.@DrJaneChi lays out some facts about Plan B weight limitations
- First the facts...
- — Jane Doe, MD (@DrJaneChi)Mon, Nov 25 2013 07:18:17A Euro mfr is labeling PlanB that it doesn't work over 176 lb. I'm getting lots of q's this am. http://www.motherjones.com/environment/2013/11/plan-b-morning-after-pill-weight-limit-pounds …
- — Jane Doe, MD (@DrJaneChi)Mon, Nov 25 2013 07:19:42There's preliminary, unpublished US data suggesting no efficacy of Plan B over 176 lb. There's no proposal for a label change yet AFAIK.
- — Jane Doe, MD (@DrJaneChi)Mon, Nov 25 2013 07:23:55It's standard practice, unfortunately, for drug trials to exclude anyone w other health problems, which they take to include extra weight.
- — Jane Doe, MD (@DrJaneChi)Mon, Nov 25 2013 07:44:27Most outpatient meds, dose can be titrated, e.g., if a BP med is sort-of working. PlanB can't sort-of work; you ovulate or don't.@The_WPCA
- — Jane Doe, MD (@DrJaneChi)Mon, Nov 25 2013 07:45:53ok PlanB questions falling into 3 categories: 1. why don't we vary the dose, 2. why wasn't it studied w/higher BMI, 3. what do I do now?
- — Jane Doe, MD (@DrJaneChi)Mon, Nov 25 2013 07:49:07Most outpatient meds don't require weight based dosing: includes antidepressants, BP meds. Depends how drug is metabolized & distributed.
- — Jane Doe, MD (@DrJaneChi)Mon, Nov 25 2013 07:51:50What can you do? I suggest the far less known EC pill "ella," ulipristal, which does have decrease in efficacy w wt but still some effect.
- — SocWorkReproJustice (@SocialWorkersRJ)Mon, Nov 25 2013 07:52:22@DrJaneChi clinical trials also exclude pregnant women so effects of drugs on fetal development not well known
- — Jane Doe, MD (@DrJaneChi)Mon, Nov 25 2013 07:53:11ella requires Rx; if you have a credit card, you can order it w an online Dr consult & they'll overnight it for $45. http://www.ella-rx.com
- — Jane Doe, MD (@DrJaneChi)Mon, Nov 25 2013 07:53:54Most effective option is Paragard IUD at all weights, but that's high cost wo insurance & many clinics don't stock, as I've discussed.
- Now some questions...first from @wxheather.
- — Heather Moser Grams (@wxheather)Mon, Nov 25 2013 08:19:24@DrJaneChi I didn't even know IUDs were used for EC. That does seem like a very expensive way to go compared to PlanB.
- — Jane Doe, MD (@DrJaneChi)Mon, Nov 25 2013 08:20:14@wxheather well, obv it's appropriate in someone who also wants it for contraception. & it also works significantly better than PlanB
- Then questions from @elledub_1920...
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