BNF for Children (BNFC) 2018-2019

Milex omniflex coil spring silicone diaphragm 85mm(Durbin Plc)

1 device.NHS indicative price = £ 10. 21 .Drug Tariff (Part IXa)

Milex omniflex coil spring silicone diaphragm 90mm(Durbin

Plc)

1 device.NHS indicative price = £ 10. 21 .Drug Tariff (Part IXa)

Silicone contraceptive pessaries

lSILICONE CONTRACEPTIVE PESSARIES

FemCap 22mm(Durbin Plc)

1 device.NHS indicative price = £ 15. 29 .Drug Tariff (Part IXa)

FemCap 26mm(Durbin Plc)

1 device.NHS indicative price = £ 15. 29 .Drug Tariff (Part IXa)

FemCap 30mm(Durbin Plc)

1 device.NHS indicative price = £ 15. 29 .Drug Tariff (Part IXa)

3.3 Contraception, emergency

Other drugs used for Contraception, emergency

Levonorgestrel, p. 508

PROGESTERONE RECEPTOR MODULATORS

Ulipristal acetate 12-Apr-2018

lDRUG ACTIONUlipristal acetate is a progesterone receptor
modulator with a partial progesterone antagonist effect.

lINDICATIONS AND DOSE

Emergency contraception

▶BY MOUTH

▶Females of childbearing potential: 30 mg for 1 dose, to be

taken as soon as possible after coitus, but no later than

after 120 hours

lCAUTIONSUncontrolled severe asthma

lINTERACTIONS→Appendix 1 : ulipristal

lSIDE-EFFECTS
▶Common or very commonBack pain.breast tenderness.
dizziness.fatigue.gastrointestinal discomfort.headaches
.menstrual cycle irregularities.mood altered.myalgia.
nausea.pelvic pain.vomiting
▶UncommonAnxiety.appetite disorder.chills.
concentration impaired.diarrhoea.drowsiness.dry
mouth.fever.flatulence.hotflush.increased risk of
infection.insomnia.libido disorder.malaise.skin
reactions.vision disorders.vulvovaginal disorders
▶Rare or very rareAbnormal sensation in eye.
disorientation.dry throat.eye erythema.genital pruritus
.ovarian cyst ruptured.painful sexual intercourse.
syncope.taste altered.thirst.tremor.vertigo

lCONCEPTION AND CONTRACEPTIONWhen ulipristal is
given as an emergency contraceptive the effectiveness of
combined hormonal and progestogen-only contraceptives
may be reduced—additional precautions (barrier methods)
required for 14 days for combined and parenteral
progestogen-only hormonal contraceptives ( 16 days for
Qlaira®) and 9 days for oral progestogen-only
contraceptives.
lPREGNANCYLimited information available when used as
an emergency contraceptive.

lBREAST FEEDINGIn emergency contraception
manufacturer advises avoid for 1 week after
administration—present in milk.

lHEPATIC IMPAIRMENT
▶When used for Emergency contraceptionManufacturer advises
avoid in severe impairment—no information available.

lPATIENT AND CARER ADVICE

▶When used for Emergency contraceptionIf vomiting occurs

within 3 hours of taking a dose, a replacement dose should

be given. When prescribing or supplying hormonal

emergency contraception, women should be advised:

.that their next period may be early or late;

.that a barrier method of contraception needs to be used

until the next period;

.to seek medical attention promptly if any lower

abdominal pain occurs because this could signify an

ectopic pregnancy;

.to return in 3 to 4 weeks if the subsequent menstrual

bleed is abnormally light, heavy or brief, or is absent, or

if she is otherwise concerned (if there is any doubt as to

whether menstruation has occurred, a pregnancy test

should be performed at least 3 weeks after unprotected

intercourse).

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Tablet

▶Ellaone(HRA Pharma UK Ltd)

Ulipristal acetate 30 mgEllaOne 30 mg tablets| 1 tabletp£ 14. 05

DT = £ 14. 05

▶Esmya(Gedeon Richter (UK) Ltd)

Ulipristal acetate 5 mgEsmya 5 mg tablets| 28 tabletP

£ 114. 13 DT = £ 114. 13

3.4 Contraception, oral

progestogen-only

Other drugs used for Contraception, oral progestogen-

onlyNorethisterone, p. 479

PROGESTOGENS

Desogestrel

lINDICATIONS AND DOSE

Contraception

▶BY MOUTH

▶Females of childbearing potential: 75 micrograms daily,

dose to be taken at same time each day, starting on day

1 of cycle then continuously, if administration delayed

for 12 hours or more it should be regarded as a‘missed

pill’

lUNLICENSED USEConsult product literature for the

licensing status of individual preparations.

lCONTRA-INDICATIONSAcute porphyrias p. 603 .history of

breast cancer but can be used after 5 years if no evidence of

disease and non-hormonal contraceptive methods

unacceptable.severe arterial disease.undiagnosed

vaginal bleeding

lCAUTIONSActive trophoblastic disease (until return to

normal of urine- and plasma-gonadotrophin

concentration)—seek specialist advice.arterial disease.

functional ovarian cysts.history of jaundice in pregnancy.

malabsorption syndromes.past ectopic pregnancy.sex-

steroid dependent cancer.systemic lupus erythematosus

with positive (or unknown) antiphospholipid antibodies

CAUTIONS, FURTHER INFORMATION

▶Other conditionsThe product literature advises caution in

patients with history of thromboembolism, hypertension,

diabetes mellitus and migraine; evidence for caution in

these conditions is unsatisfactory.

lINTERACTIONS→Appendix 1 : desogestrel

BNFC 2018 – 2019 Contraception, oral progestogen-only 507

Genito-urinary system

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