Contraception: repeat prescription online

What this service actually is

This is a written medical assessment for continuing hormonal contraception you are already established on. You choose the exact product you take, complete a medical questionnaire about your history and risk factors, and a doctor reads it and answers in writing. If he is satisfied that continuing is appropriate, he issues a prescription as a PDF and it is sent to the email address you gave. You then take it to a pharmacy of your choice.

There is no video consultation, no phone appointment and no live chat. The assessment is asynchronous, which is the trade-off: you do not have to find an appointment slot, and in return you cannot ask questions in real time. If what you need is a conversation about which method might suit you better, this is the wrong product and a GP or a family planning service is the right one.

It is also worth being clear about what the fee buys. You are paying for the medical assessment of your questionnaire, not for the issue of a document. A doctor reading your answers and concluding that a renewal is not safe has still done the work, and that outcome is a normal part of the service rather than a failure of it. The refund rules that follow from that are set out further down this page.

Who it is for, and who it is not for

It fits you if you have been taking the same combined pill, progestogen-only pill, patch or vaginal ring for some months, it suits you, you have a reasonably recent blood pressure reading, and nothing in your risk profile has changed since it was last prescribed. In that situation the medical question has already been answered by whoever started you on it, and the practical problem is supply: you are between GPs, you have moved, you cannot get a timely appointment, or you have run out sooner than expected.

It does not fit you if this would be your first prescription for hormonal contraception. A first prescription requires a blood pressure reading and a proper discussion of which method suits your circumstances, and neither of those can be done through a form. It does not fit you if you want to change method or dose, because that is a new prescribing decision rather than a renewal. It does not fit you if you want an implant or a coil, hormonal or copper, because both have to be fitted and removed by a trained clinician in a room with you.

If you are within the age band of the HSE free contraception scheme, or you hold a medical card, the state route covers the consultation and the product and is cheaper than us. Check the current age range on the HSE site before paying anybody.

What the doctor assesses

Most of the assessment for combined hormonal contraception is about the risk of blood clots and stroke, because oestrogen raises both. The questionnaire therefore asks about migraine and specifically whether it comes with aura, your blood pressure and when it was last measured, whether you smoke and your age, height and weight, any personal or family history of venous thromboembolism, known clotting disorders, recent major surgery or a period of immobility, breastfeeding and how long ago you gave birth, liver disease, and any history of breast cancer.

Some of those are absolute barriers rather than factors to weigh up. Migraine with aura rules out combined hormonal contraception because of stroke risk, and so does smoking from the age of 35. Where a combined method is ruled out, progestogen-only options generally remain available, but moving you onto one of them is a change of method and not something we do through this route: that decision belongs with a prescriber who can talk it through with you.

Interactions are checked as well. Certain anti-epileptic medicines and other enzyme-inducing drugs make hormonal contraception less reliable, and that has to be identified before a renewal rather than discovered afterwards. This is why the questionnaire asks for everything else you take, including anything bought over the counter or online.

What you need to have ready

Six things carry almost every renewal: the exact product name, the strength, how you take it, how long you have been taking it, who prescribed it last, and your most recent blood pressure reading with the date it was taken. Brand names for contraception are numerous and many of them contain the same two ingredients at the same strengths, so give the name printed on your pack rather than an approximate one.

Add the details that decide the outcome: whether your headaches come with visual or other warning symptoms beforehand, whether you smoke and how much, your height and weight, everything else you take, any allergies, and whether you are breastfeeding or have given birth recently. Say plainly if you have missed pills recently or if your bleeding pattern has changed.

The quickest way to supply most of this is a photograph of the dispensing label on your pack or of your last prescription. A blood pressure reading taken at a pharmacy, in a practice or with a home monitor is acceptable as long as you say where and when it was taken and give both numbers.

A questionnaire answered in three words is the single most common reason an assessment stalls, and a stalled assessment costs you time rather than saving it. Start while you still have a strip left.

Which methods this route can renew

The daily pill, whether combined or progestogen-only, the contraceptive patch and the vaginal ring are the methods this route suits, because you take or apply them yourself and the only thing standing between you and the next pack is a valid prescription.

The injection is different. A prescription can exist for it, but somebody has to give it to you at the correct interval, so if you have nobody arranged to administer it, a prescription on its own does not solve your problem. The implant and both the hormonal and the copper coil are outside this route entirely: they are fitted and removed as procedures and no online assessment substitutes for that.

Emergency contraception is not a prescription matter in Ireland at all. Both levonorgestrel and ulipristal acetate are supplied directly by pharmacies after a short consultation with the pharmacist, and they are free within the age band of the HSE scheme. Levonorgestrel is licensed for use up to 72 hours after unprotected sex and ulipristal acetate up to 120 hours, and both work better the earlier they are taken, so the pharmacy counter is genuinely faster here and an online route would only delay you.

One further constraint applies to everything above: a medicine that is not authorised in Ireland cannot be dispensed here whatever a prescription says, so the document names the substance in a strength and form available in Irish pharmacies.

What you receive and what to do with it

The prescription is issued as a PDF built to the Annex of Directive 2012/52/EU, the European format for a prescription intended to be dispensed in another member state. It carries your name and date of birth, the date, the prescriber's name, professional qualification, work address including the country, an email address and a telephone number with an international dialling code, a handwritten signature, and the medicine named by its international non-proprietary name with strength, form, quantity and dosage. It arrives by email.

Take it to a pharmacy of your choice with photo identification, because the pharmacist has to match you to the name on the document. Most pharmacists prefer a printed copy, so print it before you go rather than presenting a phone screen. There is no PIN code in this route and no Irish patient number: the paper is the whole of it.

The Pharmaceutical Society of Ireland publishes guidance for pharmacists on dispensing prescriptions issued in another EEA member state, which tells the pharmacist what to check. That guidance says a pharmacist may dispense, not that one must. Professional judgement stays with the pharmacist and any pharmacy may decline. Acceptance is more likely when the document is complete and legible, the product is authorised in Ireland, and the prescriber's contact details are on it. We do not name or recommend any particular pharmacy.

What it costs, and when the fee is refunded

A contraception assessment costs 19.90 euro. It is a single charge with no subscription and no recurring billing, and it is the same price as our repeat prescription assessment for other long-term medication. Our weight management assessment is 29.90 euro. The contraceptive itself is priced by whichever pharmacy dispenses it and that price has nothing to do with us.

The fee covers the medical assessment, not the issuing of a document. If the doctor declines on medical or legal grounds, the fee is refunded. If the doctor asks you for documentation, you have at least 7 days to provide it and we will remind you before the deadline; if the consultation cannot be completed, we refund the full amount.

We do not publish a turnaround time. It depends on the doctor's queue and on whether your history is complete enough to act on, and a number we could not stand over would be worse than no number at all. If the doctor comes back with a question, nothing further happens until you reply. The practical advice is the same in every case: begin the assessment while you still have contraception left, not on the day you take the last one.

When to be seen in person, and who reviews your request

Some symptoms need assessment rather than a renewal: a new severe headache, new visual symptoms, a breast lump, unexplained or heavy vaginal bleeding, or pain during sex. Others are urgent. Calf pain or swelling, sudden breathlessness, chest pain, coughing up blood, one-sided weakness or difficulty speaking while you are taking a combined hormonal method could indicate a clot or a stroke: ring 112 or 999 or go to the nearest Emergency Department, and tell them what you are taking. Contraception is also unrelated to sexually transmitted infection, and neither this assessment nor a prescription covers testing for it; the HSE offers free home testing kits and STI clinics.

Requests are reviewed by lek. Damian Wojno, a doctor registered with the Polish Medical Chamber, licence no. 3211301. He is not on the Irish Medical Council register and does not hold an Irish practice address, which is why the document he issues is a European cross-border prescription rather than an Irish one. This page was written by the MEDINOW editorial team and reviewed by him.

None of this replaces having a GP. Somebody has to hold the whole record, check your blood pressure, and look at the method again from time to time. A renewal service is useful in the gaps around that, not instead of it.