Written by Dr David Delvin, GP and family planning specialist
What is the morning-after pill?
Although lots of people talk about the morning-after pill, this term is actually misleading. In reality, you don't have to take it on the morning after sex. You should take it as soon possible. The more quickly you take it, the better are the chances that it will work.
However, you do have a little time in which to obtain it. One type of morning-after pill can if necessary be taken up to three days after sexual intercourse. Another type can be taken up to five days following sex.
In Britain, nurses and doctors call this medication the post-coital pill (PCP).
Most chemists are now willing to provide this service. The cost at the moment is about £25.
In Britain, there are currently two different types of PCP available from doctors: Levonelle and EllaOne.
I advise you to have a full discussion with the doctor about which one would be better for your individual circumstances.
In the UK, the long-established PCP is called Levonelle one step or Levonelle 1500. These are identical, but Levonelle One Step is the brand that can be bought without prescription.
It should be taken within three days (72 hours) after sex.
This PCP contains 1.5 mg of a female-type hormone called levonorgestrel – which is one of the ingredients of several types of contraceptive Pill.
It's believed that Levonelle works by:
It won't work if you're already pregnant.
What about side-effects? Levonelle doesn't often have troublesome side-effects. According to the 2011 British National Formulary, the commonest unwanted effects are:
If you throw up within TWO hours of taking a Levonelle tablet, you've probably lost it. So you need to take another one.
Important note: severe lower tummy pain could just possibly indicate an ectopic pregnancy (a pregnancy outside the womb), because Levonelle isn't good at preventing those. Contact a doctor immediately.
If you're supposed to be on the Pill, mini-Pill, vaginal contraceptive ring or contraceptive patch, you can continue using your current method after taking Levonelle. But you should either avoid sex or employ condoms until the doctor tells you that you are safe from pregnancy.
Contraindication: Levonelle shouldn't be used by women who have severe liver disease or the rare condition porphyria.
In 2010 an entirely new brand of PCP became available in the UK. It's called EllaOne – pronounced as if it were two words: 'Ella' and 'One'.
Its non-commercial name is ulipristal acetate. The dose is 30mg.
You can take EllaOne up to five days after unprotected sex.
It would be fair to say that EllaOne is relatively new, so not a lot is known about its mode of action, or possible long-term effects.
Experts state that it acts by blocking the receptors onto which your female hormone progesterone would normally bind.
The manufacturers say that it 'is thought to work by stopping your ovaries from releasing an egg'. They also state that 'it may also alter the environment in the womb'.
Although EllaOne definitely works, at present there's no overwhelming evidence that it works better than the Levonelle.
So, unless you're too late to use Levonelle (for instance, if three days have already elapsed since you had sex), your doctor may see no point in giving you this newer brand.
If you do use EllaOne, please first read the patient information leaflet that comes with it. It will be updated as more information becomes available about the drug and its side-effects.
Contraindications: EllaOne is probably not advisable for women with severe asthma or with serious liver problems. It interacts with a number of other drugs; the leaflet gives details.
The most common unwanted effects of EllaOne are:
These side-effects occur in less than 10 per cent of women. The makers state that 75 per cent of EllaOne users have their next period more or less on time, but 7 per cent experience it a little early, and 18 per cent find that it is delayed.
EllaOne's effect can be reduced by various medications, including the popular remedy St John's wort.
Please note that the effectiveness of oral contraceptives may be reduced by EllaOne. So if you happen to be on the Pill or the Mini-Pill, in my view you should use condoms till your next period arrives. Or else, don't have sex.
If you happened to throw up within THREE hours of taking EllaOne, you would need another dose.
Important note: severe low abdominal pain might indicate an ectopic pregnancy. So consult a doctor.
Is the PCP effective?
Who is it useful for?
Is it dangerous to use?
How do I take it?
Any other warnings?
If it doesn't work, could the tablet harm the unborn
Can you use the post-coital pill more than once in a
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|Last updated 10.07.2013
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