UlipristalUlipristal Acetate

About Ulipristal

Ulipristal acetate is a progesterone agonist/antagonist: taken after unprotected sex or a contraceptive failure, it prevents or delays the release of an egg. The tablet is taken once, with or without food, at any point in the cycle, and the sooner the better. It is labeled for occasional use: it is not a regular method of contraception, and taking it more than once in the same cycle is not recommended.

Headache, nausea, stomach pain, painful periods, tiredness and dizziness are common, and the next period can come up to a week early or late. It must not be taken by a woman who is or may be pregnant; it does not end a pregnancy and does not protect against HIV or other sexually transmitted infections. Lower abdominal pain afterwards, or a period more than a week late, needs a pregnancy check, including for ectopic pregnancy. Fertility returns quickly, so a barrier method is needed until the next period, and a hormonal method is not started until at least five days later, because each can blunt the other. It passes into breast milk in small amounts.

Levonorgestrel emergency contraception (Plan B One-Step and similar) is a different medicine, sold without a prescription and labeled for use within 72 hours, against 120 hours for ella. The Orange Book lists one FDA-approved generic, Logilia from Teva, but no generic ulipristal label appears on DailyMed, so the brand is what pharmacies stock.

Taking Ulipristal

How to take it

One tablet, as soon as possible within 120 hours (5 days) of unprotected sex or a contraceptive failure, with or without food. If you vomit within 3 hours, contact the prescriber about whether to repeat the dose. Use a barrier method, such as a condom, every time you have sex until your next period.

If you miss a dose

It is a single dose, so there is no schedule to miss; the label does not recommend taking it more than once in the same cycle.

Storage

At room temperature in its package, away from light, excess heat and moisture, out of reach of children.

Interactions to know about

It should not be taken with medicines that induce CYP3A4, which can make it less effective: barbiturates, bosentan, carbamazepine, felbamate, griseofulvin, oxcarbazepine, phenytoin, rifampin, St. John’s wort and topiramate. Do not start or restart a hormonal contraceptive until at least 5 days after taking it. Itraconazole and ketoconazole raise its levels. If your period is more than a week late, take a pregnancy test.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Ulipristal differs from pharmacy to pharmacy

With no generic on pharmacy shelves, every pharmacy buys the same brand tablet, so quotes differ by markup and dispensing fee, and a one-tablet package carries a full fee. Not every pharmacy keeps it in stock, and one that must order it in can miss the five-day window. Levonorgestrel products are shelf items with no fee, but they are a different medicine with a shorter window, and whether one would do is for the prescriber or pharmacist to say.

Ways to pay less for Ulipristal without insurance

• Call the pharmacy before the prescription is sent to confirm ella is in stock; the 120-hour window does not wait for an order.
• Ask the prescriber or pharmacist whether a levonorgestrel product sold without a prescription would suit your situation; it has a 72-hour window.
• Compare quotes from more than one pharmacy; for a single brand tablet the difference is entirely markup and dispensing fee.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Ulipristal

1. 1.How soon do I need to take it, and what if I vomit afterwards?
2. 2.When can I restart my regular birth control, and what do I use until then?
3. 3.Do any of my medicines, including St. John’s wort or seizure medicines, make it less effective?
4. 4.What should I do if my period is late or I get lower abdominal pain?
5. 5.Is it safe if I am breastfeeding?

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