Emergency hormonal contraception Levonelle, Emerres, Ezinelle, Melkine, Upostelle, EllaOne
Emergency hormonal contraception is an emergency 'back-up' to prevent pregnancy in case you have unprotected sex. It is for occasional use. It is not suitable as a regular method of contraception.
The pack contains one tablet - take the tablet as soon as possible.
Use a condom during sex until your next period.
The most commonly reported side-effect is feeling sick (nausea).
About emergency hormonal contraception
|Type of medicine||Emergency contraception ('morning after pill')|
|Used for||To prevent pregnancy after unprotected sex|
|Also called||Levonelle® One Step; Levonelle® 1500; Emerres®; Ezinelle®; Melkine®; Upostelle® (all of which contain levonorgestrel)|
EllaOne® (which contains ulipristal acetate)
|Available as||A tablet|
Emergency hormonal contraception (EHC) is also called the 'morning after pill'. If you have had unprotected sex, taking emergency hormonal contraception within 3-5 days can help prevent pregnancy. The pill should be taken as soon as possible after unprotected sex - the earlier it is taken, the more effective it is. EHC can be used if you have had sex without using contraception, or if you have had sex but there was a mistake with your usual contraception (for example, a split condom or if you forgot to take your usual contraceptive pills).
There are two types of 'morning after pill' available. One contains a medicine called levonorgestrel which is a female progestogen hormone. The other contains a medicine called ulipristal acetate which works on female hormone receptors within your body. They are both thought to work mainly by delaying or stopping your ovaries from releasing an egg.
Although EHC is effective, it is not as reliable as regular planned contraception. Therefore, it should only be used in an emergency.
The levonorgestrel pill is available free on prescription as brands called Levonelle® 1500, Isteranda®, and Upostelle®. It can also be purchased from a pharmacy, without a prescription, as a brand called Levonelle® One Step. It is effective for up to 72 hours (three days) after unprotected sex.
The ulipristal acetate pill is effective for up to 120 hours (five days) after having unprotected sex. Ulipristal acetate is available free on prescription through a doctor or family planning clinic as a brand called ellaOne®.
A non-hormonal method of emergency contraception is also available. An intrauterine contraceptive device (IUCD) can be inserted by a doctor or nurse up to five days after unprotected sex. This method of emergency contraception is more effective than hormonal tablets. Your doctor can give you more information about this.
Before taking emergency hormonal contraception
To make sure this is the right treatment for you, before you take the 'morning after pill' it is important that your doctor or pharmacist knows:
- If there is a possibility that you could already be pregnant.
- If you are breastfeeding.
- If you have problems with the way your liver works.
- If you have severe asthma.
- If you have ever had an ectopic pregnancy.
- If you have a condition of your small bowel that interferes with the way you absorb food, such as Crohn's disease.
- If you have a rare inherited blood disorder called porphyria.
- If you have ever had an allergic reaction to a medicine.
- If you are taking other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines. This is important because some medicines reduce the effectiveness of EHC. These include some medicines for epilepsy, two antibiotics called rifampicin and rifabutin, a herbal remedy for low mood, called St John's wort, some medicines used to treat HIV and AIDS, and some medicines taken for indigestion and heartburn.
How to take emergency hormonal contraception
- Before you take the tablet, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about the brand of pill you have been given and the side-effects from taking it. Take it exactly as you have been told.
- The pack contains one tablet. Take the tablet as soon as possible, as it works better the sooner you take it. Levonorgestrel (called Levonelle®1500, Levonelle® One Step, Isteranda®, Upostelle®) is best taken within 12 hours after unprotected sex - do not take it later than 72 hours after unprotected sex unless you have been advised otherwise by a doctor. Ulipristal acetate (ellaOne®) should be taken no later than 120 hours after unprotected sex.
- You can take the tablet at any time of day. Although you can take the tablet either before or after food, it is better to have a snack as you take the tablet if possible. This will help to reduce the risk of you feeling sick after taking the tablet. However, don't let this delay you taking the tablet.
- If you are sick within three hours of taking the tablet then you should take another tablet as soon as possible. You will need to get a further supply through your doctor or pharmacy.
- For some women your doctor may prescribe two levonorgestrel tablets, to be taken together at the same time. This will usually only happen if you are taking certain other medicines that affect how well levonorgestrel works.
Getting the most from your treatment
- EHC is for occasional use only. It should not be relied upon as a regular method of contraception. Do not use EHC more than once in the same menstrual cycle.
- Taking the 'morning after pill' will not provide protection against pregnancy for the rest of your cycle. If you are already using a regular method of contraception such as the contraceptive pill, you should continue to take this at your regular times, although you should also use a condom or avoid having sex until your next period.
- Your next period may occur a few days earlier or later than expected. If your periods are delayed by more than about 5-7 days, or if your bleeding is unusual in any way, see your doctor for further advice. Even if you have taken the tablet correctly, there is still a small risk of pregnancy and a pregnancy test may be advised.
- If you have any pain in your lower tummy (abdomen) or any unusual vaginal bleeding in the following few weeks, you should see a doctor. These may be signs of an ectopic pregnancy, and although this is rare, it is best to be aware of the possibility as it is a serious condition.
- EHC will not protect you against sexually transmitted infections. Speak with your pharmacist, doctor or clinic if you are concerned about this and need advice.
Can emergency hormonal contraception cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common side-effects associated with EHC. You will find a full list in the manufacturer's information leaflet supplied with your tablet.
|Common side-effects of emergency hormonal contraception (EHC)||What can I do if I experience this?|
|Feeling sick (nausea) or being sick (vomiting)||If you are sick within three hours of taking a tablet then you should take another tablet as soon as possible|
|Irregular bleeding before your next period, a light or heavy period, an early or late period||If your periods are delayed by more than 5-7 days, or are unusually light or heavy, see your doctor for further advice|
|Pain in your lower tummy (abdomen)||This is often nothing to worry about but if it is severe or if it continues for more than a day or so, see your doctor for further advice|
|Feeling tired or dizzy, headache, breast tenderness, diarrhoea, back pain, mood changes||These should pass within a few days|
If you experience other symptoms which you think may be due to the tablet, speak with your doctor or pharmacist for further advice.
How to store emergency hormonal contraception
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
If you are due to have an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
If you take any medicines that you have bought without a prescription, check with a pharmacist that they are suitable for you to take with your prescribed medicines.
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Levonelle® One Step; Bayer plc, The electronic Medicines Compendium. Dated June 2020.
Manufacturer's PIL, ellaOne® 30 mg film-coated tablet; HRA Pharma UK and Ireland Limited, The electronic Medicines Compendium. Dated November 2018.
British National Formulary, 80th Edition (Sep 2020); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.