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I heard there's a new emergency contraceptive pill available. What's different about it, and is it better?

By Courtney Humphries
December 6, 2010

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Q. I heard there’s a new emergency contraceptive pill available. What’s different about it, and is it better?

A. In August, the FDA approved the drug uliprisal acetate, sold under the brand name Ella in the United States, as an emergency contraceptive pill. The new pill gives women another option in addition to levonorgestrel, a drug sold under the brand names Plan B and Plan B One-Step, and the generic name Next Choice. Both drugs suppress or delay ovulation by interfering with the pregnancy hormone progesterone, and if taken shortly after having unprotected sex they can prevent pregnancy from occurring.

The major difference between the two drugs is the length of that window of opportunity. Plan B is only approved for up to three days (72 hours) after sexual intercourse and works best the earliest it is taken. Ella is approved for use up to five days (120 hours) afterward, and its effectiveness seems to persist over that period of time. Studies also suggest that Ella may be slightly better overall at preventing pregnancy.

The main advantage to levonorgestrel is that it’s now available over-the-counter to anyone over age 17, while Ella requires a prescription. Furthermore, says Dr. Robert Barbieri, chair of obstetrics and gynecology at Brigham and Women’s Hospital, “levonorgestrel has been available for over 50 years, and there’s a very strong record of safety.’’ Because it’s available as a generic pill, levonorgestrel can also offer slight cost savings.

“When you compare them head to head, either is going to be excellent,’’ Barbieri says. “The big point is that any emergency contraception is better than none.’’ He says that many couples don’t consider the option until it’s too late. He generally advises women who rely solely on a barrier method such as condoms to have a prescription for one of these forms of emergency contraception on hand.

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