Morning after pill

Medical information

Written and reviewed by a team of doctors. Dr Fox is regulated by the CQC & GPhC.

Dr Fox provides morning after pills as standby treatment. This does not replace the need to use a regular, reliable method of contraception, but it is for occasional emergency use. Dr Fox can supply emergency contraception to women aged between 18 and 55 years. Women aged under 18 should contact their GP, pharmacist, or a sexual health clinic.

Do you need a morning after pill immediately?

SMS text advice service

Text 'pharmacy EHC [and your postcode]' to 80011 (UK). You will get a text response with the 3 nearest pharmacies with their names, addresses, telephone numbers and distance from the postcode entered.

Frequency of use: women requiring the morning after pill more than once in a monthly menstrual cycle should consult a doctor or specialist contraception advisor, to ensure the best use of both emergency and ongoing contraception. Having a copper IUD (coil) fitted may be a more reliable emergency contraception, especially later in the menstrual cycle, and will also be able to be used for continuing contraception.

Morning after pill (Levonelle and ellaOne) treatment

Morning after pills are single dose treatments used to reduce the risk of pregnancy after unprotected sex or contraceptive failure.

Levonelle taken within 72 hours (3 days) or ellaOne taken within 120 hours (5 days) of sexual intercourse will prevent most pregnancies.

Generic versions of both morning after pills, levonorgestrel and ulipristal, are available at a lower cost. These contain the same active ingredients as the branded originals and are equally effective.

Women who are eligible can buy 1 or 2 doses of the morning after pill from Dr Fox to keep as a standby treatment for use when needed.

How does the morning after pill work

Morning after pills work by delaying ovulation (release of an egg).

• This prevents fertilisation from occurring.
• They do not work if ovulation has already happened.
• They will not affect an existing pregnancy.

ellaOne is slightly more effective and can prevent ovulation after it has been triggered.

Who can benefit from the morning after pill

The morning after pill may be suitable if:

• You have had unprotected sex.
• A condom failed (split, slipped, or came off).
• Contraception was used incorrectly (e.g. diaphragm or cap).
• You have missed contraceptive pills.
• Your implant, coil, or injection is overdue.
• Withdrawal method has failed.

Women needing emergency contraception more than once in a cycle should seek medical advice and consider more reliable ongoing contraception.

How to use the morning after pill

Take one dose as soon as possible after sex.

Time limits:

• Levonorgestrel: within 72 hours (3 days).
• ellaOne: within 120 hours (5 days).

Important advice:

• If you vomit within 3 hours, repeat the dose.
• Do not take Levonelle and ellaOne together, or within the same cycle.
• Avoid further unprotected sex or use condoms.
• Take a pregnancy test if your period is later than expected or abnormal, or if you have symptoms of pregnancy.

Weight considerations:

• ellaOne is preferred if BMI ≥26 or weight >70kg.
• If using Levonelle/ levonorgestrel and BMI ≥26 or weight >70kg, a double dose (two tablets) is advised*.

*Taking a double dose, recommended by the CoSRH (College of Sexual and Reproductive Health), is 'off-label' and not mentioned in the patient information leaflet. If a medicine is used for an off-label (unlicensed) purpose, the manufacturer is not liable in case of adverse events, and doctors take responsibility for the prescribing.

ellaOne and Levonelle both affect regular hormonal contraceptives (combined and progestogen only), but there are more issues with ellaOne. This affects how long it will take for you to be able to rely on your normal contraceptive again. See FAQ when and how to start or restart your regular contraception.

Who should NOT take the morning after pill

The morning after pill may not be suitable if:

• You are already pregnant.
• You have severe liver disease.
• You are taking enzyme-inducing medicines (e.g. epilepsy medication, TB antibiotics, HIV treatment, St John’s Wort).
• You have severe asthma treated with oral steroids (ellaOne only).

Checks are included in the online consultation. For a full list of interacting medicines see the manufacturer's patient information leaflet.

Morning after pill possible side effects

As with all medicines, side effects are possible, although they are usually mild and short-lived.

Common side effects (may affect up to 1 in 10 people):

• Headache.
• Nausea.
• Abdominal pain.
• Fatigue.
• Dizziness.
• Irregular bleeding or changes to your next period.
• Period pain.

Important side effects / advice:

• Vomiting within 3 hours → repeat dose required.
• Period may be early or delayed.

Seek medical advice if:

• You have unusual abdominal pain and bleeding (possible ectopic pregnancy).

Morning after pill and pregnancy or breastfeeding

Pregnancy:

• The morning after pill will not harm an existing pregnancy.

Breastfeeding:

• Current guidance indicates women can take both Levonelle/ levonorgestrel or ellaOne/ ulipristal and continue to breastfeed safely with no harm to the baby, which is supported by The Breastfeeding Network.
• Manufacturer advice differs in the patient information leaflet and advises not to breastfeed for 8 hours after taking Levonelle/levonorgestrel and for 7 days with ellaOne/ulipristal.
• The manufacturers are often slow to update their information but evidence based clinical practice has proven it is safe to take whilst breastfeeding.

Alternative treatment for emergency contraception

The most effective option is a copper IUD (coil):

• Can be fitted up to 5 days after sex or 5 days after ovulation.
• Fewer than 1 in 1000 women become pregnant.
• Provides ongoing contraception.

Regular contraception is more reliable than emergency contraception. Options include:

• Long acting reversible contraception (LARC) including copper IUD (coil), hormonal coil (IUS), depot injection or implant.
• Combined or progestogen only pills.
• Combined contraceptive patches or vaginal rings.
• Condoms.

A reliable contraceptive method should be started or resumed as soon as possible after using emergency contraception.

Progestogen only pills (mini pill) or combined contraceptive options are also available from Dr Fox pharmacy.

Other possible risks

If you need the morning after pill it may be that you are also at risk of catching sexually transmitted diseases. Contact a GP or sexual health clinic for a full sexually transmitted disease screen if you are at risk.

Local NHS Sexual Health Clinics

• England
• Wales
• Scotland
• Northern Ireland

Compare ellaOne and Levonelle

Buy treatment

Dr Fox supplies the morning after pill on prescription – you are required to answer a short medical questionnaire before your order can be completed. Emergency contraception can be obtained free of charge from an NHS provider such as your GP or a sexual health clinic following a consultation with them.

1. Medical questions
2. Choose treatment
3. Complete order

Answer medical questions to order(morning after pill)

Honest & accurate responses are necessary for safe medical assessment