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The Emergency Contraceptive Pill

There are two kinds of emergency contraceptive pill – Levonelle and ellaOne. Both work by preventing or delaying ovulation. The sooner you take either pill, the more effective it will be.

What is it?
The emergency contraceptive pill is sometimes called the “morning after pill”. There are two kinds of emergency contraceptive pill: Levonelle and ellaOne. Both work by preventing or delaying ovulation.

You can Take Levonelle more than once in a menstrual cycle and it does not interfere with your regular method of contraception. It has to be taken within 72 hours (3 days) of sex.

ellaOne may prevent other types of hormonal contraception from working a week after use and is not recommended for use more than once in a menstrual cycle. It has to be taken within 120 hours (five days) of sex.

Neither protect against sexually transmitted infections (STIs). It is thought that ellaOne is more effective than Levonelle. You only take one tablet in both cases. Both are less effective than the copper IUD at preventing pregnancy. The sooner you take either pill, the more effective it will be.

Who can use it?
Most can use the emergency contraceptive pill. This includes those who cannot usually use hormonal contraception, such as the patch or the combined pill.

There are no identified medical conditions that would mean you shouldn’t use Levonelle.

It is advised that you should not use ellaOne if you:

  • May already be pregnant.
  • Are allergic to any of the components of the drug.
  • Have severe asthma that is not properly controlled by steroids.
  • Have hereditary problems with lactose metabolism.
  • Are taking liver enzyme-inducing medication (as ellaOne will not be effective).

Neither protect against sexually transmitted infections (STIs). It is thought that ellaOne is more effective than Levonelle. You only take one tablet in both cases. Both are less effective than the copper IUD at preventing pregnancy. The sooner you take either pill, the more effective it will be.

What are the advantages?

  • There is no evidence that Levonelle affects the developing baby.
  • Levonelle can be used even if there has been an earlier episode of unprotected sex in the menstrual cycle in addition to the current episode.
  • Levonelle can be taken while breastfeeding (even though small amounts of the hormones contained in the pill may pass into your breast milk, it is not thought to be harmful to the baby).
  • Taking the either has not been shown to cause any serious long term health problems.
  • There should be no interaction between the emergency pill and most antibiotics (however, rifampicin and rifabutin, used to treat or prevent meningitis or TB, may affect ellaOne while they’re being taken and for 28 days afterwards).
  • After taking either emergency contraceptive pill, most will have a normal period at the expected time. However, you may have your period later or earlier than normal. If your period is more than seven days late, or is unusually light or short, contact your GP as soon as possible as you may need a pregnancy test.
  • You can Take Levonelle more than once in a menstrual cycle and it does not interfere with your regular method of contraception.

What are the disadvantages?

  • There is limited information on the safety of ellaOne during pregnancy, so it is recommended that you don’t use it if you are already pregnant.
  • The safety of ellaOne during breastfeeding is not yet known. The manufacturer recommends that you do not breastfeed for one week after taking this pill.
  • Taking either can have some common side effects. This includes tummy pain, headache, irregular menstrual bleeding (spotting or heavy bleeding) before your next period is due, feeling sick and tiredness.
  • Less common side effects include breast tenderness, dizziness, headache and vomiting. It is important to seek medical advice if you vomit within two hours of taking Levonelle or three hours of taking ellaOne, as you will need another dose or an IUD fitted.
  • Either contraceptive pill may interact with other medicines. This includes St John’s Wort, medication such as omeprazole (used to make your stomach less acidic) and some medicines used to treat HIV, epilepsy and TB. ellaOne cannot be used if you are taking one of these medicines, as it may not be effective. Levonelle may still be used but the dose may need to be increased (your doctor or pharmacist can advise on this).
  • ellaOne may prevent other types of hormonal contraception from working a week after use and is not recommended for use more than once in a menstrual cycle.
  • Neither protect against sexually transmitted infections (STIs).
  • Both are less effective than the copper IUD at preventing pregnancy.

Remember: talk to your GP or go to your sexual health clinic if you are concerned about any of your symptoms after taking either pill, especially if:

  • You think you might be pregnant.
  • Your next period is more than seven days late.
  • Your period is shorter or lighter than usual.
  • You have any sudden or unusual pain in your lower tummy. This could be a sign of an ectopic pregnancy, where a fertilised egg implants outside of the womb. This is rare but serious, so you will need immediate medical attention.

What if I am already using hormonal contraception?
You may need to take the emergency pill because you forgot to take your regular contraceptive pill, you did not use your contraceptive patch or vaginal ring correctly, or you were late having your contraceptive injection. If this is the case, you should take your next contraceptive pill, apply a new patch or insert a new ring within 12 hours of taking the emergency pill. You can then continue taking your regular contraceptive pill as normal.

If you have taken Levonelle, you will need to use additional contraception, such as condoms, for the next seven days if you use the patch, ring, combined pill or injection, or the next two days if you use the progestogen only pill.

If you have taken ellaOne, you will need to use additional contraception, such as condoms, for the next 14 days if you use the patch, ring combined pill or injection, or the next nine days if you use the progestogen only pill.

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