Ulipristal acetate

Ulipristal acetate, sold under the brand name Ella among others, is a medication used for emergency birth control and uterine fibroids. As emergency birth control it should be used within 120 hours of sex. For fibroids it may be taken for up to six months. It is taken by mouth. Common side effects include headache, nausea, feeling tired, and abdominal pain. It should not be used in people who are already pregnant. It is in the selective progesterone receptor modulator (SPRM) class of medications. It works by preventing the effects of progesterone thus stopping ovulation. Ulipristal acetate was approved for medical use in the United States in 2010. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. In the United Kingdom it costs the NHS about 17 pounds per course of emergency birth control of 2015. To improve access, some recommend all who can get pregnant be given a prescription for use if needed. For emergency contraception a 30 mg tablet is used within 120 hours (5 days) after an unprotected intercourse or contraceptive failure. It has been shown to prevent about 62–85% of expected pregnancies, and prevents more pregnancies than emergency contraception with levonorgestrel. Ulipristal acetate is available by prescription for emergency contraception in over 50 countries, with access through pharmacists without a prescription being tested in the United Kingdom. In November 2014 European Medicines Agency recommended availability of ellaOne emergency contraceptive without prescription in the European Union. In January 2015 the European Commission issued an implementing decision amending accordingly the marketing authorization of EllaOne in the EU. Since July 2016, it is available without prescription in Israel. Ulipristal acetate is used for pre-operative treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age in a daily dose of a 5 mg tablet. Treatment of uterine fibroids with ulipristal acetate for 13 weeks effectively controlled excessive bleeding due to uterine fibroids and reduced the size of the fibroids. Two intermittent 3-months treatment courses of ulipristal acetate 10 mg resulted in amenorrhea at the end of the first treatment course in 79.5%, at the end of the second course in 88.5% of subjects. Mean myoma volume reduction observed during the first treatment course (−41.9%) was maintained during the second one (−43.7%). After two to four 3-months courses of treatment, UPA-treated fibroids shown about -70% in volume reduction. Volume reduction of uterine fibroid induced by ulipristal acetate was tentatively explained by the combination of multifactorial events involving control of proliferation of the tumor cells, induction of apoptosis and remodeling of the extracellular matrix under the action of matrix metalloproteinases.