Plan B, A to Z: Everything You Need to Know About Emergency Contraception

Roni Shye
Roni Shye, PharmD BCGP BCACP, is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania.
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Emergency contraception (Plan B or the “morning-after pill”) has changed so much in the past few years, it can be difficult to know where things stand. There are more options than ever before to prevent pregnancy after birth control failure or unprotected sex, and many are now available over-the-counter.

To get you up to speed, here’s a Plan B timeline, from its initial approval to the present:

Still wondering what your options are? Here’s the breakdown of the different types of emergency contraceptives now available:

Which emergency contraceptives are available over-the-counter?
Only the levonorgestrel 1.5 mg products (Plan B One-Step and the others listed above) are available OTC without a prescription and with no age restrictions.

Which emergency contraceptives require a prescription?
Levonorgestrel 0.75mg tablets (previously known as Plan B or Next Choice) still require a prescription if you’re 17 or younger.

Ella requires a prescription for women of all ages.

A Copper IUD must be inserted by your doctor.

When should Plan B One-Step (or any levonorgestrel 1.5 mg product) be taken?
Plan B One-Step (levonorgestrel 1.5 mg) should be taken as soon as possible, but must be used within 72 hours (3 days) of unprotected sex or birth control failure.

What is unique about Plan B One-Step (levonorgestrel 1.5 mg)?

The 1.5 mg levonorgestrel options consist of only one pill, and are taken as a one-time single dose.

When should levonorgestrel 0.75 mg products be taken?

The levonorgestrel 0.75 mg tablets should also be taken as soon as possible, and also must be started within 72 hours (3 days) of unprotected sex or birth control failure.

How are the levonorgestrel 0.75mg tablet taken?
Levonorgestrel 0.75 mg is available as two 0.75 mg tablets. The first tablet is taken as soon as possible (within 72 hours). The second tablet is taken 12 hours after the first tablet.

What are the most common side effects of any levonorgestrel emergency contraceptives?

Side effects can include menstrual changes, nausea, lower stomach pain or cramping, tiredness, Headache, dizziness, breast pain, and vomiting.

Are there advantages to using Ella (ulipristal acetate) instead?
Ella is more flexible—it can be taken up to 120 hours or 5 days after unprotected sex or birth control failure. This is a huge advantage compared to the levonorgestrel emergency contraceptives that only offer a 3-day window.

Are there similar advantages to using a copper IUD?

Yes—like Ella, a copper intrauterine device can be inserted up to 120 hours or 5 days after unprotected sex or birth control failure.

The copper IUD is also the most effective emergency contraceptive; only 1 in 1000 women who use this method get pregnant.

Once implanted, the copper IUD will also act as a hormone-free birth control method which can last up to 10 years or be removed by your doctor at any time.

Are there disadvantages to using a copper IUD as an emergency contraceptive?

The copper IUD must be inserted and removed by your doctor, which may be more difficult to schedule in the 5-day window needed to prevent pregnancy.

Who should NOT use emergency contraceptives?

You should not use emergency contraceptives if you are already pregnant, or if you have a known allergy to any of the medications.

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