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This is an archive article published on December 18, 2005

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FEW must be the number of sexually active women who haven’t experienced days of terror following unprotected intercourse or a condom rupture. Now that anxiety can become history, thanks to emergency pills (or e-pills), taken upto five days after the exposure. And that’s not all: They’re available over the counter, without prescriptions.

How is the e-pill different from the regular contraceptive pill?
The regular pill works on the principle of prevention: It releases a low dose of hormones (oestrogen and progesterone) to inhibit ovulation, without which conception cannot occur. The new pill, on the other hand, works as an interceptive agent, so it is effective upto five days after unprotected sex.

‘‘Ideally, the e-pill should be taken immediately after unprotected sexual exposure, on the outside between 72 and 120 hours,’’ says Dr Sunita Mittal, head of the department of obstetrics and gynaecology and in-charge of the WHO-supported pill trials in India.

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That would make a big difference.
The government thinks so too, believing it can help in preventing unwanted pregnancies. Says Mittal, ‘‘It is important that women have access to this option. It removes conception-related anxiety to a huge extent and also goes a long way in improving their reproductive health by preventing an undesired conception.’’

How accessible is the emergency pill?
A recent government decision makes the e-pill available on demand over the counter under the brand names EC2, Pill 72, E-Pill and Norlevo. Though the e-pill has been manufactured in India since 2001, it could be purchased only on the production of a prescription. Besides chemists, the government is also planning to social-market it. ‘‘After the government recognised the importance of the e-pill, it was decided that it should be available to women without a visit to the doctor,’’ says Dr Ashwani Kumar, drug controller-general of India.

What is the composition of the e-pill?
The e-pill comprises of a progesterone formulation called levonogrestrel. It is sold in a pack of two, in dosages of .75 mg, for a price of Rs 25 to Rs 30 (and free in government hospitals and public health clinics). Both pills need to be taken together to be effective. There are no side effects like nausea or breast tenderness, the usual fallout of the regular pill. The failure rate is 0-2.4 per cent.

Are there any conditions in which the e-pill shouldn’t be taken?
No. At the moment, there are no conditions that bar the use of the pill, including a history of severe cardiovascular complications and liver disease.

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Does the e-pill have anything in common with the abortion pill?
‘‘The e-pill prevents conception. That’s better than having an abortion later,’’ points out Dr Mittal. ‘‘Moreover, it doesn’t interfere with an existing pregnancy. So it is not effective post-implantation of the seed.’’

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