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Giving Emergency Contraceptive Pills

1. Give pill (or pills)
  • She can take the pill or pills immediately.

  • If she is using a 2-dose regimen, tell her to take the next dose in 12 hours.
2. Describe the most common side effects
  • Nausea, abdominal pain, possibly others.
  • Slight bleeding or change in timing of monthly bleeding.
  • Side effects are not signs of illness and they do not last long. Most women have no side effects.
3. Explain what to do about side effects
  • Nausea:

    • Routine use of anti-nausea medications is not recommended.

    • Women who have had nausea with previous ECP use or with the first dose of a 2-dose regimen can take anti-nausea medication such as 25–50 mg meclizine hydrochloride (Agyrax, Antivert, Bonine, Postafene) 30 minutes to 1 hour before taking ECPs.
  • Vomiting:

    • If the woman vomits within 2 hours after taking progestin-only or combined ECPs, she should take another dose. If she vomits within 3 hours of taking ulipristal acetate ECPs, she should take another dose. (She can use anti-nausea medication with this repeat dose, as above.) If vomiting continues, she can take a repeat dose of progestin-only or combined ECPs by placing the pills high in her vagina.

    • If vomiting occurs more than 2 hours after taking progestin-only or combined ECPs, or 3 hours after taking UPA-ECPs, then she does not need to take any extra pills.
4. Give more ECPs and help her start an ongoing method
5. Follow-up
  • Encourage her to return for an early pregnancy test if her monthly bleeding is more than 7 days late.

"Come Back Any Time": Reasons to Return

No routine return visit is required. Assure every client that she is welcome to come back any time, however, and also if:

  • She thinks she might be pregnant, especially if she has no monthly bleeding or her next monthly bleeding is delayed by more than 7 days.
  • She did not start a continuing method immediately and now wants one.