Post-Coital Hormonal Contraception HF#4412

Instructions for Use of Plan B®, Next Choice®, Plan B® One-Step and Ella® 

 

Several options for emergency birth control exist for women who have had unprotected sex, been assaulted, or have a birth control method failure: Plan B®, Next Choice®, Plan B® One-Step or Ella®.  Some research says the chance of becoming pregnant after unprotected sex ranges from 1% to 17%.  Other research says the chance is as high as 15% to 30%.  The chance of pregnancy is highest during mid-cycle.  This is about 14 days after your period last began, when ovulation occurs.

 

You can buy Plan B® and Next Choice® (two-dose) over the counter if you are 18 and older.  You can buy Plan B® One-Step (single dose) over the counter if you are 17 and older.  Plan B® One-Step can be purchased with a prescription if you are under the age of 18 or 17, respectively.  Ella® (single dose) is available only with a prescription.  Plan B®, Next Choice® and Plan B® One-Step are used for one time protection in the case of sex that has occurred within the past 72 hours (3 days).  Studies have shown Plan B® to work at least 75% of the time to prevent pregnancy.  Ella® is used for one time protection in the case of sex that has occurred within the past 120 hours (5 days).  It greatly reduces the pregnancy rate after unprotected sex.  It has been found to work as well as Plan B® in recent studies.  These options are not for every one.  It is important that you discuss all your choices with your health care provider.  Plan B®, Next Choice®, Plan B® One-Step, and Ella® do not protect against HIV (the virus causing AIDS) or any other sexually transmitted disease.

 

Types of Emergency Contraception

• Plan B® and Next Choice® (levonorgestrel) – two 0.75 mg tablets
• Plan B® One Step (levonorgestrel) – one 1.5 mg tablet
• Ella® (ulipristal acetate) – one 30 mg tablet

 

You May Not Use Plan B®, Next Choice®, or Plan B® One-Step If You Have Had

 

• Blood clots (thromboembolism, deep vein thrombosis, or thrombophlebitis).
• Stroke.
• Serious liver disease.
• Unexplained abnormal vaginal or uterine bleeding.
• Known or suspected cancer of the breast or reproductive organs.
• Know or suspect that you are already pregnant.
• Current use of Coumadin®.
• Severe headaches or migraines.
• An allergy to levonorgestrel.

 

You May Not Use Ella® If You

 

• Know or suspect that you are already pregnant.
• Have had an allergy to ulipristal acetate.

 

Using Plan B®, Next Choice®, and Plan B® One-Step

 

1. Plan B® and Next Choice®:  Take the first tablet (0.75 mg) within 72 hours (it is best to use within 12-24 hours) of unprotected sex.  Then, take one more tablet (0.75 mg) 12 hours after your first dose.  Your doctor may tell you to take both tablets at once as soon as possible within 72 hours of unprotected sex.
2. Plan B® One-Step:  Take one tablet (1.5 mg) as soon as possible within 72 hours (it is best to use within 12-24 hours) of unprotected sex.
3. You may have some nausea from the pills.  In most cases, the nausea is mild.  It should stop a day or so after treatment.
   • To decrease the chance of nausea we suggest you avoid fried or spicy foods and the use of alcohol and caffeine.  We also suggest that you drink lots of water.  Eat bland meals or small snacks.
   • If you vomit within one hour after taking these pills, call your health care provider.  You may need to take more pills to make up for the ones lost in vomiting.  Your health care provider may want to prescribe anti-nausea medicine. 
   • Take with food or milk.  You can take medicine to help with nausea.  You can buy meclizine hydrochloride (Dramamine® II) or diphenhydramine (Benadryl®) over-the-counter at the drug store.  Meclizine can be taken one hour before Plan B® tablets.  It may be repeated if needed in 24 hours.  Benadryl® can be taken one hour before the Plan B® tablets.  It may be repeated every 4-6 hours as needed.  The dose for both is one or two 25 mg tablets
     
4. Watch for side effects.  Common side effects include: nausea, abdominal pain, fatigue, headache, and menstrual changes.  Although severe side effects occur rarely, if any of the side effects listed below happen to you, please contact the clinic right away.

 

A – Abdominal pain (severe).
C – Chest pain (severe), cough, and shortness of breath.
H – Headache (severe), dizziness, weakness, and numbness.
E – Eye problems (blurred or changed vision) and speech problems.
S – Severe leg pain mainly in calf or thigh.

 

What to Expect From Plan B®, Next Choice®, and Plan B® One-Step

 

1. After using this medicine, you should have your next period at the expected time. If your next period is more than one week late, check with your doctor. You may be pregnant. 
2. You may have spotting a few days after using this medicine. With your next period, you may bleed a little more or a little less than usual.

 

Using Ella®

 

1. Take one tablet (30 mg) by mouth as soon as possible within 120 hours (5 days) after unprotected sex or a known or suspected birth control failure.
2. You may have some nausea from the pills.  The nausea is most often mild and should stop a day or so after treatment.
   •  To decrease the chance of nausea we suggest you avoid fried or spicy foods and the use of alcohol and caffeine.  We also suggest that you drink lots of water.  Eat bland meals or small snacks.
   •  If you vomit within three hours after taking these pills, call your health care provider.  You may need to take another pill to make up for the one lost in vomiting.  Your health care provider may want to prescribe anti-nausea medicine. 
   •  Take with food or milk.  You can take medicine to help with nausea.  You can buy meclizine hydrochloride (Dramamine® II) or diphenhydramine (Benadryl®) at the drug store without a prescription.  Meclizine can be taken one hour before Ella® tablets.  It may be repeated if needed in 24 hours.  Benadryl® can be taken one hour before the Ella® tablets. It may be repeated every 4-6 hours as needed.  The dose for both is one or two 25 mg tablets.
3. Watch for side effects.  Common side effects include: headache, nausea, menstrual pain, abdominal pain, tiredness, and dizziness.  Although severe side effects occur rarely, if they happen to you, please contact the clinic right away.  These side effects include abdominal pain (severe) and headache (severe).
    

What to Expect from Ella®

 

1. Your next period can be early or late, but if it is more than one week late, call your health care provider as you may be pregnant.  Bleeding is sometimes heavier or lighter than normal.

 

 

Birth Control

 

1. Get started right away with an effective ongoing method of birth control.  Plan B®, Next Choice®, Plan B® One-Step and Ella® are meant only for a one-time protection!  
2. You will be given information on methods of birth control.  These methods include non-prescription methods such as condoms or foam.  Prescription methods include birth control pills, the diaphragm, or cervical caps.  If you choose a prescription method of birth control, an appointment will be made with a health care provider.  This visit will include a complete exam including a pap smear and pelvic exam.

 

Future Care

 

It is recommended that all women have yearly physical exams that include a pap smear and pelvic exam when they become sexually active or reach the age of 18, which ever occurs first.  You may have this exam at this clinic.

 

If you have further questions or problems, please contact the ______________________ Clinic at (608) _____________________.  Ask to talk with a nurse.

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 07/28/2011

Copyright © 07/28/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4412

Print Health Fact For You