A 29-year-old woman had unprotected intercourse 96 hours ago. She cannot take combined hormonal pills. Which single-dose emergency contraceptive is licensed for use up to 120 hours after the event?
- A Levonorgestrel 1.5 mg
- B Ulipristal acetate 30 mg ✓
- C Ethinyl estradiol 100 microgram with levonorgestrel 0.5 mg, repeated in 12 hours
- D Mifepristone 10 mg
Correct answer: B. Ulipristal acetate 30 mg
Explanation
Ulipristal acetate, a selective progesterone receptor modulator given as a single 30 mg dose, retains efficacy up to 120 hours (5 days) after unprotected intercourse and is more effective than levonorgestrel between 72 and 120 hours. Levonorgestrel is recommended only up to 72 hours. The Yuzpe regimen of ethinyl estradiol plus levonorgestrel is also limited to 72 hours and carries more side effects. Low-dose mifepristone is not the standard licensed emergency contraceptive in this setting.
Reference: WHO Medical Eligibility Criteria for Contraceptive Use, 5th ed.
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Written and medically reviewed by the StethoPrep medical team.