How to Take Ella (Ulipristal Acetate) for Emergency Contraception
Administration
Take ella as a single 30 mg tablet orally as soon as possible, and no later than 120 hours (5 days) after unprotected intercourse or contraceptive failure. 1
- Take the tablet as soon as possible within the 120-hour window—earlier administration is always preferable, though efficacy remains consistent throughout the full 5-day period 1
- The tablet can be taken with or without food 1
- No pregnancy test is required before taking ella, though one should be done if menses is delayed by more than 1 week after the expected date 1
If Vomiting Occurs
- Contact your healthcare provider immediately if vomiting occurs within 3 hours of taking the tablet 1
- You may need to take another tablet, as vomiting can compromise absorption 1
Critical Post-Administration Instructions
After taking ella, you must use barrier contraception (condoms) or abstain from intercourse for all subsequent acts until your next menstrual period. 1
Restarting or Starting Hormonal Contraception
- Do not start or restart any hormonal contraception for at least 5 days after taking ella 1
- After the 5-day waiting period, you can start hormonal contraception, but you must continue using barrier contraception or abstain for an additional 14 consecutive days (or until your next menses, whichever comes first) 2, 3, 1
- This extended barrier method requirement exists because ulipristal acetate can reduce the effectiveness of hormonal contraceptives if started too soon 3
Important Drug Interaction
- Do not take levonorgestrel emergency contraceptive pills within 5 days after taking ella, as this can reduce ella's effectiveness 1
Expected Menstrual Changes
- Your next period may occur a few days earlier or later than expected (typically delayed by 2-3 days) 1, 4
- Contact your healthcare provider if your period is delayed by more than 1 week beyond when it was expected, as pregnancy testing should be considered 1
- A pregnancy test is recommended if you do not have a withdrawal bleed within 3 weeks after taking ella 3
Warning Signs Requiring Medical Attention
- Seek immediate medical care if you experience severe lower abdominal pain 3 to 5 weeks after taking ella, as this may indicate an ectopic pregnancy 1
Important Limitations
- Ella does not protect against HIV or other sexually transmitted infections—barrier methods are still needed for STI prevention 1
- Ella should not be used as regular birth control; it is only for emergency situations 1
- Efficacy may be reduced in women with BMI > 30 kg/m² (observed pregnancy rate 3.1% vs expected 4.5%), though it remains more effective than levonorgestrel in this population 5, 1