Emergency contraception: Frequency Asked Questions

Yes. You can take emergency contraception pills (the morning-after pill) at any time of day for up to 5 days after unprotected sex. For emergency contraception pills like Plan B One-Step, Next Choice, Next Choice One Dose, and Levonorgestrel, the sooner you take them more effective they are. The emergency contraceptive pill ella doesn’t decrease in effectiveness over those 5 days.

To prevent nausea and vomiting, you can take the non-prescription anti-nausea medicine meclizine (also sold under the brand names Dramamine II or Bonine) an hour before taking the first dose of EC. Note that this might make you drowsy.

If you end up puking within an hour of taking a dose of EC, you may want to take that dose again in case your body didn’t absorb the hormones yet.

The effectiveness of almost all types of birth control will not be impacted by your weight. Two exceptions are the patch and emergency contraception.

For the patch, Xulane may be less effective if you weigh more than 198 pounds. Twirla, the other patch option, may be less effective at preventing pregnancy if your BMI is 25 or greater, and it should not be used at all if your BMI is 30 or greater because of decreased effectiveness and a potentially increased risk of blood clots.

When it comes to emergency contraception, over-the counter levonorgestrel-based emergency contraception, like Plan B One-Step, Next Choice One Dose, and others, may not be as effective in people who weigh 165 pounds or more. Ella, which is prescription-only emergency contraception, is equally effective in people who weigh between 165 and 194 pounds as it is in people who weigh under 165 pounds. But ella may not work as well if you weigh 195 pounds or more. The copper IUD and IUDs with 52mg of levonorgestrel (Mirena and Liletta) are the only emergency contraception options proven equally effective if you weigh 195 pounds or more. IUDs are also the most effective form of emergency contraception for everyone, regardless of weight.

Plan B One-Step, Next Choice One Dose, and other levonorgestrel-based emergency contraception pills work because of the synthetic hormone progestin. Basically, progestin tricks your body into thinking it's already pregnant. And that jumpstarts your body's pregnancy-preventing reactions. Birth control pills use this same science (in low, daily doses). On the other hand, ella acts to suppress progesterone. This delays ovulation for up to five days, giving sperm time to die before an egg is released. (And that's good because sperm can survive in your uterus anywhere from three to six days after sex.) Ella may also thin the lining of your uterus, making it harder for a fertilized egg to be implanted.

While all methods of emergency contraception can be used up to five days after unprotected sex, Plan B One-Step and Next Choice One Dose are most effective when used within 72 hours (three days), and they work even better within 24 hours. But ella is just as effective on the fifth day as it is on the first.

No. No. No. If you're already pregnant (even if you don't know it yet), EC won't work. EC can only prevent a pregnancy from starting; it can't stop one that already has. And if you accidentally take EC before you know you're pregnant, it won't hurt you or the pregnancy.

Levonorgestrel is one of the longest-studied types of progestin, and all the scientific evidence to date shows it is super safe. It’s used in hormonal IUDs, some emergency contraception pills, and certain birth control pills.

There are a bunch of generic types of levonorgestrel-based EC pills for sale without a prescription over the counter or online. Generics are usually cheaper than brand names, and the cheapest alternative we know of, AfterPill, is only $25 including shipping. Note that AfterPill doesn’t offer expedited shipping, so you have to order it in advance, not after an emergency!

Medications and herbal supplements that may make regular birth control pills less effective may also reduce the effectiveness of emergency contraceptive pills. So if you are using an enzyme inducer, it probably makes sense to increase the dose of EC. You should talk to your doctor about how much to increase the dose.

Yes. To be safe, you should take another dose of emergency contraception.

Whatever age or gender you are, you can buy levonorgestrel-based emergency contraception (EC) pills including Plan B One-Step, Next Choice One Dose, and My Way over-the-counter at the pharmacy without a prescription. Learn more about getting EC.