Levonorgestrel Emergency Contraceptive Pills

In March 2014, Health Canada issued an advisory to Canadians about decreased effectiveness of levonorgestrel-only emergency contraceptive pills (morning-after pills) in women weighing 165–176 pounds (75–80 kg), and lack of effectiveness in women weighing >176 pounds (80 kg). In May 2014, the Society of Obstetricians and Gynaecologists of Canada (SOGC) responded with a position statement that was endorsed by the Canadian Pharmacists Association (CPhA). The SOGC statement clarified that levonorgestrel-only emergency contraceptive pills may be less effective in women with a body mass index (BMI) of 25–29 and potentially ineffective in women with a BMI ≥30. However, women with a BMI ≥30 who do not have access to or do not want a copper intrauterine device (IUD) for emergency contraception should not be discouraged from using levonorgestrel-only emergency contraception, since it may still provide some benefit.

CPhA Statement
Women with a BMI ≥30 should not be discouraged from using levonorgestrel-only emergency contraception if they cannot access, or do not want, a copper IUD. Pharmacists, as medication experts and trusted health care providers, should discuss the available evidence and options with patients. Overweight patients should not be discouraged from using the pills, but they should be counseled that the medication may not be as effective.

CPhA provides health care professionals with evidence-based resources, such as e-Therapeutics, for prescribing and managing drug therapy at the point of care to ensure that all frontline practitioners have access to reliable Canadian drug and therapeutic information.