Does Chewing or Dissolving Emergency Contraceptive Pills Affect Their Efficacy?

Emergency contraceptive pills should not be crushed or dissolved?

Hello, I have been taking the oral contraceptive pill [Kylian] for over a year.
I recently came across an article discussing whether crushing the pill affects its efficacy, and a doctor responded that it does not.
I also have difficulty swallowing pills; when I first started taking them, I would crush them, but eventually I learned to swallow pills of that size (although sometimes it goes smoothly and other times it does not, so I gave up on crushing them).
Over the past year, I have had unprotected intercourse, and my menstrual cycle has been normal.
However, today when I took the pill, I accidentally used water that was too hot due to the cold weather, and while I was trying to swallow it, it dissolved into a very small size (one tablet) before I could swallow it.
Will this affect its efficacy? Although I previously crushed the pills without any issues (and the articles I read also stated it wouldn't affect efficacy), I am concerned that today’s situation is different.
I worry that some of the dissolved medication might have remained in my mouth and not been ingested immediately, which could potentially affect the drug's effectiveness.
Thank you, doctor.

xuan, 20~29 year old female. Ask Date: 2021/01/13

Dr. Cao Guotao reply Obstetrics and Gynecology

Generally, it does not have an impact.
Wishing you good health.

Reply Date: 2021/01/13

More Info

When it comes to emergency contraceptive pills (ECPs), such as the one you mentioned, the method of ingestion can indeed raise questions about their efficacy. However, based on current medical understanding, chewing or dissolving ECPs does not significantly affect their effectiveness.

Emergency contraceptive pills are designed to prevent pregnancy primarily by delaying ovulation, inhibiting fertilization, or preventing implantation of a fertilized egg. The active ingredients in these pills are formulated to be effective when taken as directed. While the manufacturers typically recommend swallowing the pills whole, if they are chewed or dissolved, the active ingredients are still likely to be absorbed into the bloodstream effectively, provided that the entire dose is ultimately ingested.

In your case, you mentioned that you have been taking the contraceptive for over a year and have had regular menstrual cycles, which is a good indicator that the medication has been effective for you. The concern about the pill dissolving in your mouth and potentially leaving some residue is understandable, but as long as you swallowed the majority of the medication, it is unlikely to have a significant impact on its efficacy.

It's important to note that the effectiveness of emergency contraceptive pills can be influenced by several factors, including the timing of ingestion relative to unprotected intercourse, body weight, and individual metabolic differences. However, the method of ingestion (chewing versus swallowing whole) is not typically a critical factor in determining efficacy.

If you find swallowing pills challenging, you might consider discussing this with your healthcare provider. They can provide alternative options or formulations that may be easier for you to take. Additionally, if you have any concerns about potential pregnancy or the effectiveness of your contraceptive method, it is always a good idea to consult with a healthcare professional for personalized advice.

In summary, while it is generally recommended to swallow emergency contraceptive pills whole, chewing or dissolving them does not appear to compromise their effectiveness significantly. As long as you ensure that you ingest the entire dose, you should be protected against unintended pregnancy. If you have further concerns or experience any unusual symptoms, don't hesitate to reach out to your healthcare provider for guidance.

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