Supply scenarios

The following case studies are designed to help your pharmacy team identify and support patients with dysmenorrhoea.

Case Study  1

• The patient’s symptoms suggest they have primary dysmenorrhoea
• Their usual treatment of paracetamol is a second-line recommendation in the NICE guidelines, which also does not recommend the use of opioids¹
• Instead, NICE guidance recommends NSAIDs, such as naproxen or ibuprofen, as the first-line treatment choice for period pain¹
• A supply of Ultravana can be made³
• From a self-care perspective advise them that exercise, heat, TENS machines and relaxation can be beneficial.^1,13,27.

Case Study  2

• The patient’s symptoms suggest they have primary dysmenorrhoea
• Their usual treatment of paracetamol is a second-line recommendation in the NICE guidelines, which also does not recommend the use of opioids¹
• Instead, NICE guidance recommends NSAIDs, such as naproxen or ibuprofen, as the first-line treatment choice for period pain¹ but before recommending a switch from paracetamol it is important to ask about their asthma
• If they have experienced an asthmatic reaction after taking aspirin or an NSAID, then an NSAID, such as Ultravana is contraindicated and a supply cannot be made³
• If they haven’t had a previous reaction to aspirin or other NSAIDs, then Ultravana can be supplied²⁴
• From a self-care perspective advise them that exercise, heat, TENS machines and relaxation can be beneficial.^1,13,27

Case Study  3

• The patient’s symptoms suggest they have primary dysmenorrhoea
• While NICE guidance recommends NSAIDs, such as naproxen or ibuprofen, as the first-line treatment choice for period pain¹. As Ultravana can only be recommended for those 15 years and over, a supply cannot be made³
• Ibuprofen can be recommended as an alternative NICE-recommended first-choice treatment¹.
• From a self-care perspective recommend exercise heat, such as a hot water bottle, and relaxation exercises^1,13,27.

Case Study  4

• The patient’s symptoms suggest they have secondary dysmenorrhoea¹
• As such, an Ultravana supply cannot be made and they should be referred to their doctor as a matter of urgency. Analgesics and vaginal thrush treatment are inappropriate for OTC sale in this case. 

Case Study  5

• The patient’s symptoms suggest they have secondary dysmenorrhoea caused by their IUD¹
• They require GP referral for further investigation
• Ultravana cannot be supplied for the relief of secondary dysmenorrhoea, however, heat, such as a hot water bottle, may be of benefit in the interim¹.