A 24-year-old woman presents 96 hours after unprotected intercourse requesting emergency contraception. She declines an intrauterine device. Which option is appropriate for her?

• A Levonorgestrel 1.5 mg single dose
• B Mifepristone 10 mg single dose
• C Combined estrogen-progestin Yuzpe regimen
• D Ulipristal acetate 30 mg single dose ✓

Explanation

Ulipristal acetate, a selective progesterone receptor modulator, retains efficacy up to 120 hours after intercourse and is more effective than levonorgestrel between 72 and 120 hours. Levonorgestrel and the Yuzpe regimen lose efficacy substantially beyond 72 hours. Low-dose mifepristone is not the standard recommended oral emergency contraceptive in this setting. Since she declines the copper IUD, which would otherwise be the most effective option, ulipristal is the correct choice.

Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.

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Written and medically reviewed by the StethoPrep medical team.