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EC and vomiting after dose — DFSRH MCQ

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ModerateEmergency contraceptionEC and vomiting after doseDFSRH

A 18-year-old vomits 90 minutes after taking levonorgestrel EC supplied by a pharmacy. She presents the same day, is well hydrated and declines Cu-IUD. What is the most appropriate management?

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Correct answer: A — Repeat the levonorgestrel dose as soon as possible

The best answer is “Repeat the levonorgestrel dose as soon as possible”. Vomiting within 3 hours of oral emergency contraception may prevent adequate absorption, so levonorgestrel should be repeated as soon as possible when a copper IUD is declined. Antiemetic assessment may be appropriate if vomiting persists. A later pregnancy test remains important when indicated, but waiting to test or starting CHC does not replace the missed emergency-contraception dose.

Reference: CoSRH/FSRH, Emergency Contraception (amended July 2023): https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-emergency-contraception03dec2020-amendedjuly2023-11jul.pdf