Patient Checklist
| Indications |
Yes or No |
| Unprotected intercourse within 72 hours |
|
| Contraindications | |
| Suspected pregnancy: period overdue/LMP abnormal/other
UPIC since last period (do pregnancy test) |
|
| Unexplained vaginal bleeding | |
| Current breast cancer | |
| Hypersensitivity to any ingredient | |
| Severe liver disease | |
| Porphyria | |
| Precautions | |
| Excessive vomiting, diarrhoea, other causes of malabsorption
eg Crohns |
|
| Meds which reduce effectiveness: St John’s Wort Rifamycins eg rifabutin, rifampicin Antiepileptics Griseofulvin Ritonavir |
|
| Increases blood level of: Cyclosporin |
|
| Breast feeding: Take immediately after a breast feed |
|
| Instructions for use | |
| Take both tablets stat ASAP | |
| If vomits within 3 hours, need to repeat full dose |
|
| Discuss possible Side Effects: Nausea, vomiting, breast tenderness, dizziness, disturbed bleeding pattern |
|
| Follow up | |
| Pregnancy test 2-4 weeks post Especially if period is >5days late or if unusually light or heavy or severe abdomen pain (ectopic) |
|
| Discuss long term methods of contraception |
|
| Discuss STI screening and offer 2-4 weeks later with pregnancy test | |
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