EllaOne (ulipristal acetate 30mg) is a newly available morning after pill with an advantage. The only previously available morning after pill, Levonelle, must be taken within 3 days of intercourse. EllaOne can be taken up to 5 days after intercourse.
EllaOne is as effective as Levonelle within the first 3 days, and crucially remains effective within a further 2 days. EllaOne is a prescription only medicine and is available from Dr Fox.
The extension to the window in which emergency contraception can be taken is significant. It is not always easy for women to obtain morning after pills, particularly if they obtain them through an NHS prescription. An emergency appointment with a doctor’s surgery or family planning clinic is required, and then a prescription has to be filled at a pharmacy. It is easy for 3 days to pass if there is a delay in a woman deciding she wants emergency contraception.
Cost of ellaOne
Dr Fox supplies low cost ellaOne and Levonelle. Other online doctor services have a similar service at a higher cost. To buy ellaOne from other online doctors can cost £43.00 compared with £24.40 from Dr Fox. Levonelle costs £25.99 from some services compared with £12.80 from Dr Fox. The medication is the same.
Buying ellaOne online
EllaOne is a prescription only medicine and is not normally available from pharmacies without a prescription unless pharmacies are using specialist ‘patient group directions’.
Dr Fox provides ellaOne on prescription to women who wish to keep a standby supply for emergency use. If the medication is to hand when it is needed, it is likely to be taken early at the time when it is most effective. Women in remote areas far from pharmacies or women who are travelling may find this particularly useful.
Women wishing to buy ellaOne online first need to read an information page and then complete a yes/no questionnaire. Doctors issue electronic prescriptions which allow pharmacies to post out medication.
Levonelle One Step (Levonelle without a prescription) is available from most pharmacies without a prescription. The recommended retail price of Levonelle One Step is £22.35, which may be out of the price range of some women, particularly young women.
How effective is ellaOne
Studies show pregnancy rates of close to 1.5 in 100 after women take ellaOne. This rate of pregnancies after taking ellaOne remains fairly constant whether ellaOne is taken on day 1 after intercourse or day 5 (up to 120 hours) after intercourse.
The manufacturers of ellaOne suggest that, if taken immediately before ovulation, it is more likely to stop ovulation occurring compared with Levonelle. Levonelle is licensed to be taken only up to 3 day (72 hours) after unprotected intercourse.
Side effects of ellaOne
EllaOne side effects include headache (18%), nausea (12%), dysmenorrhea (painful period) (9%), abdominal pain (8%), fatigue (6%) and dizziness (5%). Most women do not experience significant side effects and in most cases they are not severe.
Women who have vomiting after ellaOne should take a repeat tablet if they vomit within 3 hours.
More detail about ellaOne side effects is presented in the manufacturer’s Patient Information Leaflet.
Interactions (taking other medication with ellaOne)
EllaOne has the potential to interact with rifampicin, phenytoin, phenobarbital, carbamazepine, ritonavir, St John’s wort, Hypericum perforatum, antacids and anti-ulcer medication. If any of these medications is being taken women need to discuss this with a doctor or pharmacist before taking ellaOne.
How does ellaOne work?
EllaOne stops or delays ovulation (release of eggs from the ovary) which occurs around the middle of the menstrual cycle. Without ovulation there can be no pregnancy. If ellaOne is taken after ovulation it may reduce the chance of a fertilised ovum implanting in the womb. It has been suggested that the use of ellaOne, which has a longer window of effectiveness after intercourse than Levonelle, is similar to a termination of pregnancy (abortion) although it is debatable at what stage life begins (ovulation, implantation or thereafter).
Alternatives to ellaOne
The only tablet form of post coital contraception available in the UK apart from ellaOne is Levonelle. Doctors and family planning clinics can insert an IUCD (intrauterine contraception device) after unprotected intercourse; usually no later than 5 days after intercourse, up to which time it is nearly 100% effective.
Women who need regular contraception should not rely on taking ellaOne on an ‘as required’ basis. They would be better advised to take a regular oral contraceptive pill, either a progesterone only mini pill or a combined oral contraceptive pill containing an oestrogen and a progestogen, both of which are more effective and reliable than morning-after-pills.
Barrier contraception with condoms or caps is also more reliable and protects against sexually transmitted disease, which of course, ellaOne does not.
Women taking a contraceptive pill should continue to take it after taking ellaOne, although it cannot be relied upon for contraception for the remainder of the same menstrual cycle.
Buy EllaOne online from Dr Fox.