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Enables independent prescribing of contraceptives by pharmacists under state guidelines.
Helpful Links: Utah Code § 58-17b-803 & Administrative Rule R156-17b.
Pro's: Easiest to implement, no state forms required, simply follow standard of practice for prescribing.
Con's: regulations are weak
Allows pharmacists to prescribe contraceptives following patient assessment protocols.
Helpful Codes: Utah Code § 26B-4-505 & R433-200.
Allows prescribing under agreements with supervising healthcare providers.
Helpful Links: (CPA), Utah Code § 58-17b-102 & R156-17b-614.
Persistent side effects from hormonal contraception are one of the most common reasons patients discontinue or switch methods. Pharmacists are uniquely positioned to recognize patterns, validate patient concerns, and recommend evidence-based alternatives—or refer when needed.
If a side effect persists beyond 2–3 months and significantly impacts quality of life, switching to a different formulation or method may improve tolerability and adherence.
| Symptom | Methods More Likely to Cause | Consider Switching To |
|---|---|---|
| Acne | Progestin-only pills (POPs), DMPA | COCs or vaginal ring (if no estrogen contraindications) |
| Amenorrhea | DMPA, continuous COCs or vaginal ring | Cyclic COC regimens or POP (if regular bleeding desired) |
| Breakthrough Bleeding | Low-dose COCs, POPs, continuous regimens | COC with up to 35 mcg EE, patch, or ring with ≥3-day hormone-free interval |
| Breast Tenderness | Patch | COC with ≤20 mcg EE or vaginal ring |
| Decreased Libido | Very low-dose COCs (15 mcg EE) | COC with higher EE dose (up to 35 mcg) |
| Depressed Mood | DMPA (possible link) | Try COC, patch, or vaginal ring; refer if symptoms persist |
| Headache | All hormonal methods (esp. >35 years old) | No method shown superior; screen for migraines with aura—estrogen contraindicated in these cases |
| Heavy Menses | DMPA | COCs, patch, or vaginal ring |
| Hirsutism | POPs, DMPA | COCs (especially with anti-androgenic progestins) |
| Increased Vaginal Discharge | Vaginal ring | COC, patch, or POP |
| Irregular Menses | DMPA, emergency contraception | COC, patch, ring, or POP |
| Nausea | Patch, emergency contraception | Vaginal ring; antiemetics if EC is needed |
| Oily Skin | POPs, DMPA | COCs |
| Weight Gain | DMPA | COCs, patch, ring, or POP |
Normalize some side effects during the first 1–3 months, but empower the patient to track them.
Explain expected changes when switching methods—especially in bleeding patterns, mood, and skin/hair.
Use patient-centered language ("How is this affecting your daily life?" vs. "That’s a common side effect.")
Consider adherence and lifestyle—a side effect that compromises consistency may be more harmful than the symptom itself.
Note: This resource is intended for pharmacists and healthcare professionals. Always refer to the latest clinical guidelines and product labeling for prescribing decisions.
Eligible Medications: Contraceptive pills, patches, and vaginal rings.
Prescription Limitations: Up to 12 months of refills. Follow-up required after two years.
Age Restrictions: Patients must be 18 years or older.
Documentation Requirements: Maintain patient records for 7 years; comply with HIPAA regulations.
Training Requirements: Completion of state-mandated courses for prescribing and patient counseling.
Eligibility:
Billing Codes:
Use CPT Code 99401 (preventive counseling) with FP Modifier for family planning services. Pharmacy claims for self-administered hormonal
contraceptives must include one of the following diagnosis codes:
Dispensing Fee:
Pharmacists can receive a dispensing fee for prescriptions billed under Medicaid when using their Medicaid-registered individual NPI.
Submission Process:
Submit claims via Utah Medicaid PRISM system.
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