§ Mr. Knoxasked the Secretary of State for Social Services whether he has yet received the advice that he has sought from the Committee on Safety of Medicines on the safety of the morning-after pill.
§ 4. Mr. Kenneth ClarkeThe Committee of Safety of Medicines endorses the view that post-coital contraception should be used only as an emergency measure, and advises that, on the information available, the best method is that using a particular oral contraceptive pill. Its recommended method of post-coital contraception is, in fact, the method most widely employed at the moment in this country.
The committee has advised on the hormonal methods of post-coital contraception as follows:
The Committee is aware of four hormonal methods of which some evidence is available:Combined oral contraceptive pill
(0.25mg levonorgestrel (progestogen) 0.05mg ethinyloestradiol (oestrogen). Two tablets, followed by two further tablets 12 hours later, starting within 72 hours of unprotected intercourse).The committee considers that this combination (ie progestogen and oestrogen) oral contraceptive pill used in this way is acceptably safe for occasional emergency use only, but its efficacy falls far short of conventional hormonal contraception. The published evidence on other combination oral contraceptives used as post-coital contraception is very limited.Oestrogen alone post-coital contraception
(Ethinyloestradiol 5mg daily for five days, or stilbestrol 50mg for five days).The committee understands that these methods are used infrequently in the United Kingdom. On the basis of the limited evidence available, these methods would appear to offer a similar level of efficiency to the combined oral contraceptive used as post-coital contraceptive, but have possibly more adverse reactions. The combined oral contraceptive also has a shorter treatment regimen and is therefore likely to be more acceptable to patients.Progestogen only post-coital contraception
The method has been studied little, and the committee feels that there are insufficient suitable data on the use of probestogens on their own as a post-coital contraceptive to give a judgment on the risks and benefits involved. It would not, therefore, recommend their use for this purpose.Danazol
This is a semi-synthetic steroid which is still at an early stage of evaluation, and no judgment on it as a post-coital contraceptive can yet be made.If emergency hormonal post-coital contraception is needed, the committee considers that at present the most suitable method would be the specific combination oral regimen described above.I have arranged for this advice to be conveyed to the interested medical bodies.