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How does ellaOne work?

EllaOne contains ulipristal acetate 30mg which works by delaying the release of eggs from the ovaries at the time of ovulation.

How effective is ellaOne?

EllaOne is licensed to be taken up to 120 hours (5 days) after intercourse.

EllaOne has an effect on the ovaries right up until the actual egg release, whereas the alternative morning after pill, Levonelle, only works to prevent the hormone change which triggers the egg release. This makes ellaOne a better choice if a woman is closer to expected ovulation (ovulation is usually 14 days before next period is expected).

Out of 100 women who take ellaOne in one monthly cycle, approximately 2 will become pregnant. Overall ellaOne has been shown to be more effective as emergency contraception than Levonelle. See also ellaOne FAQs.

After 120 hours (5 days) ellaOne will be largely ineffective.

EllaOne does not work after ovulation has occurred, but a copper coil can still be fitted up to 5 days after ovulation to prevent pregnancy. It can be difficult to pinpoint ovulation exactly, so many women will choose to take ellaOne, even in the later part of the monthly cycle.

Who can use ellaOne?

EllaOne is for use by women only and is suitable for most women.

It is used to prevent pregnancy, after having sex where contraception has not been used successfully, when:

• No contraception was used.
• Condom split or slipped off.
• Diaphragm or cap was used incorrectly.
• Using the withdrawal method has failed.
• The next implant, coil, or depot injection is delayed.
• In some cases after forgetting to take the regular contraceptive pill, patch, or ring. See NHS information 'what should I do if I miss a pill?': combined pill or progestogen-only pill

When is ellaOne not indicated?

Some medications may reduce the effectiveness of ellaOne.

EllaOne should not be used, if any of the following have been used in the previous 4 weeks:

• Epilepsy medication.
• Antibiotics to treat tuberculosis.
• HIV treatment.
• Griseofulvin to treat fungal infections.
• St John's Wort.

EllaOne may be less effective if any of the following have been used in the previous 7 days:

• Progesterone - found in the combined pill, POP, implant, depot injection or IUS, or it may have been prescribed to treat heavy or irregular periods, or to delay periods.
• Antacids and antiulcer medication.

EllaOne should not be used if you have severe asthma treated with steroid tablets or severe liver disease.

How to take ellaOne

ellaOne is a single tablet which is swallowed whole as soon as possible after having sex with no effective contraception. If vomiting occurs within 3 hours a repeat dose should be taken.

As time of ovulation can be unpredictable, even in women with regular cycles, emergency contraception is often taken regardless of the day of the cycle when a woman has unprotected sexual intercourse. Women requiring emergency contraception more than once in a menstrual cycle should consult a doctor or specialist contraception advisor.

EllaOne should not be taken at the same time, or in the same cycle, as Levonelle.

Side effects of ellaOne

As with any medicine, ellaOne has the potential to produce side effects, although these do not occur in most cases and are usually not severe. The most common side effects include:

• Headache
• Nausea
• Painful period
• Mild abdominal pain
• Fatigue
• Dizziness

A complete list of common side effects can be found in the manufacturer's Patient Information Leaflet supplied with ellaOne tablets.

Cautions

EllaOne may cause spotting or bleeding between periods and your next period may arrive early or late and may be shorter or longer than usual. If your period is not 'normal' or it doesn't arrive until more than 5 days after expected, then you should take a pregnancy test.

There is no increased risk of ectopic pregnancy (pregnancy outside the uterus/womb) after taking a morning after pill. However, ectopic pregnancy can still occur. Take a pregnancy test and seek medical advice if there is unusual abdominal pain and vaginal bleeding 4-5 weeks after taking ellaOne as there is a chance these could be symptoms of an ectopic pregnancy.

Breastfeeding

The active ingredient (ulipristal acetate) may pass into breast milk for up to 7 days. A risk to the breast-fed child cannot be excluded. It is recommended that breast milk is expressed and not fed to the infant for 7 days after using ellaOne, and that a breast pump is used to maintain milk production.

Sexually transmitted infections

EllaOne does not protect against sexually transmitted infections. Only condoms can protect you from sexually transmitted infections. If you may be at risk, see a GP or sexual health clinic for full checks.

Other options for emergency contraception

The most reliable form of emergency contraception is having an IUD (copper coil) fitted and this can then also provide ongoing contraception. They can be fitted by some GPs and at sexual health clinics.

Local NHS Sexual Health Clinics

• England
• Wales
• Scotland
• Northern Ireland

An alternative pill is Levonelle which, like ellaOne, delays ovulation, but can be taken up to 72 hours (3 days) after sex.

Regular contraception and ellaOne

ellaOne is a form of emergency contraception. It is for use when routine regular contraception has failed or not been used and is not a replacement for regular contraception. Regular contraception is generally more effective, more reliable, and a lower overall hormone dose. Regular contraception should be used for the rest of the monthly cycle, as ellaOne does not provide ongoing contraception.

Condoms should be used to provide contraception until a hormone method is working again. Hormone contraception (including COC and POP) prevents ellaOne from working so cannot be started until 5 days after taking ellaOne.

For the combined pill, contraceptive patch or vaginal ring wait 5 days after taking ellaOne to start, and it then takes a further 7 days to work effectively - i.e. use condoms for 12 days in total (unless taking Qlaira - 14 days in total).

The progesterone-only pill (POP, mini pill) should not be started until 5 days after taking ellaOne. However only 2 more days of condom use are needed until it works, so use condoms for 7 days in total.

Emergency contraception (morning after pills or IUD) may or may not be needed after forgetting or missing hormone contraceptive pills. There is advice in the patient information leaflet supplied with your pills and further information can be found on the NHS website: progesterone only pills and regular combined pills.

Pregnancy and ellaOne

There is no evidence ellaOne harms ongoing pregnancies, in those who become pregnant despite using it.

However, women should not take ellaOne whilst knowingly pregnant. It is still a relatively new drug and potential adverse effects on pregnancy are being monitored. There is an official register www.hra-pregnancy-registry.com where you can anonymously report having taken ellaOne whilst pregnant. The information obtained will be used to improve understanding about any possible effects on pregnancy. Your doctor or midwife should also be informed if ellaOne is taken inadvertently during pregnancy.

Requesting ellaOne

Women who would like to obtain a supply of ellaOne from Dr Fox, to keep as a standby for use at short notice, MUST first read important medical information and follow links to a short yes/no online questionnaire. At the end of the questionnaire women can request one or two ellaOne tablets, enter a delivery address and make a payment.

Doctors review each request and issue prescriptions for the ellaOne tablet(s). Medication is posted from a UK registered pharmacy. The shelf life (expiry date) is usually 3 years.

Further information

• NHS: emergency Contraception section
• ellaOne website

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