• When pills specially packed for emergency contraception are available as supplied in the New Emergency Health Kit 98, or when high-dose pills containing 0.5 mg ethinylestradiol and 0.25 mg of levonorgestrel are available:
  

  • two pills should be taken as the first dose as soon as convenient but no later than 72 hours after the rape. These should be followed by two more pills 12 hours later.
     

• When only low-dose pills containing 0.3 mg ethinylestradiol and 0.15 mg of levonorgestrel are available:
  

  • four pills should be taken as the first dose as soon as convenient but no later than 72 hours after the rape. These should be followed by four more pills 12 hours later.
     

• Emerging data indicate that alternative hormonal regimes consisting of levonorgestrel-only pills are equally effective and have significantly fewer side effects. When pills containing 0.75 mg levonorgestrel are available:
  

  • one pill should be taken as the first dose as soon as convenient but no later than 72 hours after the rape. This should be followed by another pill 12 hours later.
     

Managing Side Effects
Nausea occurs in about 50 per cent of clients using combined ECPs and 25 per cent for those using levonorgestrel only. Taking the pills with food may reduce nausea. Routine prophylactic use of anti-emetics is not recommended in settings with limited resources. If vomiting occurs within two hours of taking ECPs, repeat the dose.

Contra-indications
There are no known medical contraindications to the use of ECPs. The dose of hormones used in ECPs is relatively small and the pills are used for a short time. Contraindications associated with continuous use of hormonal contraceptives do not apply.

ECPs should not be given if there is a confirmed pregnancy. ECPs may be given when pregnancy status is unclear and pregnancy testing is not available, as there is no evidence of harm to the woman or to an existing pregnancy.
 

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