Emergency Contraception

NHSL Medicines Guidance
NHS Lanarkshire

General Notes

The College of Sexual and Reproductive Healthcare (CoSRH) Clinical Guidance for Emergency Contraception summarises the available evidence on emergency contraception (EC).

Important points from this guidance are:

  • A copper intrauterine device (Cu-IUD) is the most effective method of EC and is not known to be affected by weight or BMI.

  • Ulipristal has been demonstrated to be more effective than levonorgestrel.

  • Ulipristal acetate EC (UPA-EC) can be effective for EC up to 120 hours after unprotected sexual intercourse (no contraception used or contraception used incorrectly) (UPSI).

  • Levonorgestrel EC (LNG-EC) is licensed for EC up to 72 hours after UPSI. The evidence suggests that LNG-EC is ineffective if taken more than 96 hours after UPSI.

  • It is possible that higher weight or BMI could reduce the effectiveness of oral EC, particularly LNG-EC.

  • Enzyme-inducing drugs could also reduce the effectiveness of UPA-EC and LNG-EC.

  • Available evidence suggests that oral EC administered after ovulation is ineffective.

All women requiring emergency contraception should be offered a Cu-IUD if appropriate as it is the most effective method of contraception. In many cases it is appropriate to provide emergency contraception as immediate treatment, as well as referring for a Cu-IUD. 

Further information is available at the NHS Lanarkshire Sexual Health website.

The FSRH advises to quick-start on-going method of contraception which means starting a method immediately after the administration of emergency contraception (EC).

A method that has been quick started may be continued as an ongoing method of contraception or it may be used as a temporary ‘bridging’ method until pregnancy can be excluded and a longer-acting method initiated.

The decision to start a contraceptive method immediately after progestogen-only emergency contraception (POEC) should be considered on an individual basis.

For further information on quick-starting contraception and the effect of EC on this please refer to CoSRH Clinical Guidance for Quick Starting Contraception.

Emergency Contraception

Preferred list (P)

ELLAONE®

  • Ulipristal acetate 30mg

  • Use up to 120 hours after unprotected sexual intercourse.

Total list (T)

UPOSTELLE®

  • Levonorgestrel 1500mcg

  • Use up to 72 hours after unprotected sexual intercourse.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/12/2026

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.