There are four emergency contraceptive options: levonorgestrel (Plan B, Next Choice), uliptristal acetate
(Ella), contraceptive pills containing estrogen and progesterone, and the copper intrauterine device (IUD).
She asks you to explain the differences among the various options. What will you tell her?
• In the United States, there are two FDA)–approved products for EC. Levonorgestrel (Plan B, Next
Choice) is a progestin-only containing pill. The instructions are to take one pill within 72 hours
after unprotected intercourse and the second dose 12 hours later. There is a one-step option that
involves taking one pill within the 72-hour time frame. Levonorgestrel is available to women
17 years old or older without a prescription and to those aged 16 or younger with a prescription.
When taken within 24 hours, Plan B is about 95% effective; within 72 hours, it is about 89%
effective. The EC agent Ella is a progesterone agonist that is available by prescription only. The
instructions are to take one 30-mg pill up to 5 days after intercourse.
• Copper-releasing IUD (ParaGard) insertion can be done up to 7 days after unprotected intercourse
in women who are good candidates for an IUD. That includes women who are at low risk for sexually
transmitted infections (STIs) and who are in a monogamous relationship. The copper IUD is 99%
effective when used as an EC and provides the user with 10 years of highly effective contraception.
• The Yuzpe regimen consists of two doses of an oral contraceptive that contains an estrogen plus a
progestin. The first dose should be taken within 72 hours of unprotected intercourse, and the second
dose 12 hours later. Most oral contraceptive brands can be used. The dose varies by brand based on
the composition of the pills. Combination EC is about 75% effective in preventing pregnancy.
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