ACTA FAC MED NAISS 2014;31(3):155-161

Review article

UDC:615.256.5.03

DOI:10.2478/afmnai-2014-0019

Mechanism of Action, Efficacy and Safety of Emergency Hormonal Contraception

(levonorgestrel and ulipristal acetate) and Attitudes of Pharmacists

Jelena Milosavljević¹, Katarina Ilić², Dušanka Krajnović^1,3

¹University of Belgrade, Faculty of Pharmacy, Department of Social Pharmacy and Pharmaceutical Legislation, Serbia

²University of Belgrade, Faculty of Pharmacy, Department of Pharmacology, Serbia

³University of Belgrade, Centre for the Study of Bioethics, Serbia


SUMMARY

Emergency hormonal contraception is used to prevent unintended pregnancy postcoitally. The mechanism of action of the most frequently used hormonal preparations for emergency contraception, levonorgestrel (LNG) and ulipristal acetate (UPA), is still not fully known, but clinical trials indicate that they act by inhibiting or delaying ovulation. LNG has a long history of use for emergency contraception, proven safety and high efficacy if administered in the preovulation period. The newest emergency contraceptive, UPA, available only with a prescription, is indicated within this period of 120 hours after sexual intercourse and the data indicate that UPA does not lose efficacy within this period. Clinical trials showed its non-inferiority versus LNG and its effect on the potentially occurring pregnancy is being additionally monitored. However, many misconceptions and controversial opinions about emergency contraception are still present, even among pharmacists. A search of Medline database identified 20 papers published from January 1993 to December 2012, on pharmacists’ knowledge, attitudes and practices related to emergency contraception. In these papers, the attitudes of pharmacists pertaining to the dispensing regime of emergency contraception were different. Research in Australia has shown that personal attitudes and religious convictions influence the practice of dispensing emergency contraception. In the research conducted in New Mexico, 30% of pharmacists were against prescribing emergency contraception for religious or moral reasons. There were no published data in regards to pharmacists’ knowledge, attitudes and dispensing practice in Serbia and such research is highly recommended.

Key words: emergency contraception, levonorgestrel, ulipristal acetate, pharmacist