First-lineellaOne
Ulipristal Acetate
Selective progesterone receptor modulator (SPRM)
EC up to 120 h post-UPSI; outperforms LNG late.
Oral
First-line for
- Emergency contraception ≤120 h
- Most effective oral EC near ovulation
Mechanism
Delays/inhibits ovulation by blocking progesterone-driven LH surge.
UPA vs LNG
- UPA — up to 5 days, works closer to ovulation
- LNG — 72 h only, less effective if BMI >26
Dosing
- EC
- 30 mg PO single dose ≤120 h
Contraindications
- AbsoluteSevere asthma on oral steroids
- CautionBreastfeeding — express & discard ×7 days
Side effects
- Headache, nausea, dysmenorrhoea
- Cycle disturbance
Fetal & maternal notes
- • No evidence of teratogenicity if pregnancy ensues.
Key interactions
Progestogens (POP/COC)
AvoidMutual antagonism — wait 5 days before restarting hormonal contraception
Enzyme inducers
Avoid↓ efficacy → use Cu-IUD
Clinical pearls
- 💡 Cu-IUD remains most effective EC overall.
- 💡 Repeat pregnancy test if no period in 3 weeks.
Content last reviewed: REPLACE_ME (e.g. 2026-07)
Spotted something out of date? See our disclaimer or use Report an Error above.