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EC and severe asthma on steroids — DFSRH MCQ

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ModerateEmergency contraceptionEC and severe asthma on steroidsDFSRH

A 37-year-old woman with severe asthma taking oral prednisolone presents 80 hours after UPSI and declines copper IUD. She asks for ulipristal. What is the most appropriate management?

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Reveal the answer and explanation

Correct answer: E — Consider levonorgestrel and discuss reduced efficacy compared with ulipristal

Ulipristal is a progesterone receptor modulator and may be unsuitable with severe asthma treated by oral glucocorticoids. Levonorgestrel may be considered if within timing, with counselling that it may be less effective. Cu-IUD remains the most effective option if acceptable.

Reference: FSRH Emergency Contraception Guideline 2017 amended 2023; FSRH UPA breastfeeding statement 2025; BNF