POST-COITAL PILLS AND THEIR MOA

INJECTABLE CONTRACEPTIVES-THEIR ADVANTAGE AND DISADVANTAGE

CHOYTOO Shiksha25.05.15

CONTENTS Post coital pills

Agents Mechanism of action

Injectable contraceptives Injections Injectables Advantages Disadvantages

POST COITAL PILLS Emergency post coital pill

use in women not taking contraceptive who had sexual intercourse risking unwanted pregnancy

Reserve for unexpected or accidental exposure (rape, condom rupture) only as the have a high failure rate as compared to combined pills.

Agents Levornorgestrel

0.75 mg two doses 12 hrs apart OR 1.5 mg single dose taken as soon as possible

but 72 hrs of unprotected intercourse Ulipristal

30 mg single dose as soon as possible, but within 120 hrs of intercourse

Mifepriston 600 mg single dose taken as soon as

possible, but within 72 hrs of intercourse

MECHANISH OF ACTIONS1. Dampens LH surge preventing ovulation to occur.

2. Endometrium- hypersecretion or hyperproliferation or atrophic. Not suitable for implantation of blastocyst.

3. Uterine and tubal contraction1. Enhance transport of ovum 2. Not allow implantation for blastocyst

4. Thus, may dislodge a just implanted blastocyst or interferes with fertilization or implantation

5. Thickening of cervical mucus is the MOA of other OCP and does not apply for Emergency pills

INJECTABLE CONTRACEPTIVES

Injections Develop to obviate the use for daily

ingestion of pills. They are given I.M as oily solutions Injected once in 2-3 months depending

on the steroids and its dose. Highly effective

INJECTABLE CONTRACEPTIVES

Implants Drug delivery systems implanted

subcutaneously Steroid released slowly over a period of

5 months Biodegradable polymeric matrices Non-biodegradable rubber membranes

AGENTSInjections

DMPA- depot medroxyprogesterone acetate 150 mg at 3mths interval

deep i.m during the first 5 days of menstruation

NEE-Norethisterone enanthate 200 mg at 2 mths interval

deep i.m during the first 5 days of menstruation

Implants

Norplant 1 6 capsules containing

levornorgestrel 216 mg (5 yrs)

Norplant 2 Implanon

ADVANTAGES Highly effective against pregnancy for 2-

3 mnths Obviate daily pill ingestion Suitable for women in whom estrogen is

contraindicated May provide some protection against

cancer of the uterus and cervix and PID

DISDAVANTANTAGES Menstrual irregularities, amenorrhea Return of fertility may take up to 6-30 months

after discontinuation Permanent sterility may occur Weight gain Headache Decrease in bone density after long term use Menopause like symptoms may occur ( hot

flushes, vaginal dryness , reduced libido.

Thank you

Shiksha25.05.15