Aftera

• Tell all of your health care providers that you take this medicine. This includes your doctors, nurses, pharmacists, and dentists.
• This medicine does not stop the spread of diseases like HIV or hepatitis that are passed through blood or having sex. Do not have any kind of sex without using a latex or polyurethane condom. Do not share needles or other things like toothbrushes or razors. Talk with your doctor.
• This medicine will not end a pregnancy.
• This medicine is not for regular use to prevent pregnancy.
• Use birth control that you can trust to prevent pregnancy.
• If your period is delayed for more than 7 days, talk with your doctor.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Use Aftera as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Take this medicine within 72 hours after unprotected sex. Take it as soon as you can.
• If you throw up within 2 hours of taking Aftera, you may need to take 1 more dose. Call your doctor right away.

What do I do if I miss a dose?

• Call your doctor to find out what to do.
• Do not take 2 doses at the same time or extra doses.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Very bad belly pain.

Intrauterine System (IUS):
-Insert 1 IUS (13.5 mg or 52 mg) during the first 7 days of the menstrual cycle or immediately after a first trimester miscarriage or abortion
-Duration of therapy: Mirena(R): 5 years; Liletta(R) and Skyla(R): 3 years

Comments:
-Postpone postpartum insertion and insertions following second trimester abortions a minimum of 6 weeks or until the uterus is fully involuted; if involution is delayed, wait until it is complete before insertion.
-If not inserted during first 7 days of menstrual cycle, abstinence or a barrier method should be used for 7 days following insertion; if using continuous hormonal contraception, discontinue method 7 days after IUS insertion.
-IUS should be replaced after 5 years [Mirena(R)] or 3 years [Skyla(R) and Liletta(R)] if continued use is desired.

Uses:
-Liletta(R) and Skyla(R): Prevention of pregnancy for up to 3 years
-Mirena(R): Prevention of pregnancy for up to 5 years in women who have had at least 1 child; Treatment of heavy menstrual bleeding

Emergency Contraception:
-One tablet of 1.5 mg orally once or two tablets of 0.75 mg orally, taken 12 hours apart

Comments:
-Doses should be taken as soon as possible within 72 hours after unprotected intercourse or known/suspected contraception failure.
-If vomiting occurs within 2 hours of taking either dose, consider repeating the dose.
-Efficacy is optimal if taken as soon as possible following unprotected intercourse.
-May be used at any time during the menstrual cycle; not intended for use in premenarcheal population.

Use: Prevention of pregnancy following unprotected intercourse or a known/suspected contraceptive failure

Data not available

Safety and efficacy have been established in female patients of reproductive age; use prior to menarche is not indicated.

This drug has not been studied in patients 65 or older and is currently not approved for use in this population or postmenopausal woman.

Consult WARNINGS section for additional precautions.

Data not available

Administration advice:
-IUS: Consult the manufacturer product information for recommended insertion and removal techniques.

Timing of IUS Removal:
-If pregnancy is desired, the IUS may be removed at any time.
-If pregnancy is not desired, the IUS may be removed at any time, however, an alternate contraception method should be started prior to removal.

Storage requirements:
-IUS: For single use only; store pouch in outer carton until use to protect from light.
Monitoring:
-IUS Follow-up: Re-examine patient 4 to 6 weeks following IUS insertion and once a year thereafter, or more frequently if clinically indicated.
-Emergency Contraception Follow-up: Physical or pelvic exam is recommended if there is any doubt concerning general health or pregnancy status of any woman after using this drug for postcoital contraception.

Patient advice:
-Counsel patient of risk of becoming pregnant if intercourse occurs in the week prior to IUS removal without use of a backup contraceptive method.
-Contact your doctor if you become pregnant due to the risk of ectopic pregnancy.
-Report any signs/symptoms of lower abdominal pain, long-lasting or heavy bleeding, painful intercourse, chills, or fever.
-Report severe pain or fever following IUS insertion due to the risk of infection.