Hospital Pharmacists: what they are doing now
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[post_date] => 2026-06-22 14:44:11
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[post_content] => New research has found that real-time prescription monitoring (RTPM) is changing prescribing behaviour – ultimately saving lives.
The study, led by Monash University researchers, is the first Australian research to examine the association between prescription drug monitoring program implementation and changes in multiple prescriber rates.
Key findings after SafeScript introduction (2019):
|
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The PSA has opened Expressions of Interest (EOIs) for its first PSA Harm Reduction Champion, who will act as a national spokesperson – advocating for and supporting PSA’s work in policy, professional practice, and community engagement.
EOIs are sought from passionate pharmacists looking to do more to support patients accessing harm reduction services such as opioid dependence therapy (ODT), the administration of long-acting injectable buprenorphine, naloxone access, and needle and syringe programs.
Supported by a grant from Camurus, the PSA Harm Reduction Champion role aims to elevate pharmacist leadership in harm reduction and strengthen the profession’s role in improving access to care, reducing stigma and supporting safer health outcomes for the community.
PSA National President, Professor Mark Naunton MPS, said pharmacists play a critical role in ensuring the safe provision of harm reduction services on the frontline.
‘Pharmacists have an important role to play in harm reduction, through improving access to essential services such as ODT, take-home naloxone, and needle and syringe programs, but there is still more to be done to support the equitable access to these services,’ Professor Naunton said.
‘This is why we’re looking for a pharmacist who is making a real impact in their community, and ready to help lead the conversations, support their communities, and advocate for expanded access to care through the PSA Harm Reduction Champion initiative.
‘If this sounds like you, or someone you know, I encourage you to submit an EOI to become PSA’s first Harm Reduction Champion.’
Dr Annie Madden AO, Executive Director of Harm Reduction Australia, welcomed the PSA Harm Reduction Champion initiative as an important step in further strengthening pharmacists’ leadership in harm reduction.
‘Pharmacists play a vital role in improving access to harm reduction services, and this new advocacy approach will hopefully inspire more pharmacists to engage in this highly rewarding area of practice, further expanding access to services that reduce harm, save lives, and strengthen the health and wellbeing of communities across Australia.’
EOIs are open to all PSA members and close 30 June 2026.
Pharmacists interested in becoming the 2026 PSA Harm Reduction Champion can submit an EOI at: https://forms.office.com/
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[post_content] => While effective for many, smoking cessation strategies are not a one-size-fits-all approach.
Nicotine replacement therapy (NRT) aims to reduce cravings and withdrawal symptoms by delivering nicotine in a safer, slower release form than smoking.1,2 NRT is a first-line pharmacotherapy for smoking cessation if clinically appropriate, and is shown to be effective.3 Pharmacists can also help to reframe past quit attempts as valuable learning opportunities for patients.
Here are some key NRT troubleshooting considerations pharmacists should consider.
Is the dose high enough?
NRT is safer than smoking and has low addictive potential.4 It is often under-dosed in practice, which can undermine a patient’s confidence in treatment.2,4,5 Patients may receive an inadequate dose, use NRT inconsistently or discontinue treatment prematurely.
When used at optimal doses, evidence shows NRT increases quit success.2 Pharmacists should use a nicotine dependence assessment tool (e.g. Quit Centre’s NRT tool) for dosage guidance and encourage proactive use of faster-acting NRT in anticipation of a trigger or cravings. Patients who have stopped smoking after an initial 8-week course of NRT may also benefit from a follow-up course.4
For some patients, combination NRT (patch and faster-acting form) may be appropriate. Combination NRT is equally as effective as varenicline and more effective than NRT monotherapy for smoking cessation.4
Does technique impact efficacy?
Incorrect use of NRT may lead to reduced nicotine absorption, increased adverse effects and reduced confidence in treatment.
To ensure maximum absorption, counselling points could include:
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[post_content] => Meet the award-winning pharmacists recognised for their exceptional contributions to patients, communities and the profession.
The PSA acknowledged the outstanding contributions, leadership, and dedication of the five pharmacists who were recognised at the PSA Victorian Pharmacist Awards.
The 2026 award recipients are:
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[post_content] => Body weight may reduce the effectiveness of oral emergency contraception (EC). Here's how pharmacists can help navigate this nuance in your consultations.
A patient walks into a pharmacy and asks for emergency contraception. During the consultation, they disclose that they are breastfeeding, so the pharmacist recommends levonorgestrel.
But what if the patient weighs more than 70 kg?
The effectiveness of oral EC may be reduced by body weight, particularly for levonorgestrel.
Given the average Australian woman weighs 72 kg, weight is an important factor to consider during EC consultations.
Weighing up first-line therapy
Levonorgestrel is widely stocked in Australian pharmacies, with 2024 research revealing 98% of pharmacies have this EC on hand compared with 70% for ulipristal acetate.
This gap is problematic, as for most people, ulipristal is first-line therapy. It’s particularly problematic for people >70kg who wish to use emergency contraception to avoid pregnancy.
The Australian Pharmaceutical Formulary and Handbook (APF’s) treatment guide for emergency contraception states that for people with a BMI above 26 kg/m² or weight above 70 kg, ulipristal is the preferred first-line option. Above 85 kg or BMI above 30 kg/m², effectiveness is unknown.
Crafting conversations
Part of what makes these thresholds challenging in practice is that weight does not always correlate with what pharmacists might expect.
'Weight and BMI can be really hard to assess, particularly when people are so fit,’ said Ruth Nona, pharmacist and researcher at James Cook University in Cairns. ‘If somebody does CrossFit and has a higher muscle mass, they may be heavier on the scale, but they may not appear so.’
As such, Queensland-based pharmacy intern Lindsay Cameron has developed a consultation approach that sidesteps weight assumptions entirely.
‘I don’t ask for a specific weight. I ask whether they think they may fall into that category,’ she said. ‘I usually say, “I’ll ask a few questions so I can recommend the most appropriate EC for you.” Then I explain, “Ulipristal is generally more effective than other oral EC options, unless it is contraindicated or unsuitable, because it can delay ovulation even when hormone levels are rising. That gives it a longer window to work. In particular, if you think you may weigh over 70 kg, I recommend ulipristal, as the other option may be less effective”.’
Ms Cameron will further tweak her approach, often based on the patient's body language, if she detects any sensitivity around weight.
‘I might use myself as an example,’ she said. ‘For example, I will say, “I would choose this option because I am over 70 kg and I don't want an unplanned pregnancy”,’ she said.
Ms Nona also emphasises the importance of ensuring that patients are given all the information they need to make an informed choice. ‘When someone presents to the pharmacy seeking emergency contraception, they have already made an informed decision to prevent pregnancy. It is important that patients understand the differences in effectiveness between the two emergency contraception options, as well as how weight may also influence that effectiveness.’
When oral EC isn’t enough
For patients above 85 kg, the conversation should extend beyond oral EC. The copper intrauterine device (IUD), inserted within 120 hours of unprotected sex, is the most effective option regardless of weight.
However, the main barrier is often access rather than clinical appropriateness. The copper IUD requires insertion by a trained medical professional, and appointments are not always readily available, particularly in regional, rural and remote areas.
The APF is clear that pharmacists should always supply oral EC and refer, not withhold the oral option while waiting for an IUD appointment.
Ms Nona makes this a routine part of conversations with people seeking emergency contraception.
‘When considering BMI, if a patient is thought to weigh over 85 kg, we should always discuss the option of a copper IUD with them, as it is 99% effective,' Ms Nona said. ‘Another benefit of a copper IUD is that it offers ongoing, long-term contraception.'
'If they can't get to the doctor [immediately], we would supply oral EC and refer them to a GP or sexual health clinic,’ she said.
When ulipristal is contraindicated
While ulipristal is the first-line treatment option, offering protection for a wider weight range, it’s important to understand when it’s contraindicated.
As suggested earlier in the article, ulipristal is generally second line in breastfeeding mothers.
For people >70kg who are breastfeeding, the APF treatment guidelines recommends 3 mg (2 tablets) levonorgestrel as first line treatment.
However, this is off-label use, and based on international guidance. Its clinical efficacy is unknown.
‘[As] the effectiveness of double dosing levonorgestrel is not known … we should inform the patient that they should follow up with a doctor.’ Ms Nona said.
The other most common contraindication is drug-drug interactions. The most significant interaction with ulipristal involves progestogens.
‘You cannot use ulipristal and progestogen within 5 days of each other as it reduces the effectiveness of both,’
Ms Nona reflects this is something she sees frequently in practice:.
‘That could be because the patient was taking a progestogen-containing oral contraceptive such as Slinda, if they missed a couple of pills or ceased taking it, or if they took levonorgestrel.’
CYP3A4-inducing medicines – including carbamazepine, phenytoin, rifampicin, topiramate and St John's Wort – used within the previous 4 weeks also affect both oral EC options. In this scenario, the APF recommends a 3 mg dose of levonorgestrel – noting that a copper IUD is preferred where feasible, explicitly stating that double-dose ulipristal is not recommended.
For more information on emergency contraception, access the Australian Pharmaceutical Formulary and Handbook.
[post_title] => What does weight have to do with emergency contraception?
[post_excerpt] => Body weight may reduce the effectiveness of oral emergency contraception. Pharmacists can help navigate this nuance in consultations.
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[post_content] => New research has found that real-time prescription monitoring (RTPM) is changing prescribing behaviour – ultimately saving lives.
The study, led by Monash University researchers, is the first Australian research to examine the association between prescription drug monitoring program implementation and changes in multiple prescriber rates.
Key findings after SafeScript introduction (2019):
|
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[post_content] =>
The PSA has opened Expressions of Interest (EOIs) for its first PSA Harm Reduction Champion, who will act as a national spokesperson – advocating for and supporting PSA’s work in policy, professional practice, and community engagement.
EOIs are sought from passionate pharmacists looking to do more to support patients accessing harm reduction services such as opioid dependence therapy (ODT), the administration of long-acting injectable buprenorphine, naloxone access, and needle and syringe programs.
Supported by a grant from Camurus, the PSA Harm Reduction Champion role aims to elevate pharmacist leadership in harm reduction and strengthen the profession’s role in improving access to care, reducing stigma and supporting safer health outcomes for the community.
PSA National President, Professor Mark Naunton MPS, said pharmacists play a critical role in ensuring the safe provision of harm reduction services on the frontline.
‘Pharmacists have an important role to play in harm reduction, through improving access to essential services such as ODT, take-home naloxone, and needle and syringe programs, but there is still more to be done to support the equitable access to these services,’ Professor Naunton said.
‘This is why we’re looking for a pharmacist who is making a real impact in their community, and ready to help lead the conversations, support their communities, and advocate for expanded access to care through the PSA Harm Reduction Champion initiative.
‘If this sounds like you, or someone you know, I encourage you to submit an EOI to become PSA’s first Harm Reduction Champion.’
Dr Annie Madden AO, Executive Director of Harm Reduction Australia, welcomed the PSA Harm Reduction Champion initiative as an important step in further strengthening pharmacists’ leadership in harm reduction.
‘Pharmacists play a vital role in improving access to harm reduction services, and this new advocacy approach will hopefully inspire more pharmacists to engage in this highly rewarding area of practice, further expanding access to services that reduce harm, save lives, and strengthen the health and wellbeing of communities across Australia.’
EOIs are open to all PSA members and close 30 June 2026.
Pharmacists interested in becoming the 2026 PSA Harm Reduction Champion can submit an EOI at: https://forms.office.com/
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[post_content] => While effective for many, smoking cessation strategies are not a one-size-fits-all approach.
Nicotine replacement therapy (NRT) aims to reduce cravings and withdrawal symptoms by delivering nicotine in a safer, slower release form than smoking.1,2 NRT is a first-line pharmacotherapy for smoking cessation if clinically appropriate, and is shown to be effective.3 Pharmacists can also help to reframe past quit attempts as valuable learning opportunities for patients.
Here are some key NRT troubleshooting considerations pharmacists should consider.
Is the dose high enough?
NRT is safer than smoking and has low addictive potential.4 It is often under-dosed in practice, which can undermine a patient’s confidence in treatment.2,4,5 Patients may receive an inadequate dose, use NRT inconsistently or discontinue treatment prematurely.
When used at optimal doses, evidence shows NRT increases quit success.2 Pharmacists should use a nicotine dependence assessment tool (e.g. Quit Centre’s NRT tool) for dosage guidance and encourage proactive use of faster-acting NRT in anticipation of a trigger or cravings. Patients who have stopped smoking after an initial 8-week course of NRT may also benefit from a follow-up course.4
For some patients, combination NRT (patch and faster-acting form) may be appropriate. Combination NRT is equally as effective as varenicline and more effective than NRT monotherapy for smoking cessation.4
Does technique impact efficacy?
Incorrect use of NRT may lead to reduced nicotine absorption, increased adverse effects and reduced confidence in treatment.
To ensure maximum absorption, counselling points could include:
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[post_date] => 2026-06-15 09:23:36
[post_date_gmt] => 2026-06-14 23:23:36
[post_content] => Meet the award-winning pharmacists recognised for their exceptional contributions to patients, communities and the profession.
The PSA acknowledged the outstanding contributions, leadership, and dedication of the five pharmacists who were recognised at the PSA Victorian Pharmacist Awards.
The 2026 award recipients are:
td_module_mega_menu Object
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[post_content] => Body weight may reduce the effectiveness of oral emergency contraception (EC). Here's how pharmacists can help navigate this nuance in your consultations.
A patient walks into a pharmacy and asks for emergency contraception. During the consultation, they disclose that they are breastfeeding, so the pharmacist recommends levonorgestrel.
But what if the patient weighs more than 70 kg?
The effectiveness of oral EC may be reduced by body weight, particularly for levonorgestrel.
Given the average Australian woman weighs 72 kg, weight is an important factor to consider during EC consultations.
Weighing up first-line therapy
Levonorgestrel is widely stocked in Australian pharmacies, with 2024 research revealing 98% of pharmacies have this EC on hand compared with 70% for ulipristal acetate.
This gap is problematic, as for most people, ulipristal is first-line therapy. It’s particularly problematic for people >70kg who wish to use emergency contraception to avoid pregnancy.
The Australian Pharmaceutical Formulary and Handbook (APF’s) treatment guide for emergency contraception states that for people with a BMI above 26 kg/m² or weight above 70 kg, ulipristal is the preferred first-line option. Above 85 kg or BMI above 30 kg/m², effectiveness is unknown.
Crafting conversations
Part of what makes these thresholds challenging in practice is that weight does not always correlate with what pharmacists might expect.
'Weight and BMI can be really hard to assess, particularly when people are so fit,’ said Ruth Nona, pharmacist and researcher at James Cook University in Cairns. ‘If somebody does CrossFit and has a higher muscle mass, they may be heavier on the scale, but they may not appear so.’
As such, Queensland-based pharmacy intern Lindsay Cameron has developed a consultation approach that sidesteps weight assumptions entirely.
‘I don’t ask for a specific weight. I ask whether they think they may fall into that category,’ she said. ‘I usually say, “I’ll ask a few questions so I can recommend the most appropriate EC for you.” Then I explain, “Ulipristal is generally more effective than other oral EC options, unless it is contraindicated or unsuitable, because it can delay ovulation even when hormone levels are rising. That gives it a longer window to work. In particular, if you think you may weigh over 70 kg, I recommend ulipristal, as the other option may be less effective”.’
Ms Cameron will further tweak her approach, often based on the patient's body language, if she detects any sensitivity around weight.
‘I might use myself as an example,’ she said. ‘For example, I will say, “I would choose this option because I am over 70 kg and I don't want an unplanned pregnancy”,’ she said.
Ms Nona also emphasises the importance of ensuring that patients are given all the information they need to make an informed choice. ‘When someone presents to the pharmacy seeking emergency contraception, they have already made an informed decision to prevent pregnancy. It is important that patients understand the differences in effectiveness between the two emergency contraception options, as well as how weight may also influence that effectiveness.’
When oral EC isn’t enough
For patients above 85 kg, the conversation should extend beyond oral EC. The copper intrauterine device (IUD), inserted within 120 hours of unprotected sex, is the most effective option regardless of weight.
However, the main barrier is often access rather than clinical appropriateness. The copper IUD requires insertion by a trained medical professional, and appointments are not always readily available, particularly in regional, rural and remote areas.
The APF is clear that pharmacists should always supply oral EC and refer, not withhold the oral option while waiting for an IUD appointment.
Ms Nona makes this a routine part of conversations with people seeking emergency contraception.
‘When considering BMI, if a patient is thought to weigh over 85 kg, we should always discuss the option of a copper IUD with them, as it is 99% effective,' Ms Nona said. ‘Another benefit of a copper IUD is that it offers ongoing, long-term contraception.'
'If they can't get to the doctor [immediately], we would supply oral EC and refer them to a GP or sexual health clinic,’ she said.
When ulipristal is contraindicated
While ulipristal is the first-line treatment option, offering protection for a wider weight range, it’s important to understand when it’s contraindicated.
As suggested earlier in the article, ulipristal is generally second line in breastfeeding mothers.
For people >70kg who are breastfeeding, the APF treatment guidelines recommends 3 mg (2 tablets) levonorgestrel as first line treatment.
However, this is off-label use, and based on international guidance. Its clinical efficacy is unknown.
‘[As] the effectiveness of double dosing levonorgestrel is not known … we should inform the patient that they should follow up with a doctor.’ Ms Nona said.
The other most common contraindication is drug-drug interactions. The most significant interaction with ulipristal involves progestogens.
‘You cannot use ulipristal and progestogen within 5 days of each other as it reduces the effectiveness of both,’
Ms Nona reflects this is something she sees frequently in practice:.
‘That could be because the patient was taking a progestogen-containing oral contraceptive such as Slinda, if they missed a couple of pills or ceased taking it, or if they took levonorgestrel.’
CYP3A4-inducing medicines – including carbamazepine, phenytoin, rifampicin, topiramate and St John's Wort – used within the previous 4 weeks also affect both oral EC options. In this scenario, the APF recommends a 3 mg dose of levonorgestrel – noting that a copper IUD is preferred where feasible, explicitly stating that double-dose ulipristal is not recommended.
For more information on emergency contraception, access the Australian Pharmaceutical Formulary and Handbook.
[post_title] => What does weight have to do with emergency contraception?
[post_excerpt] => Body weight may reduce the effectiveness of oral emergency contraception. Pharmacists can help navigate this nuance in consultations.
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[post_content] => New research has found that real-time prescription monitoring (RTPM) is changing prescribing behaviour – ultimately saving lives.
The study, led by Monash University researchers, is the first Australian research to examine the association between prescription drug monitoring program implementation and changes in multiple prescriber rates.
Key findings after SafeScript introduction (2019):
|
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[post_date] => 2026-06-22 14:24:10
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[post_content] =>
The PSA has opened Expressions of Interest (EOIs) for its first PSA Harm Reduction Champion, who will act as a national spokesperson – advocating for and supporting PSA’s work in policy, professional practice, and community engagement.
EOIs are sought from passionate pharmacists looking to do more to support patients accessing harm reduction services such as opioid dependence therapy (ODT), the administration of long-acting injectable buprenorphine, naloxone access, and needle and syringe programs.
Supported by a grant from Camurus, the PSA Harm Reduction Champion role aims to elevate pharmacist leadership in harm reduction and strengthen the profession’s role in improving access to care, reducing stigma and supporting safer health outcomes for the community.
PSA National President, Professor Mark Naunton MPS, said pharmacists play a critical role in ensuring the safe provision of harm reduction services on the frontline.
‘Pharmacists have an important role to play in harm reduction, through improving access to essential services such as ODT, take-home naloxone, and needle and syringe programs, but there is still more to be done to support the equitable access to these services,’ Professor Naunton said.
‘This is why we’re looking for a pharmacist who is making a real impact in their community, and ready to help lead the conversations, support their communities, and advocate for expanded access to care through the PSA Harm Reduction Champion initiative.
‘If this sounds like you, or someone you know, I encourage you to submit an EOI to become PSA’s first Harm Reduction Champion.’
Dr Annie Madden AO, Executive Director of Harm Reduction Australia, welcomed the PSA Harm Reduction Champion initiative as an important step in further strengthening pharmacists’ leadership in harm reduction.
‘Pharmacists play a vital role in improving access to harm reduction services, and this new advocacy approach will hopefully inspire more pharmacists to engage in this highly rewarding area of practice, further expanding access to services that reduce harm, save lives, and strengthen the health and wellbeing of communities across Australia.’
EOIs are open to all PSA members and close 30 June 2026.
Pharmacists interested in becoming the 2026 PSA Harm Reduction Champion can submit an EOI at: https://forms.office.com/
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[post_content] => While effective for many, smoking cessation strategies are not a one-size-fits-all approach.
Nicotine replacement therapy (NRT) aims to reduce cravings and withdrawal symptoms by delivering nicotine in a safer, slower release form than smoking.1,2 NRT is a first-line pharmacotherapy for smoking cessation if clinically appropriate, and is shown to be effective.3 Pharmacists can also help to reframe past quit attempts as valuable learning opportunities for patients.
Here are some key NRT troubleshooting considerations pharmacists should consider.
Is the dose high enough?
NRT is safer than smoking and has low addictive potential.4 It is often under-dosed in practice, which can undermine a patient’s confidence in treatment.2,4,5 Patients may receive an inadequate dose, use NRT inconsistently or discontinue treatment prematurely.
When used at optimal doses, evidence shows NRT increases quit success.2 Pharmacists should use a nicotine dependence assessment tool (e.g. Quit Centre’s NRT tool) for dosage guidance and encourage proactive use of faster-acting NRT in anticipation of a trigger or cravings. Patients who have stopped smoking after an initial 8-week course of NRT may also benefit from a follow-up course.4
For some patients, combination NRT (patch and faster-acting form) may be appropriate. Combination NRT is equally as effective as varenicline and more effective than NRT monotherapy for smoking cessation.4
Does technique impact efficacy?
Incorrect use of NRT may lead to reduced nicotine absorption, increased adverse effects and reduced confidence in treatment.
To ensure maximum absorption, counselling points could include:
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[post_content] => Meet the award-winning pharmacists recognised for their exceptional contributions to patients, communities and the profession.
The PSA acknowledged the outstanding contributions, leadership, and dedication of the five pharmacists who were recognised at the PSA Victorian Pharmacist Awards.
The 2026 award recipients are:
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[post_content] => Body weight may reduce the effectiveness of oral emergency contraception (EC). Here's how pharmacists can help navigate this nuance in your consultations.
A patient walks into a pharmacy and asks for emergency contraception. During the consultation, they disclose that they are breastfeeding, so the pharmacist recommends levonorgestrel.
But what if the patient weighs more than 70 kg?
The effectiveness of oral EC may be reduced by body weight, particularly for levonorgestrel.
Given the average Australian woman weighs 72 kg, weight is an important factor to consider during EC consultations.
Weighing up first-line therapy
Levonorgestrel is widely stocked in Australian pharmacies, with 2024 research revealing 98% of pharmacies have this EC on hand compared with 70% for ulipristal acetate.
This gap is problematic, as for most people, ulipristal is first-line therapy. It’s particularly problematic for people >70kg who wish to use emergency contraception to avoid pregnancy.
The Australian Pharmaceutical Formulary and Handbook (APF’s) treatment guide for emergency contraception states that for people with a BMI above 26 kg/m² or weight above 70 kg, ulipristal is the preferred first-line option. Above 85 kg or BMI above 30 kg/m², effectiveness is unknown.
Crafting conversations
Part of what makes these thresholds challenging in practice is that weight does not always correlate with what pharmacists might expect.
'Weight and BMI can be really hard to assess, particularly when people are so fit,’ said Ruth Nona, pharmacist and researcher at James Cook University in Cairns. ‘If somebody does CrossFit and has a higher muscle mass, they may be heavier on the scale, but they may not appear so.’
As such, Queensland-based pharmacy intern Lindsay Cameron has developed a consultation approach that sidesteps weight assumptions entirely.
‘I don’t ask for a specific weight. I ask whether they think they may fall into that category,’ she said. ‘I usually say, “I’ll ask a few questions so I can recommend the most appropriate EC for you.” Then I explain, “Ulipristal is generally more effective than other oral EC options, unless it is contraindicated or unsuitable, because it can delay ovulation even when hormone levels are rising. That gives it a longer window to work. In particular, if you think you may weigh over 70 kg, I recommend ulipristal, as the other option may be less effective”.’
Ms Cameron will further tweak her approach, often based on the patient's body language, if she detects any sensitivity around weight.
‘I might use myself as an example,’ she said. ‘For example, I will say, “I would choose this option because I am over 70 kg and I don't want an unplanned pregnancy”,’ she said.
Ms Nona also emphasises the importance of ensuring that patients are given all the information they need to make an informed choice. ‘When someone presents to the pharmacy seeking emergency contraception, they have already made an informed decision to prevent pregnancy. It is important that patients understand the differences in effectiveness between the two emergency contraception options, as well as how weight may also influence that effectiveness.’
When oral EC isn’t enough
For patients above 85 kg, the conversation should extend beyond oral EC. The copper intrauterine device (IUD), inserted within 120 hours of unprotected sex, is the most effective option regardless of weight.
However, the main barrier is often access rather than clinical appropriateness. The copper IUD requires insertion by a trained medical professional, and appointments are not always readily available, particularly in regional, rural and remote areas.
The APF is clear that pharmacists should always supply oral EC and refer, not withhold the oral option while waiting for an IUD appointment.
Ms Nona makes this a routine part of conversations with people seeking emergency contraception.
‘When considering BMI, if a patient is thought to weigh over 85 kg, we should always discuss the option of a copper IUD with them, as it is 99% effective,' Ms Nona said. ‘Another benefit of a copper IUD is that it offers ongoing, long-term contraception.'
'If they can't get to the doctor [immediately], we would supply oral EC and refer them to a GP or sexual health clinic,’ she said.
When ulipristal is contraindicated
While ulipristal is the first-line treatment option, offering protection for a wider weight range, it’s important to understand when it’s contraindicated.
As suggested earlier in the article, ulipristal is generally second line in breastfeeding mothers.
For people >70kg who are breastfeeding, the APF treatment guidelines recommends 3 mg (2 tablets) levonorgestrel as first line treatment.
However, this is off-label use, and based on international guidance. Its clinical efficacy is unknown.
‘[As] the effectiveness of double dosing levonorgestrel is not known … we should inform the patient that they should follow up with a doctor.’ Ms Nona said.
The other most common contraindication is drug-drug interactions. The most significant interaction with ulipristal involves progestogens.
‘You cannot use ulipristal and progestogen within 5 days of each other as it reduces the effectiveness of both,’
Ms Nona reflects this is something she sees frequently in practice:.
‘That could be because the patient was taking a progestogen-containing oral contraceptive such as Slinda, if they missed a couple of pills or ceased taking it, or if they took levonorgestrel.’
CYP3A4-inducing medicines – including carbamazepine, phenytoin, rifampicin, topiramate and St John's Wort – used within the previous 4 weeks also affect both oral EC options. In this scenario, the APF recommends a 3 mg dose of levonorgestrel – noting that a copper IUD is preferred where feasible, explicitly stating that double-dose ulipristal is not recommended.
For more information on emergency contraception, access the Australian Pharmaceutical Formulary and Handbook.
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[post_content] => New research has found that real-time prescription monitoring (RTPM) is changing prescribing behaviour – ultimately saving lives.
The study, led by Monash University researchers, is the first Australian research to examine the association between prescription drug monitoring program implementation and changes in multiple prescriber rates.
Key findings after SafeScript introduction (2019):
|
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The PSA has opened Expressions of Interest (EOIs) for its first PSA Harm Reduction Champion, who will act as a national spokesperson – advocating for and supporting PSA’s work in policy, professional practice, and community engagement.
EOIs are sought from passionate pharmacists looking to do more to support patients accessing harm reduction services such as opioid dependence therapy (ODT), the administration of long-acting injectable buprenorphine, naloxone access, and needle and syringe programs.
Supported by a grant from Camurus, the PSA Harm Reduction Champion role aims to elevate pharmacist leadership in harm reduction and strengthen the profession’s role in improving access to care, reducing stigma and supporting safer health outcomes for the community.
PSA National President, Professor Mark Naunton MPS, said pharmacists play a critical role in ensuring the safe provision of harm reduction services on the frontline.
‘Pharmacists have an important role to play in harm reduction, through improving access to essential services such as ODT, take-home naloxone, and needle and syringe programs, but there is still more to be done to support the equitable access to these services,’ Professor Naunton said.
‘This is why we’re looking for a pharmacist who is making a real impact in their community, and ready to help lead the conversations, support their communities, and advocate for expanded access to care through the PSA Harm Reduction Champion initiative.
‘If this sounds like you, or someone you know, I encourage you to submit an EOI to become PSA’s first Harm Reduction Champion.’
Dr Annie Madden AO, Executive Director of Harm Reduction Australia, welcomed the PSA Harm Reduction Champion initiative as an important step in further strengthening pharmacists’ leadership in harm reduction.
‘Pharmacists play a vital role in improving access to harm reduction services, and this new advocacy approach will hopefully inspire more pharmacists to engage in this highly rewarding area of practice, further expanding access to services that reduce harm, save lives, and strengthen the health and wellbeing of communities across Australia.’
EOIs are open to all PSA members and close 30 June 2026.
Pharmacists interested in becoming the 2026 PSA Harm Reduction Champion can submit an EOI at: https://forms.office.com/
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[post_content] => While effective for many, smoking cessation strategies are not a one-size-fits-all approach.
Nicotine replacement therapy (NRT) aims to reduce cravings and withdrawal symptoms by delivering nicotine in a safer, slower release form than smoking.1,2 NRT is a first-line pharmacotherapy for smoking cessation if clinically appropriate, and is shown to be effective.3 Pharmacists can also help to reframe past quit attempts as valuable learning opportunities for patients.
Here are some key NRT troubleshooting considerations pharmacists should consider.
Is the dose high enough?
NRT is safer than smoking and has low addictive potential.4 It is often under-dosed in practice, which can undermine a patient’s confidence in treatment.2,4,5 Patients may receive an inadequate dose, use NRT inconsistently or discontinue treatment prematurely.
When used at optimal doses, evidence shows NRT increases quit success.2 Pharmacists should use a nicotine dependence assessment tool (e.g. Quit Centre’s NRT tool) for dosage guidance and encourage proactive use of faster-acting NRT in anticipation of a trigger or cravings. Patients who have stopped smoking after an initial 8-week course of NRT may also benefit from a follow-up course.4
For some patients, combination NRT (patch and faster-acting form) may be appropriate. Combination NRT is equally as effective as varenicline and more effective than NRT monotherapy for smoking cessation.4
Does technique impact efficacy?
Incorrect use of NRT may lead to reduced nicotine absorption, increased adverse effects and reduced confidence in treatment.
To ensure maximum absorption, counselling points could include:
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[post_content] => Meet the award-winning pharmacists recognised for their exceptional contributions to patients, communities and the profession.
The PSA acknowledged the outstanding contributions, leadership, and dedication of the five pharmacists who were recognised at the PSA Victorian Pharmacist Awards.
The 2026 award recipients are:
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[post_content] => Body weight may reduce the effectiveness of oral emergency contraception (EC). Here's how pharmacists can help navigate this nuance in your consultations.
A patient walks into a pharmacy and asks for emergency contraception. During the consultation, they disclose that they are breastfeeding, so the pharmacist recommends levonorgestrel.
But what if the patient weighs more than 70 kg?
The effectiveness of oral EC may be reduced by body weight, particularly for levonorgestrel.
Given the average Australian woman weighs 72 kg, weight is an important factor to consider during EC consultations.
Weighing up first-line therapy
Levonorgestrel is widely stocked in Australian pharmacies, with 2024 research revealing 98% of pharmacies have this EC on hand compared with 70% for ulipristal acetate.
This gap is problematic, as for most people, ulipristal is first-line therapy. It’s particularly problematic for people >70kg who wish to use emergency contraception to avoid pregnancy.
The Australian Pharmaceutical Formulary and Handbook (APF’s) treatment guide for emergency contraception states that for people with a BMI above 26 kg/m² or weight above 70 kg, ulipristal is the preferred first-line option. Above 85 kg or BMI above 30 kg/m², effectiveness is unknown.
Crafting conversations
Part of what makes these thresholds challenging in practice is that weight does not always correlate with what pharmacists might expect.
'Weight and BMI can be really hard to assess, particularly when people are so fit,’ said Ruth Nona, pharmacist and researcher at James Cook University in Cairns. ‘If somebody does CrossFit and has a higher muscle mass, they may be heavier on the scale, but they may not appear so.’
As such, Queensland-based pharmacy intern Lindsay Cameron has developed a consultation approach that sidesteps weight assumptions entirely.
‘I don’t ask for a specific weight. I ask whether they think they may fall into that category,’ she said. ‘I usually say, “I’ll ask a few questions so I can recommend the most appropriate EC for you.” Then I explain, “Ulipristal is generally more effective than other oral EC options, unless it is contraindicated or unsuitable, because it can delay ovulation even when hormone levels are rising. That gives it a longer window to work. In particular, if you think you may weigh over 70 kg, I recommend ulipristal, as the other option may be less effective”.’
Ms Cameron will further tweak her approach, often based on the patient's body language, if she detects any sensitivity around weight.
‘I might use myself as an example,’ she said. ‘For example, I will say, “I would choose this option because I am over 70 kg and I don't want an unplanned pregnancy”,’ she said.
Ms Nona also emphasises the importance of ensuring that patients are given all the information they need to make an informed choice. ‘When someone presents to the pharmacy seeking emergency contraception, they have already made an informed decision to prevent pregnancy. It is important that patients understand the differences in effectiveness between the two emergency contraception options, as well as how weight may also influence that effectiveness.’
When oral EC isn’t enough
For patients above 85 kg, the conversation should extend beyond oral EC. The copper intrauterine device (IUD), inserted within 120 hours of unprotected sex, is the most effective option regardless of weight.
However, the main barrier is often access rather than clinical appropriateness. The copper IUD requires insertion by a trained medical professional, and appointments are not always readily available, particularly in regional, rural and remote areas.
The APF is clear that pharmacists should always supply oral EC and refer, not withhold the oral option while waiting for an IUD appointment.
Ms Nona makes this a routine part of conversations with people seeking emergency contraception.
‘When considering BMI, if a patient is thought to weigh over 85 kg, we should always discuss the option of a copper IUD with them, as it is 99% effective,' Ms Nona said. ‘Another benefit of a copper IUD is that it offers ongoing, long-term contraception.'
'If they can't get to the doctor [immediately], we would supply oral EC and refer them to a GP or sexual health clinic,’ she said.
When ulipristal is contraindicated
While ulipristal is the first-line treatment option, offering protection for a wider weight range, it’s important to understand when it’s contraindicated.
As suggested earlier in the article, ulipristal is generally second line in breastfeeding mothers.
For people >70kg who are breastfeeding, the APF treatment guidelines recommends 3 mg (2 tablets) levonorgestrel as first line treatment.
However, this is off-label use, and based on international guidance. Its clinical efficacy is unknown.
‘[As] the effectiveness of double dosing levonorgestrel is not known … we should inform the patient that they should follow up with a doctor.’ Ms Nona said.
The other most common contraindication is drug-drug interactions. The most significant interaction with ulipristal involves progestogens.
‘You cannot use ulipristal and progestogen within 5 days of each other as it reduces the effectiveness of both,’
Ms Nona reflects this is something she sees frequently in practice:.
‘That could be because the patient was taking a progestogen-containing oral contraceptive such as Slinda, if they missed a couple of pills or ceased taking it, or if they took levonorgestrel.’
CYP3A4-inducing medicines – including carbamazepine, phenytoin, rifampicin, topiramate and St John's Wort – used within the previous 4 weeks also affect both oral EC options. In this scenario, the APF recommends a 3 mg dose of levonorgestrel – noting that a copper IUD is preferred where feasible, explicitly stating that double-dose ulipristal is not recommended.
For more information on emergency contraception, access the Australian Pharmaceutical Formulary and Handbook.
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