Pharmacists in France are now allowed to supply progestogen-only emergency contraception without prescription. The Government has delisted levonorgestrel, in the amounts required for this purpose.
Commenting on the change, the authors of an article in La Revue Prescrire (1999;19:645), an independent French bulletin on therapeutics, say that the questions pharmacists need to ask before supplying this type of emergency contraception are simple. They include an estimation of the time since unprotected intercourse, plus details of other treatments being taken concurrently (to note any enzyme inducers that might diminish effectiveness). Pharmacists also need to explain the dosage and what to do in case of vomiting within two hours of taking a dose, and should warn patients that normal menstruation may take a variable time to return. The authors also note that supplying emergency contraception is a time to counsel patients on standard methods of regular contraception.
A levonorgestrel only emergency contraception product, Norlevo, is marketed in France by HRA Pharma. Use of this new type of emergency contraception follows the reporting last year of a World Health Organisation study which showed the levonorgestrel product to be more effective and to produce fewer side effects than the standard oestrogen/progestogen regimen.
A spokeswoman for HRA Pharma said on October 5 that the company was planning to apply for European approval for Norlevo through the mutual recognition procedure. The application would be for a P licence.
In the UK, a POM licence application for a levonorgestrel emergency contraceptive has been submitted by Gedeon Richter, a Hungarian company. The product will be marketed by Schering (PJ, September 25, p476). A spokeswoman for Schering said on October 5 that the company would certainly not want to move to a P licence straight away. It believed that clinical experience of use as a POM product was needed before any action was taken to apply for a P licence.