Prescription Counter

Have you read the patient information leaflet?
See the morning after pill medical information.

Yes No

Do you require Levonelle or ellaOne for immediate use now?

Morning after pills work best if taken early, delay can result in failure.
Do NOT order for immediate use - see a doctor or pharmacist if you need a morning after pill straight away - postal orders are NOT fast enough.

Yes No

Are you aware that women who are already taking a regular contraceptive pill who have missed pills do not always need a morning-after-pill?

There is information about 'missed pills' and 'restarting regular contraception on our website.

Yes No

Have you taken any of the following in the last 4 weeks?

Barbiturates, Primidone, Phenytoin, Carbamezepine, rufinamide, topiramate (used predominantly to treat epilepsy)
Rifampicin or Rifabutin (usually for tuberculosis)
Ritonavir (for HIV infection)
Steroids for asthma or other conditions
Bosentan, modafinnil or aprepitant
Progesterone (usually used to treat heavy of irregular periods)
Griseofulvin (for fungal infections)
Ciclosporin
Herbal remedies containing St John's Wort, Hypericum perforatum
Antacids and anti-ulcer medication

Yes No

Have you been diagnosed with any of the following?

Severe liver problems
Severe digestive problems e.g. Crohn's disease
Previous ectopic pregnancy, fallopian tube surgery or pelvic inflammatory disease

Yes No

Are you aware that 'morning after pills' are not 100% effective?

Levonelle can be taken up to 72 hours (3 days) and ellaOne up to 120 hours (5 days) after intercourse.
When taken in the first 72 hours (3 days) after intercourse, pregnancy rates are close to 1.5 in 100 (ellaOne) or 2 in 100 (Levonelle)

Yes No

Do you think you are already pregnant?

Levonelle and ellaOne will NOT terminate an existing pregnancy. There is no evidence they will harm an ongoing pregnancy.

Yes No

Are you aware Levonelle should NOT be ordered by women who are overweight because it is less effective?

If your BMI (Body Mass Index) calculator result is 30 or above, Levonelle should NOT be ordered.
EllaOne will be more effective and should be ordered instead.

Yes No

Are you aware Levonelle and ellaOne should NOT both be taken in the same menstrual cycle (period) without consulting a doctor or contraception specialist?

Yes No

Do you have any further medical information or questions?
Is there anything you do not understand or do you need further help?

Yes No

Do you have any concerns about your safety or well-being?
Answer 'Yes' if you feel vulnerable, or you are being forced to obtain treatment.

Yes No

Medical Assessment - Morning After Pill