Pharmacists take advice on pill afterwards

EU Commission gives drug „ellaOne“ free

01/21/2015

In the future, women across Europe can use the so-called „Pill afterwards“ also received without a prescription directly in the pharmacy. The EU Commission had the drug „ellaOne“ released with the active ingredient ulipristal acetate earlier this year to allow women a faster and anonymous access to the drug. The pharmacists are now facing a major challenge, because the free sale of the emergency drug will require more counseling and care in the future.

So far, doctor's visit and counseling session was mandatory
The "morning after pill" should in the future also be available without a prescription within the EU. The EU Commission came to this decision at the beginning of the year and follows with the release of a recommendation from the European Medicines Agency (Ema) from November last year. Unlike so far falls for women after one „prevention range“ thus a previous visit to the doctor as well as a counseling away. Instead, the patients can pick up the hormone preparation directly in the pharmacy to prevent an unwanted pregnancy.

Active ingredients inhibit or delay ovulation and thus prevent pregnancy
Accordingly, the pill is then used by medical professionals as well „emergency contraception“ referred to, because the active substances contained inhibit or delay ovulation. Therefore, if the pill is taken in time, a possible pregnancy can be prevented with high probability. To date, two drugs with different active ingredients on the market: The agent „Pidana“ contains the active substance levonorgestrel and can be taken up to 72 hours after unprotected intercourse, „ellaOne“ Ulipristal acetate, on the other hand, is effective up to five days after „accident“.

EllaOne on the market since 2009
Both pills were previously prescription, but for the newer, since 2009 on the market „ellaOne“ This prescription requirement now no longer applies after EU clearance. For many pharmacists a big challenge, because consultation and information of the patients must now be taken over by them: „This is the black Peter at the pharmacies. We can not completely check the health risks that doctors usually inform about. The hormone-based drugs can in the worst case lead to occlusions in the vessels“, so Christoph Lohstöter, owner of the Löwen pharmacy in Bad Wildungen, opposite the „Hessian / Lower Saxony general“ (HNA).

Risk of careless handling of the drug could rise
In addition to Lohstöter many other colleagues are skeptical of the release, just because it is a drug, which should be taken only in an emergency: „I explicitly do not support the release of the drug. This is not a small hormone therapy, but a means to terminate the pregnancy. This should not be handled lightly“, supplements the pharmacist of the city pharmacy in Waldeck, Ulrike Joachim, opposite the newspaper.

More counseling for young women?
However, the consulting effort would not necessarily increase, because so far, the customers have been informed prior to each drug delivery accordingly explained Ulrike Joachim on. However, according to Sabine Kelling, pharmaceutical technical assistant at the Kilian pharmacy in Korbach, it would be conceivable that especially young women could become more careless in their prevention by giving them free access to the pill. Accordingly, this target group may possibly require even more care than before. „Especially young women often make income mistakes and then come to the consultation anyway. I think it is absolutely necessary to have medical advice before taking it“, Korbacher gynecologist Tatjana Valentin-Ljolje told the HNA.

The prescription requirement will remain until spring
According to the Federal Association of Gynecologists e.V. (BVF), the pill will remain prescriptive in Germany until the spring, but the changeover to prescription freedom should, according to the presentation of the ministry, still be prescription-only „speedy“ respectively. But until then, according to the BVF, all questions about prescriptions for medication and questions of advice and documentation in the pharmacy would have to be clarified. „Both medicines for emergency contraception are highly effective medicines that of course remain outside of the emergency situation in the prescription requirement, "explains Dr. med Klaus König, vice president of the professional association of gynecologists in a press release from the association. „Pharmacies therefore have, in principle, the same duties of education and documentation as doctors in delivering these medicines, and they would have to submit to the same standards [...]“, so Dr. med. Klaus King continues. (No)