Emergency contraception with ulipristal acetate (UPA, EllaOne) has which advantage over levonorgestrel (Plan B)?

• A UPA is effective up to 72 hours after unprotected intercourse, whereas LNG is only effective up to 48 hours
• B UPA is safe in women with known liver disease, whereas LNG is contraindicated
• C UPA can be used in breastfeeding women without any precautions, unlike LNG
• D UPA maintains efficacy up to 120 hours (5 days) after unprotected intercourse and is superior to LNG at 72–120 hours ✓

Explanation

Ulipristal acetate (selective progesterone receptor modulator) is effective for emergency contraception up to 120 hours (5 days) after unprotected intercourse and maintains consistent efficacy throughout this window, unlike levonorgestrel which is effective up to 72 hours with declining efficacy. Meta-analyses show UPA is superior to LNG for contraceptive efficacy particularly in the 72–120 hour window and in heavier women (>75 kg). Breastfeeding is a relative concern with UPA (FSRH recommends expressing and discarding milk for 1 week after UPA).

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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Written and medically reviewed by the StethoPrep medical team.