Contraceptive Pearl: Emergency Contraception Clinician Guide
Emergency Contraception Clinician Guide
Happy Valentines Day!
Because Emergency Contraception (EC) is not yet available over the counter to people of all ages – and because some pharmacies don’t keep it in stock, clinicians need to know about multiple types of EC. Advance prescribing of EC pills makes it easier for patients to use. Ideally, every woman/teen who may be at risk of unintended pregnancy should have emergency contraceptive pills in her medicine cabinet!
Use the EC Clinician Guide below to determine the most appropriate EC method for your patient. When the best method is unavailable, this chart can help you find an alternative that’s easier to obtain quickly.
| Progestin: levonorgestrel | Ulipristal acetat | Estrogen/progestin
(Yutzpe Method) |
Copper IUD | |
| Brand name/s | Plan B One-Step
Next Choice Levonorgestral Tablets |
ella® | Many brands of combined oral contraceptive pills (COC) | Paragard |
| Dosage
|
1.5 mg levonorgestrel
(1 or 2 pills, depending on brand) |
1 pill | Varies, depending on pill pack used | IUD |
| Timing after sex | ASAP: Can be used up to 5 days (120 hours) after sex. | ASAP: Can be used up to 5 days (120 hours) after sex. | ASAP: Can be used up to 5 days (120 hours) after sex. | Can be inserted up to 5 days after sex. |
| Availability | Levonorgesterl is available over the counter for people over age 17 (with photo ID). Younger people require a prescription from a clinician. | ella® requires a prescription. It’s not carried by all pharmacies, but it can be ordered online without an existing prescription. | Oral contraceptive pills are available by prescription only. | The IUD must be inserted by a trained clinician. |
| Instructions
|
Take pill(s) at once | Take pill at once | Take pills at once. Follow directions based on COC brand. | Call your health care provider ASAP for IUD insertion. |
| Cost*
|
Plan B One-Step: $35-$60.
Next Choice: $30-$55. Levonorgestrel (Plan B generic): $35-$40 |
ella® can be ordered online for $40 including shipping. | One pack of COCs may cost $8 to $50. | About $500 in US, but may be covered by a health plan. Cost includes up to 12 years of high-efficacy contraception. |
| Efficacy | Days 1-2: Medium
Days 3-5: Medium-low |
Days 1-5: Medium | Days 1-2: Medium
Days 3-5: Medium-low |
Days 1-5: High |
| Efficacy over time | Efficacy decreases over the 5 days. | Efficacy does not change over the 5 days. | Efficacy decreases over the 5 days. | Efficacy does not change over the 5 days. |
*Costs vary
Levonorgestel EC is available directly from pharmacies without a prescription for people of any age in the following states: Washington, California, Vermont, Alaska, Maine, New Hampshire, New Mexico, Hawaii, and Maine.
Resources
Medical Eligibility for Initiating Contraception Chart
Emergency Contraception Website
Emergency Contraception and Medication Abortion: What’s the Difference? Fact Sheet
Emergency Contraception Pills or EC Fact Sheet
Back Up Your Birth Control Campaign
Sources
Zieman, Mimi. A Pocket Guide to Managing Contraception 2010-2012. Bridging the Gap Foundation.
Pharma-free
The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.
