Over-the-counter emergency contraception available soon across country?
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* Barbara Sibbald

Following a Feb. 16 meeting with the Society of Obstetricians and Gynaecologists of Canada (SOGC) and 4 other organizations, Health Canada has started working toward making emergency postcoital contraception available without a prescription across the country.

A proposal to “switch” the drug from prescription to nonprescription status will appear in the *Canada Gazette* within a year, SOGC spokesperson Dr. Vyta Senikas told *CMAJ*. Approval could come soon after. “The meeting with the Therapeutics Products Program was very encouraging,” she added.

Over-the-counter (OTC) sales of the morning-after pill began in Britain in December. Some pharmacies in Washington state already provide the drug OTC, and several more states are considering it. Women in British Columbia can get the drug without a prescription through a delegation-of-duty scheme.

Meanwhile, the SOGC is tackling the problem nationally with its lobby partners — the Planned Parenthood Federation of Canada, the Canadian Pharmacists Association, the Women's Capital Corporation (a US company that owns the rights to Plan B emergency contraception) and the Canadian distributor, Paladin Labs.

Senikas says the main challenge in increasing availability of emergency postcoital contraception (EPC) is ensuring that patients know how to use the product ([http://pharminfo.com/pubs/druginfoline/druginfo1_41.html](http://http\|[colon]\|//pharminfo.com/pubs/druginfoline/druginfo1_41.html)). Plan B is the first progestin-only EPC approved in the US (1999) and Canada (2000). The SOGC, which is launching a contraception-awareness campaign, will ensure there is information and contraception counselling for women who take it.

EPC comprises 2 levonorgestrel tablets. The first must be taken within 72 hours of unprotected sex, the second 12 hours later. “There are very, very few contraindications,” says Senikas.

Senikas says some opponents equate EPC with abortion and “have this misplaced notion that emergency contraception is like RU-486. It's not. It will never displace a pregnancy.”

Senikas also says that only about 5% to 10% of women use EPC more than once. “Usage is usually a wake-up call.” —