Can any birth control pill be used for emergency contraception?

February 24, 2006 7:51 PM

Last night: condom slippage. Today: want emergency backup contraception.

I know that I have 5 days to use it (though obviously the sooner, the better). I'd normally just go to my doc to get a prescription, but unfortunately he's on vacation and I can't even get through to his office to get an appointment today with another doctor in the practice. (All my calls have gone to voicemail for the last 5 hours.)

In the meantime, the information I've turned up says that the combination birth control pills that can be used are those that contain ethinyl estradiol and levonorgestrel. I have several packets of my former birth control pill (went off it last year due to side effects) containing ethinyl estradiol and norethindrone acetate. Can those be used instead? I know that the former class of pills is the only one officially approved (so far) by the FDA for emergency contraception use, but are there studies that show others might work as well?

posted by anonymous to health & fitness (42 comments total)

Are you sure you need an appointment? The doctor covering your doctor's practice will probably be happy to phone in an emergency contraception prescription without seeing you first. Try asking the receptionist, to start.
posted by equipoise at 8:03 PM on February 24, 2006

I don't understand. Where I live you can just go to a pharmacy and ask for emergency contraception. No perscription needed. I suggest you call your pharmacy.
posted by 9000.68 at 8:06 PM on February 24, 2006 [1 favorite]

You have 72 hours - 3 days, not 5. Do you have a Planned Parenthood near you? If you can get through to them, they'll probably be able to help you.
posted by dilettante at 8:07 PM on February 24, 2006

Call your local Planned Parenthood branch (assuming that you live in a part of the country lucky enough to have one). They deal with these situations (emergency contraception needed, doctor out of town or no doctor) all the time.
posted by foxy_hedgehog at 8:07 PM on February 24, 2006

If you are in the US you can call Planned Parenthood and ask for advice. I also agree that the physican covering for yours should be able to prescribe.
posted by 6:1 at 8:08 PM on February 24, 2006

Call your doctor's office and tell them what's up.

Then call Planned Parenthood and see if they can help you.

Then, if all else fails, go to the ER.

Also, when you get the prescription, get the doctor to write you a duplicate one, for future use if needed.
posted by elisabeth r at 8:09 PM on February 24, 2006

Here are some other ways to get the morning-after pill. Note: DO NOT WAIT FIVE DAYS. The website I linked to says that you have a THREE-day window, and even so, I'd get it as soon as possible.

Your doctor's office may not phone in a prescription for you--if you live somewhere where doctors are unwilling to do that, try Planned Parenthood.

My lazy google search did not reveal the right combo of birth control pills to take that will have the same effect as the morning-after pill. I'm sure that information is findable...I would just recommend putting in the extra work to get the real thing. Especially since you don't have to wait to get examined. As long as you're being careful (which I commend you for), why not make sure you're doing everything you can?
posted by equipoise at 8:09 PM on February 24, 2006

On preview...oops. Sorry.
posted by equipoise at 8:10 PM on February 24, 2006

What about Planned Parenthood?
posted by srah at 8:10 PM on February 24, 2006

Erm, oops, forgot to reload the page...
posted by srah at 8:10 PM on February 24, 2006

You can get EC in many more places than just the doctor.
http://www.getthepill.com/ if your state is supported.
posted by sian at 8:26 PM on February 24, 2006

You can probably use your regular pills. Here's a chart explaining how.
posted by desuetude at 8:31 PM on February 24, 2006

I don't understand. Where I live you can just go to a pharmacy and ask for emergency contraception. No perscription needed. I suggest you call your pharmacy.

And you live where?

ethinyl estradiol and levonorgestrel. I have several packets of my former birth control pill (went off it last year due to side effects) containing ethinyl estradiol and norethindrone acetate.

According to this plan B is 75mg of levonorgestrel. According to this page, as far as I can tell all emergency contraceptives contain levonorgestrel. According to wikipedia.
norethindrone acetate has 22.6% much Progestational activity, meaning you would have to take about 331 mg of it to have the a similar effect, although as you can see there are also androgen effects which would be different as well, and you would also be taking another hormone (which isn't even listed on the page). It's not something that I would do at all, I personally feel you would be better off just calling a hospital or planned parenthood or something that then playing amateur endocrinologist based on information on wikipedia (I'm not a doctor, obviously, and I didn't know any of this until just now)

Call a hospital, planned parenthood, etc, etc. Chances are pretty good you won't even get pregnant at all.
posted by delmoi at 8:35 PM on February 24, 2006

The sooner, the better, I hear.

Planned Parenthood will help you.

Don't mess around with using your regular pill unless you know exactly what you're doing, and by that I mean don't do it.
posted by anjamu at 8:37 PM on February 24, 2006

Hmm, according to desuetude's link you can do it. Hmm. Well good luck.
posted by delmoi at 8:39 PM on February 24, 2006

Again, Planned Parenthood, and waste no more time.
posted by Miko at 8:44 PM on February 24, 2006

If you are in Canada, go to a pharmacist -- it's over the counter. If you are elsewhere, go to Planned Parenthood.
posted by acoutu at 8:59 PM on February 24, 2006

You have 72 hours - 3 days, not 5.

The sooner you take it, the better the odds. Get it today. (Day 1 is better than Day 2 etc.)
posted by callmejay at 9:01 PM on February 24, 2006

Gyns have been explaining how to use regular pills as EC for years and years. If you don't have access to Plan B, don't sweat it. Better to get EC earlier than to wait around for the "offically licensed and marketed" version.
/personal experience not getting knocked up
posted by desuetude at 9:08 PM on February 24, 2006

In eight states you can get EC from the pharmacist without a prescription: Washington, California, Alaska, New Mexico, Hawaii, Maine, New Hampshire and Massachusetts. If you live in any of those states, you do not need to talk to your doctor, just head to the pharmacy (assuming the pharmacy carries it, and the pharmacist will give it to you; I've had no problem with Walgreens; obviously, avoid Walmart).
posted by occhiblu at 9:29 PM on February 24, 2006

Where I live you can just go to a pharmacy and ask for emergency contraception. No perscription needed.

As far as the US goes, that only applies to a handful of states. (On preview: thanks, occhiblu!)

You seem almost unconcerned at the possibility of having a kid.

Why, because the OP isn't evincing hysterical panic? The fact that she's asking about EC alone indicates she's concerned. Don't parse the tone of the post beyond that.

According to what I found on the Planned Parenthood site, EC using an increased dose of regular oral birth control (which, as desuetude says, has been done for decades) can indeed be used up to 120 hours -- i.e., 5 days -- after intercourse. (Desuetude's link looks very helpful on that score.) Plan B (the super-dose of progestin only) needs to be taken within 72 hours. So as far as using the pills she already has, she's not actually wrong.

And as for everyone telling her to go to PP immediately, let's take a minute to remember -- on the day when South Dakota banned abortion outright -- that there are entire states in the U.S. with starkly limited access to family planning, emergency contraception, abortion, etc. And let's not forget the pharmacists who take it upon themselves to refuse to fill prescriptions for emergency contraception, to boot.
posted by scody at 9:33 PM on February 24, 2006

(Oh, and reading through again, I think delmoi's actually nailed it with the difference in types of progestin being the key factor here.)
posted by scody at 9:56 PM on February 24, 2006

Don't go to the ER, they will charge you about a hundred million dollars and make you sit in line for 70 of the 72 hours. Call PP or your docs office or one of those 24 hour walk in clinics or your college health clinic or just go to the pharmacy and explain and ask them for a referral.

And get an anti-emitic while you're at it, emergency BC makes you pukey.
posted by fshgrl at 11:04 PM on February 24, 2006

Lesson learned the hard way: take emergency contraception with food or you will spend several hours feeling like someone kicked you in the gut.

Sooner is better on this kind of thing, obviously, and if you can't get through to your doctor you may want to try going to an Urgent Care facility (if you can't go directly to a pharmacist). It may mean waiting around for a few hours, but at least you'll have something in hand by morning.
posted by stefanie at 11:15 PM on February 24, 2006

Yes, definitely emergency pills make you incredibly nauseated. Totally worth it, of course, but don't schedule anything more than necessary for those three (?) days you're taking the increased dose.
(It may be less than three - this was a while ago, but 3 days stands out for me)
posted by Iamtherealme at 1:03 AM on February 25, 2006

I was in this situation and simply reported to my local WalGreens drugstore where a program was in place to provide the drug after a brief consulation. There were no major side effects and it didn't cost all that much.
posted by scarabic at 1:18 AM on February 25, 2006

http://ec.princeton.edu/

or

1-800-NOT2LATE

to find an emergency contraception provider near you (in the US or Canada)
posted by falconred at 2:17 AM on February 25, 2006

Derail... but only a slight one. For everyone who is suggesting Planned Parenthood (which is an excellent option)... they can really use your donations right now. Also, in some states you can request EC online from your local PP affiliate.
posted by kimdog at 3:49 AM on February 25, 2006

All of those 3 days in the 3 day window are not created equal--the sooner you use EC, the more likely it will work.
posted by availablelight at 5:02 AM on February 25, 2006

It's a good idea to be prepared for nausea, but you may not experience it. When I used Plan B I could detect no side effects at all. Apparently it affects about 30% of people.
posted by Miko at 8:05 AM on February 25, 2006

If it's really "The sooner the better" then wouldn't she be better off taking a large dose of her old birth control then trying to get over the counter EC
posted by delmoi at 8:14 AM on February 25, 2006

My Plan B was half of one month's supply of my BC pill. This at a time when contraception was illegal in Ireland (Yes I said illegal), administered by my boyfriend, a med student after he's researched it.
If it is difficult to get to PP, try it as speed is important here. Good luck
PS double check the expiry date of your batch, you say you haven't used them in a while but they may have been produced years before you bought them.
posted by Wilder at 8:17 AM on February 25, 2006

Here's what Wikipedia says:

Emergency contraceptive pills (ECPs), are an oral drug containing high doses of the same hormones found in regular oral contraceptive pills, which, when taken after unprotected sexual intercourse, may prevent pregnancy from occurring.

There are several mechanisms of action by which such drugs may work. Depending on the time during the menstrual cycle that they are taken, this drug may inhibit or delay ovulation, inhibit tubal transport of the ovum or sperm cell, interfere with fertilization, or, in cases where it fails to prevent fertilization, prevent implantation. In this respect, emergency contraceptive pills work by triggering the same hormonal changes in the body as regular birth control pills or even breastfeeding — but they require much higher doses and are less effective than ongoing hormonal contraceptives.

The phrase "morning-after pill" is a misnomer that is falling out of use due to the fact they are licensed for use up to 72 hours after sexual intercourse. Emergency contraception or "emergency contraceptive pills" is the phrase preferred by the medical community. Unlike forms of chemical abortion such as Mifepristone, emergency contraception does not end pregnancies and will not harm a developing embryo.


_____


Some folks still think it's abortion, but it's a tough call. Good luck with finding the right path.
posted by parallax7d at 8:28 AM on February 25, 2006

Some folks still think that the regular pill is abortion.

falconred's Princeton link is great.
posted by librarina at 8:48 AM on February 25, 2006

And, anonymous: good luck.
posted by librarina at 8:48 AM on February 25, 2006

Local college or university health services offices may be able to help. If there's a big state university near you, give them a call.
posted by Coffeemate at 9:48 AM on February 25, 2006

Some folks still think it's abortion, but it's a tough call.

It's her body, it's her business, and it's legal. Who cares what "some folks" think.
posted by Flakypastry at 12:26 PM on February 25, 2006

Coincidentally, BitchPhd's site just linked to more info on using BC as EC. More brands listed here at Planned Parenthood than at the site linked above.
posted by occhiblu at 1:15 PM on February 25, 2006

Also from that Planned Parenthood link:

With a regular 28-pill birth control pack, use any of the first 21 pills for emergency contraception. Don't use the last seven pills in a 28-day pack. They are only reminder pills that contain no hormones. With Enpresse, use only the orange ones. With Triphasil or Tri-Levlen, use only the yellow ones. With Trivora, use only the pink ones.

Swallow the pills in the first dose as soon as possible, up to 120 hours — five days — after having unprotected sex. If you are using combined-hormone pills, you may want to take a medication to reduce nausea, such as Dramamine® or Bonine®.

If you are taking the pills in two doses, swallow the second dose 12 hours after taking the first dose. If you threw up after the first dose, be sure to use an anti-nausea medication one hour before taking the second dose. Or you may want to take the second dose as a vaginal suppository by inserting the pills with your fingers as high into the vagina as you can reach. (The medication will be absorbed through the vaginal tissue.)

If you vomit the second dose, do not take any extra pills. They probably won't reduce the risk of pregnancy any further.
posted by occhiblu at 1:16 PM on February 25, 2006

EC works within FIVE days.

There have been conversations among health and advocacy groups over how public to be about that, since they want to encourage people to get it sooner (the earlier you use it, the more effective it is.)
posted by crabintheocean at 4:52 PM on February 25, 2006

It's a good idea to be prepared for nausea, but you may not experience it. When I used Plan B I could detect no side effects at all. Apparently it affects about 30% of people.

If you are in that 30 percent who gets violently ill, please resist the urge to not take the second pill in the set. If you follow the directions exactly, you are giving yourself the best chance possible for the medication to work. You may want to have some gatorade or another electrolyte replacement drink on hand before you take this. In my personal experience, I became absolutely incapacitated with nausea and vomiting 2 hours after taking the pill. I threw up so much that I was getting dehydrated, so I had to drink a lot of gatorade. You will throw that up too, but some will get into your system and make it at least a teensy bit tolerable. Being dehydrated on top of feeling like your stomach is going to come out of your mouth makes it 100 times worse. The nausea wore off in a few hours, but by that time it was time to take the next pill, and it happened again. I missed a day of work, so you may want to take off of work or rethink any obligations you might have tomorrow just in case this happens to you. Also, if by some chance you throw the pill up in the first 20 minutes after taking it, you have to call the doctor. Very very important. Also , be prepared for a very strange menstrual cycle after this; don't freak out right away if it's really different, but make sure you do take a test or go back to the doctor if you haven't started.

Also, a personal note; I needed to take the pill because I was on some medication that could potentially cause birth defects, and we had an accident exactly like yours, so I took the EC. I was very scared after I did this that I affected my fertility ( I don't know why but I was very upset). I was able to conceive when we wanted to a few months later and I now have a healthy son.

If you want to email me, my email is in the profile. Good luck and I hope you are getting through this ok.
posted by Emperor Yamamoto's Eggs at 6:33 PM on February 25, 2006

EC works within FIVE days.

There have been conversations among health and advocacy groups over how public to be about that, since they want to encourage people to get it sooner (the earlier you use it, the more effective it is.)

Just to add, the above is exactly what my doctor told me when I came in; you do have 5 days but it is less effective the later it is taken.
posted by Emperor Yamamoto's Eggs at 6:38 PM on February 25, 2006