Emergency hormonal contraception

Some medicines may only be sold when certain criteria have been met, for example, when supplying emergency hormonal contraception from a community pharmacy. 

The book deals with the minor illnesses or conditions that can be self-treated with advice and treatment from a pharmacist. Three chapters deal with medicines (Chapter 24, nicotine replacement therapy Chapter 32, emergency hormonal contraception and Chapter 2, simvastatin) that have become available without prescription within the last few years and are not treatments for illnesses but are used prophylactically or preventively. 

The book is organised into 34 chapters, arranged in 10 sections based on body systems (e.g. respiratory) or types of condition (e.g. fungal infections), plus a section dealing with women s conditions that includes a chapter on emergency hormonal contraception (Chapter 32). 

The efficacy of both the progestogen-only and combined emergency hormonal contraceptive is likely to be reduced by enzyme inducers such as rifampicin and some antiepileptics. 

Royal Pharmaceutical Society of Great BritaiiL Practice guidance ai the siqrply of emergency hormonal contraception as a pharmacy medicine. September 2004. Available at htty //www.rpsgb.org/pdfs/ehcguid.pdf (accessed 23/08/07). 

Note that antibacterials that do not induce liver enzymes do not affeet the reliability of the progestogen-only contraceptives, see Progestogen-only contraceptives + Antibacterials, p.l007, or the progestogen-only emergency hormonal contraceptive, see Emergency hormonal contraceptives + Antibacterials , p.977. 

The effeetiveness of the progestogen-only emergency hormonal contraceptive will be redueed in women taking liver enzyme indueers, see Emergeney hormonal eontraeeptives + Enzyme indueers , p.977, for further guidanee. 

The FFPRHC has issued guidance on the use of liver enzyme inducers, such as rifampicin and rifabutin, with all forms of hormonal contraceptives, including the emergency hormonal contraceptive, and these are given in detail elsewhere, see Hormonal contraceptives + Antiepileptics Barhiturates or Phenytoin , p.985. 

St John s wort may affect the pharmacokinetics of desogestrel, ethinylestradiol, and norethisterone. Both breakthrough bleeding and, more rarely, combined oral contraceptive failure have been reported in women taking St John s wort Two cases describe the failure of emergency hormonal contraception, which was attributed to the use of St John s wort... 

The CSM in the UK has received reports of 2 women taking St John s wort who became pregnant despite taking emergency hormonal contraception. One of them was also taking an oral contraceptive. ... 

See also Emergency hormonal contraceptives + Enzyme inducers , p.977 for information on how to manage the interaction with emergency hormonal contraception. 

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