Ulipristal
Indications for use
- Emergency contraception within 120 hours (5 days) of unprotected sexual intercourse or contraceptive failure
Age
- Any woman of child bearing age, including adolescents (will need to consider other legislation such as the legal age of consent in tandem to the manufacturer's recommended age)
Dose/Directions
- One tablet as soon as possible, but no later than 120 hours (5 days) after unprotected intercourse or contraceptive failure
Duration
- Single dose
Contra-indications/referral criteria
- Hypersensitivity to active substance or excipients
- Pregnancy - should be excluded before ellaOne administered
- Breastfeeding: The ellaOne SmPC/PIL advises avoiding breastfeeding for one week after intake. However, CoSRH (formerly FSRH) advises that there is no need to avoid breastfeeding after a single dose of ulipristal acetate EC, based on evidence that negligible amounts are excreted in breast milk (Emergency Contraception guideline, amended April 2026)
- For occasional use only (but note the repeated use in the one cycle is not a contraindication)
Examples of drug interactions
- CYP3A4 inducers eg rifampicin, phenytoin, carbamazepine, St John's Wort
- Oral contraceptives (see manufacturer's guidance and BNF about additional contraceptive measures and be aware that the information differs)
ellaOne PIL: After you take emergency contraception and until your next period comes, you should use a condom every time you have sex. ellaOne may make regular hormonal contraceptives, like pills and patches, temporarily less effective. If you are currently taking hormonal contraception, continue to use it as usual after taking ellaOne, but be sure to use condoms every time you have sex until your next period. Do not use ellaOne together with another emergency contraceptive pill that contains levonorgestrel. By taking them both together, you might make ellaOne less effective.
CoSRH (formerly FSRH): women should be advised to wait 5 days after taking ulipristal acetate before starting suitable hormonal contraception. Women should be made aware that they must use condoms reliably or abstain from sex during the 5 days waiting and then until their contraceptive method is effective. There is one exception to this 5 day delay rule which relates to combined hormonal contraception (CHC) i.e. "If CHC pills are restarted after a scheduled hormone-free interval and pills are then missed later in the first week of pill taking, ulipristal acetate may be considered, with immediate restart of pill taking." See CoSRH (formerly FSRH) for more information on this.
[The BNF/CoSRH outlines guidance on combined and progestogen- only contraceptives: i.e. what to do if a pill is missed and additional precautions that are required until the particular contraceptive becomes effective again]
Side-effects
- Mood disorders, headache, dizziness, nausea, abdominal pain/discomfort, vomiting, myalgia, back pain, dysmenorrhea, pelvic pain, breast tenderness, fatigue
- ellaOne may have minor or moderate influence on the ability to drive or use machines
Other pertinent information
- If vomiting occurs within 3 hours of ellaOne intake, another tablet should be taken
- Will not offer protection for subsequent sexual intercourse or against sexually transmitted infections
- If the menstrual period is more than 7 days late, unusually light or unusually heavy, or if the patient experiences symptoms such as abdominal (stomach) pain, breast tenderness, vomiting or nausea, then pregnancy status should be ascertained
- Reclassified POM→P: 2015