Dr. Jim Shelton's Pearls: Oral Emergency Contraceptive

Jim Shelton

CCP | Editor-in-Chief, Global Health Science & Practice

Dr. Jim Shelton's Pearls is an occasional series by USAID’s Global Health Science Advisor that answers commonly asked questions about family planning. 

Originally posted on September 1, 2010.

Question: I understand the FDA has approved a new emergency contraceptive (EC). Can you please tell me about it?

Answer: Yes, on August 13, 2010 the FDA approved ella (ulipristal acetate) as a new oral emergency contraceptive. Some of its attributes:

  •  Ella has a larger window of action – up to 120 hours after unprotected sex, compared to 72 hours for LNG. For either, the sooner the EC is taken, the more effective it is.
  • It is somewhat more effective than the current standard levonorgestrel (LNG) EC. In comparative clinical studies, women using ella had a 1.8% chance of pregnancy after an episode of unprotected coitus compared to 2.6%. (The expected rate of pregnancy is approximately 5.5% had they not used EC.)
  • Ella is a progesterone agonist/antagonist, whereas LNG is a progestin.



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