EC in six Jordanian governorates. Study designIn 2016, we conducted 100 structured interviews with pharmacists in both urban and rural areas regarding their EC knowledge and provision practices. We interviewed representatives from both chain and independently-owned pharmacies in purposively selected areas of the country. We analyzed interviews for content and themes using deductive and inductive techniques. ResultsOur findings reveal a lack of knowledge of all EC modalities as well as misinformation about effectiveness and protocols for use. However, after describing dedicated progestin-only EC pills, study participants expressed tremendous enthusiasm for a dedicated product and the overwhelming majority indicated that they would stock EC pills if and when they were registered. ConclusionThe private sector plays a major role in contraceptive service delivery in Jordan. Although pharmacists are not well-versed in post-coital contraception they appear interested in incorporating EC pills into the contraceptive method mix. Redoubling efforts to register a dedicated progestin-only EC pill and supporting initiatives to educate pharmacists about how to use available technologies as EC appear warranted. ImplicationsLack of access to emergency contraception has significant implications for women, in general, and refugee and displaced populations in particular. Supporting efforts to incorporate EC pills into the contraceptive mix in Jordan is a first step in supporting adherence to global standards of care and could help address unmet contraceptive needs.

Emergency Contraception Counseling in California Community Pharmacies: A Mystery Caller Study.

This study was conducted to determine which emergency contraception (EC) methods are offered by community pharmacists in response to patient calls. Female mystery callers called all community pharmacies in two California cities using standardized scripts. The callers inquired about options available to prevent pregnancy after sex and whether that method was available at the pharmacy, using follow-up probes if necessary. A total of 239 calls were completed in San Diego (n = 127, 53%) and San Francisco (n = 112, 47%). Pharmacists indicated availability at most sites (n = 220, 92%) with option(s) reported as levonorgestrel only (LNG; n = 211, 88.3%), both ulipristal acetate (UPA) and LNG (n = 4, 1.6%), UPA only (n = 1, 0.4%), or non-specific EC (n = 4, 1.7%). Nineteen pharmacies (7.9%) did not have EC available on the day of the call. Following additional probing, some pharmacists discussed UPA (n = 49, 20.5%) or the copper intrauterine device (n = 1, 0.4%) as EC options. LNG EC products were available same-day in 90.1% of pharmacies, whereas UPA was available same-day in 9.6% of pharmacies. The majority of pharmacies called in this study offered and stocked at least one EC option, but the focus of discussions was on LNG and matched what was in stock and available.

Single-Dose Levonorgestrel Emergency Contraception and Silent Barriers to Its Access: Is It Really Just One Step?

Single-dose levonorgestrel has been legally available over the counter in the United States without age restriction since 2013. The objective of this study was to discover if there are barriers to access and to determine if such barriers vary based on the gender of the person making the purchase. A male and female caller contacted 146 Richmond, Virginia pharmacies listed on the Plan B One Step® website. Ultimately, these callers interviewed 90 pharmacies via phone and used a rehearsed standardized script to ask eight questions regarding emergency contraception (EC) in relation to availability, age restrictions, parental consent, counseling requirements, and a male's ability to purchase the product. The statistical data were analyzed using Fisher's exact test. Pharmacy employees provided incorrect information to both men and women regarding age restrictions for purchasing Plan B One Step 51% of the time. However, only seven of the pharmacy employees counseled that males were unable to purchase the medication. Both callers received correct information regarding parental consent and in-store counseling at the time of purchase. Pharmacy technicians provided the majority of information, and the male caller was more likely to be transferred to another person when requesting the medication (9 vs. 0 transfers for the male and female callers, respectively). Given the inconsistent data provided to the public regarding the purchase of EC, clinicians are obligated to convey accurate up-to-date information to patients about emergency contraceptive products as part of their counseling and should not assume that consumers receive accurate information when inquiring about over-the-counter EC.

For emergency contraception, political gaps are not scientific gaps.

Emergency contraception (EC) is the only opportunity for women to prevent an unwanted pregnancy after unprotected intercourse. Simple compassion for women who are in this situation combined with solid scientific data to support the safety of oral EC should be enough to promote strategies to expand access to these medications as well as the most effective method of EC, the copper IUD. A wide array of women's healthcare organisations promote increasing EC access to improve clinical care, a position clearly supported by the four foundations of biomedical ethics: autonomy, nonmaleficence, beneficence, and justice. Ironically, in the political sphere, conservative morals are the foundation for limiting access, despite the conflict with scientific evidence. In this issue, Drs. Cameron, Li, and Gemzell-Danielson present an opportunity for clinicians to review the data behind public and scientific oral EC controversies. These controversies can easily be divided into two groups. The first group contains issues that despite scientifically sound evidence remain controversial because of religious and political opposition. In essence, these issues are not scientifically controversial. Contention exists only because EC provides greater reproductive autonomy and thus clashes with conservative sexual values, which aim to shame women having sex for pleasure and not for procreation. Limiting effective methods of post coital contraception supports this position and limits women's sexual freedom. This scientifically uncontroversial group includes the oral EC mechanism of action, excellent safety, lack of population effect, and inability to serve as an abortifacient. The second group contains topics where scientific evidence is lacking or imperfect. This group includes the potential decrease in progestin containing contraception efficacy when initiated with ulipristal, methods to manage the potential negative effect of obesity on EC efficacy, and whether the oral EC mechanism of action is important to users. Ironically, despite sound evidence, it is this first group which forms the foundation for opposition to implementing EC best practices. As scientists and clinical researchers have done their work here, this realm is now the work of policy experts, advocates, and politicians. There are many examples of politics influencing good clinical care, which for oral EC means improving access and affordability. Inexpensive over the counter (OTC) availability of oral EC is the target for advocates and politicians on both sides. Whereas oral levonorgestrel and ulipristal EC products are available OTC in Europe, a long political battle has been waged on this issue in the USA, where OTC ulipristal is not even on the horizon. However, promoting regulatory approval is not enough. Politics can also support pharmacists who refuse women access to EC or prevent this behaviour. Sexual assault victims are a critical group in need of EC and several entities have passed legislation mandating offering EC when these women present for medical care. Finally, EC coverage can be mandated or restricted through private and government-sponsored medical coverage. In the USA, a Supreme Court decision enables private companies to forego EC insurance coverage for employees based on moral beliefs even though the court has acknowledged these are not scientifically valid. In areas of medical controversy, scientific evidence and biomedical ethics can lead both clinicians and policy makers in the right direction. In this case the road clearly leads to increasing EC access and affordability. Dr Turok reports grants and personal fees from Teva pharmaceuticals, outside the submitted work. Teva distributes the Paragard copper IUD, a method of emergency contraception. The ICMJE disclosure form is available as online supporting information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Committee Opinion No 707: Access to Emergency Contraception.

Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

Committee Opinion No. 707 Summary: Access to Emergency Contraception.

Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

Role of the community pharmacist in emergency contraception counseling and delivery in the United States: current trends and future prospects.

Women and couples continue to experience unintended pregnancies at high rates. In the US, 45% of all pregnancies are either mistimed or unwanted. Mishaps with contraceptives, such as condom breakage, missed pills, incorrect timing of patch or vaginal ring application, contraceptive nonuse, forced intercourse, and other circumstances, place women at risk of unintended pregnancy. There is a critical role for emergency contraception (EC) in preventing those pregnancies. There are currently three methods of EC available in the US. Levonorgestrel EC pills have been available with a prescription for over 15 years and over-the-counter since 2013. In 2010, ulipristal acetate EC pills became available with a prescription. Finally, the copper intrauterine device remains the most effective form of EC. Use of EC is increasing over time, due to wider availability and accessibility of EC methods. One strategy to expand access for both prescription and nonprescription EC products is to include pharmacies as a point of access and allow pharmacist prescribing. In eight states, pharmacists are able to prescribe and provide EC directly to women: levonorgestrel EC in eight states and ulipristal acetate in seven states. In addition to access with a prescription written by a pharmacist or other health care provider, levonorgestrel EC is available over-the-counter in pharmacies and grocery stores. Pharmacists play a critical role in access to EC in community pharmacies by ensuring product availability in the inventory, up-to-date knowledge, and comprehensive patient counseling. Looking to the future, there are opportunities to expand access to EC in pharmacies further by implementing legislation expanding the pharmacist scope of practice, ensuring third-party reimbursement for clinical services delivered by pharmacists, and including EC in pharmacy education and training.

Emergency Contraception in Post-Conflict Somalia: An Assessment of Awareness and Perceptions of Need.

In conflict-affected settings such as Somalia, emergency contraception (EC) has the potential to serve as an important means of pregnancy prevention. Yet Somalia remains one of the few countries without a registered progestin-only EC pill. In 2014, we conducted a qualitative, multi-methods study in Mogadishu to explore awareness of and perceptions of need for EC. Our project included 10 semi-structured key informant interviews, 20 structured in-person interviews with pharmacists, and four focus group discussions with married and unmarried Somali women. Our findings reveal a widespread lack of knowledge of both existing family planning methods and EC. However, once we described EC, participants expressed enthusiasm for expanding access to post-coital contraception. Our results shed light on why Somalia continues to be a global exception with respect to an EC product and suggest possible politically and culturally acceptable and effective avenues for introducing EC into the health system.

Practice Bulletin Summary No. 152: Emergency Contraception.

Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (1-3). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (4-6). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers.

Practice Bulletin No. 152: Emergency Contraception.

Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers.

Physical and mental development of children after levonorgestrel emergency contraception exposure: a follow-up prospective cohort study.

Levonorgestrel (LNG), a dedicated emergency contraception (EC) product, has been available over-the-counter in China for more than 14 yr. Although LNG-EC is considered to have no effects on the developing fetus if the contraceptive fails and pregnancy occurs, there have been a few studies specifically examining this issue. The purpose of this study was to compare the physical and mental development of children born after LNG-EC failure with that of a cohort of children born to mothers with no history of exposure to LNG or any teratogenic substances. A group of 195 children who were exposed to LNG-EC during their mothers' conception cycle (study group) were matched to a group of 214 children without exposure to LNG (control group). The physical and mental development of the children were evaluated and compared over a 2-yr period. There were four congenital malformations in the study group and three in the control group (2.1% vs. 1.4%, respectively, P > 0.05). Over the 2-yr follow-up period, there were no statistically significant differences between the two groups with respect to children's weight, height, head circumference, and intelligence scores, and the values of all parameters of both groups were similar to those of the national standards. In summary, LNG-EC has no effect on the physical growth, mental development, or occurrence of birth defects in children born from pregnancies in which EC failed.

Emergency contraception in a country with restricted access to contraceptives and termination of pregnancy, a prospective follow‐up study

Poland has a restrictive abortion law. Emergency contraception (EC) is expensive and available only on prescription, which is not easily obtainable in public health care. We aimed to identify the main reasons for EC requests, observed failure rates and the type and incidence of adverse effects. Prospective single-center observational study. A cohort of women living in Warsaw, who requested EC. Data were collected via a questionnaire completed by healthcare providers prescribing EC, and included age, date of the request, previous EC use, time from intercourse to clinic visit and day of menstrual cycle on which intercourse took place. Reason for EC request, time lapse between unprotected intercourse and EC use, age of women requesting EC, reported cases of pregnancy. A total of 4655 women requested EC. Of these 62.9% (n=2928) were ≤25years old. During follow up, 0.75% (31 individuals) became pregnant. Adverse effects of hormonal EC were rare and mild. The main reason for requesting EC was problems associated with condoms (63.2%, n=2609). The mean interval between unprotected intercourse and EC use was 21.2h, but 26.7h when EC failed (n.s.). Considering intake within and after 24h, the difference was significant (p<0.05). Women living in Warsaw seeking EC used the EC product very soon after unprotected intercourse, and this was probably one of the most important reasons for the low pregnancy rates in the studied population.

Age, sale restrictions lifted for Plan B One-Step

the proper amendments with FDA. In a June 12 memorandum, Judge Edward R. Korman of the Eastern District of New York ruled that the Obama administration’s proposal was suffi cient to comply with his order “to make levonorgestrel-based emergency contraceptives available without a prescription and without point-of-sale or age restrictions.” The ruling ended a lawsuit brought in 2005 by organizations and individuals concerned with women’s health, as well as minors and their parents, to challenge FDA’s denial of a 2001 citizen petition seeking OTC access to Plan B for all ages. As things stood before the new developments, Plan B was OTC only for women aged 17 years and older if purchased at a pharmacy with government-issued proof of age; Plan B— which consists of two doses—is no longer marketed, but generic versions of Plan B are available. Plan B One-Step, approved by FDA in 2009, was only OTC subject to the same requirements until the agency decided on April 30, 2013, to make Plan B One-Step available OTC for women aged 15 years and older, just 1 day before the administration fi led a notice of appeal and a motion to stay the judge’s April order.

Access increases for emergency contraception

Headlines, confusion, and ongoing debate have surrounded the status of Plan B and other emergency contraception products. Many other countries have approved levonorgestrel to be sold OTC without age restrictions; however, restrictions continue to be enforced in the United States.1.Grimes D.A. Switching emergency contraception to over-the-counter status.N Engl J Med. 2002; 347: 846-849Crossref PubMed Scopus (39) Google Scholar In 2011, Teva, the manufacturer of Plan B One-Step (levonorgestrel), applied for OTC status without age restrictions and was denied.2.Belluck P. Judge strikes down age limits on morning-after pill.www.nytimes. com/2013/04/06/health/judge-orders-fda-tomake-morning-after-pill-available-over-thecounter-for-all-ages.html?pagewanted=allDate: 2013Google Scholar Despite this setback, recent events show a trend toward increasing access. April 5, 2013. A federal judge ordered FDA to remove age and sale restrictions on levonorgestrel-based products. This was in response to a lawsuit requesting expanded access so that all women could purchase the products without a prescription. The judge called for FDA to take action within 30 days of the ruing.2.Belluck P. Judge strikes down age limits on morning-after pill.www.nytimes. com/2013/04/06/health/judge-orders-fda-tomake-morning-after-pill-available-over-thecounter-for-all-ages.html?pagewanted=allDate: 2013Google Scholar■Plan B One-Step (levonorgestrel) has been approved to be sold without a prescription to women 15 years or older.■The product will be sold OTC and can be purchased by patients after showing a valid form of identification. ■Plan B One-Step (levonorgestrel) has been approved to be sold without a prescription to women 15 years or older.■The product will be sold OTC and can be purchased by patients after showing a valid form of identification. April 30, 2013. FDA announced approval of Plan B One-Step without a prescription for women 15 years or older. This approval applies to an amended application submitted by Teva and was not related to the judge’s ruling. Therefore, this approval applies to Plan B One-Step only.3.Food and Drug AdministrationFDA approves Plan B One-Step emergency contraceptive without a prescription for women 15 years of age and older.www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm350230.htmDate: 2013Google Scholar May 1, 2013. The Justice Department filed a notice of appeal on the judge’s ruling, but FDA’s approval of Plan B One-Step is not affected by the appeal.4.Brusk S. Carter C.J. Justice Department appeals morning-after pill ruling.www.cnn.com/2013/05/01/health/morning-after-pill/index.htmlDate: 2013Google Scholar As of May 13, 2013, Plan B One-Step has been approved to be sold without a prescription to women 15 years or older. The product will be coded to prompt the cashier to verify the buyer’s age with a form of identification such as a driver’s license, passport, or birth certificate. The labeling will state: "Not for sale to those under 15 years of age *proof of age required* not for sale where age cannot be verified." To obtain approval, Teva submitted study data showing that women 15 years or older demonstrated an understanding that emergency contraception is not for routine use and does not prevent against sexually transmitted infections (STIs).3.Food and Drug AdministrationFDA approves Plan B One-Step emergency contraceptive without a prescription for women 15 years of age and older.www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm350230.htmDate: 2013Google Scholar A simulation study of women aged 11 years to 17 years showed that 91.5% were able to use emergency contraception appropriately based on the product label.5.Raine T.R. Ricciotti N. Sokoloff A. et al.An over-the-counter simulation study of a singletablet emergency contraceptive in young females.Obstet Gynecol. 2012; 119: 772-779Crossref PubMed Scopus (14) Google Scholar FDA also completed a postmarketing analysis of adverse events in patients aged 15 years to 17 years. Serious adverse events were reported in three cases only. Based on these findings, FDA concluded that no evidence of safety concerns existed for use of levonorgestrel in this population.6.Food and Drug AdministrationPediatric postmarketing adverse event review.www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/PediatricAdvisoryCommittee/UCM288775.pdfDate: 2013Google Scholar One concern raised about increasing access to emergency contraception is that it will lead to decreased use of other methods (e.g., condoms), thereby increasing pregnancy rates and STIs. A trial randomized participants to (1) a group that received Plan B to keep at home or (2) a group that would need to go through the standard process for obtaining emergency contraception. Similar pregnancy rates were seen in both groups, and no difference in incidence of STIs was observed.7.Raymond E.G. Stewart F. Weaver M. et al.Impact of increased access to emergency contraceptive pills: a randomized controlled trial.Obstet Gynecol. 2006; 108: 1098-1106Crossref PubMed Scopus (82) Google Scholar Emergency contraception will become available OTC to women 15 years or older and possibly to women of all ages, pending the court’s decision. After Teva repackages Plan B One-Step, it will move from behind the counter to the OTC aisles, where patients can purchase it with or without pharmacist consultation.

Nova Scotia pharmacists' knowledge of, experiences with and perception of factors interfering with their ability to provide emergency contraceptive pill consultations

The objective of this research was to explore pharmacists' knowledge of, experiences with and perception of factors interfering with their ability to provide non-prescription emergency contraceptive pill consultations in the Canadian province of Nova Scotia. A self-administered paper questionnaire was mailed, using Dillman's tailored design method, to all pharmacists (n = 1123) registered with the Nova Scotia College of Pharmacists. The response rate was 53.0% (595/1123), with 451 respondents working in community practice. Most respondents reported that they had provided consultations for the emergency contraceptive product Plan B since it became available without a prescription (93.6%), and that Plan B is kept behind the pharmacy counter (83.6%). Pharmacists most frequently (47.8%) reported spending 6-10 min providing Plan B consultations. Respondents were generally knowledgeable about Plan B; however, only 39.2% knew that it can be effective for up to 5 days and 69.3% knew that the incidence of vomiting is less than 50%. The factors interfering the most with providing Plan B consultations were lack of privacy (46.1%) and lack of staff to cover during the consultation (50.9%). In general, Nova Scotia pharmacists are knowledgeable about emergency contraceptive pills; however, education regarding effective timing for use of such pills would be helpful. Private areas for counselling and consideration of pharmacy staffing schedules in community pharmacies may help address pharmacist concerns regarding their ability to provide Plan B consultations.

Committee Opinion No. 542

Emergency contraception includes contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to access to emergency contraception remain. The purpose of this Committee Opinion is to examine the barriers to the use of oral emergency contraception methods and to highlight the importance of increasing access.

Requests for emergency contraception in community pharmacy: An evaluation of services provided to mystery patients

BackgroundRequests for supply of the emergency contraceptive pill (ECP) through community pharmacies require consideration of a range of factors and the application of professional judgment. Pharmacists should therefore be able to follow a structured reasoning process. ObjectivesThe research involved an assessment of history taking and counseling by pharmacy staff through mystery patient emergency contraception product requests. MethodsTwo challenging ECP request case scenarios were developed with assessment tools. Mystery patients were trained to present the scenarios to pharmacies. A project information package and expression of interest form was posted to 135 pharmacies in the Gold Coast, Australia; 23 (17%) pharmacies agreed to participate. ResultsPharmacy staff was exposed to 1 of 2 scenarios during December 2010. Staff interactions were recorded, analyzed, and rated to evaluate the management of ECP requests. The results identified practice gaps among pharmacy staff with respect to information gathering and the provision of advice. ConclusionOngoing training is required to enhance the skills, competence, and confidence of pharmacy staff in managing complicated requests for nonprescription medicines, such as the ECP. The impact of time pressures and financial burdens on the provision of pharmaceutical services needs to be acknowledged.

Updates in Hormonal Emergency Contraception

In recent years, there have been many updates in hormonal emergency contraception. Levonorgestrel emergency contraception has been available for several years to prevent pregnancy when used within 72 hours after unprotected intercourse or contraceptive failure, and it was recently approved for nonprescription status for patients aged 17 years or older. Current research suggests that the primary mechanism of action is delaying ovulation. Ulipristal is the newest emergency contraception, available by prescription only, approved for use up to 120 hours after unprotected intercourse or contraceptive failure. The primary mechanism of action is delaying ovulation. When compared with levonorgestrel emergency contraception, ulipristal was proven noninferior in preventing pregnancy. Evidence suggests that ulipristal does not lose efficacy from 72-120 hours; however, more studies are warranted to support this claim. Many misconceptions and controversies about hormonal emergency contraception still exist. Research does not support that increased access to emergency contraception increases sexual risk-taking behavior. Several studies suggest that health care providers, including pharmacists, could benefit from increased education about emergency contraception. It is important for pharmacists to remain up-to-date on the most recent hormonal emergency contraception products and information, as pharmacists remain a major point of access to emergency contraception.

Beware of Fake Emergency Contraceptive Products

The FDA has warned consumers that an over-the-counter emergency contraceptive labeled as Evital with claims to work as a “morning after pill” has not