Ulipristal (Ella) for Emergency Contraception
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Abstract:
Ulipristal is a prescription-only emergency contraceptive. It is at least as effective as levonorgestrel when administered within 72 hours of unprotected sexual intercourse, and is more effective than levonorgestrel in the 72- to 120-hour window.Keywords:
Ulipristal acetate
Levonorgestrel
Emergency Contraception
Intrauterine device
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To assess the availability of oral emergency contraception in southwestern Pennsylvania pharmacies.We conducted a simulated patient study to assess on-the-shelf availability of levonorgestrel emergency contraception and immediate availability of ulipristal acetate emergency contraception.Only 44% of pharmacies stocked levonorgestrel on-the-shelf and only 5% of pharmacies had ulipristal acetate immediately available.We found significant barriers to obtaining timely oral emergency contraception in southwestern Pennsylvania.Timely access to emergency contraception is important for people's ability to determine if, when, how, and under what circumstances to have children. Pharmacies in southwestern Pennsylvania need to expand access to oral emergency contraception.
Ulipristal acetate
Emergency Contraception
Levonorgestrel
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In Australia, use and understanding of emergency contraception among women remains relatively low. This is despite the introduction of levonorgestrel emergency contraceptive pills (ECPs) more than a decade ago. In April 2016, a new ECP with the active ingredient ulipristal acetate became available in Australia.The aims of this article are to increase understanding of the recently introduced ulipristal acetate ECP, including its safety profile, effi-cacy and special considerations; dispel common myths and misconceptions about emergency contraception; and to provide guidance on emergency contraceptive management in general practice, considering the recent advances.Women are more receptive to information about emergency contraception that has been provided by a general practitioner (GP). As such, the availability of the ulipristal acetate ECP in Australia provides an important opportunity for GPs to help women prevent unplanned pregnancies.
Ulipristal acetate
Emergency Contraception
Levonorgestrel
Pill
Intrauterine device
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1report a randomised single-blind non-inferiority multicentre trial involving an analysis of nearly 2000 women who requested emergency contraception within 5 days of unprotected sexual intercourse. The investigators compared the effi cacy and side-eff ects of levonorgestrel, the widely marketed emergency contraceptive, and ulipristal acetate, a selective progesteronereceptor modulator, recently licensed for emergency contraception in Europe. Both treatments decreased the pregnancy rate: from an expected 5·5% to 1·8% in the ulipristal group and from 5·4% to 2·6% in the levonorgestrel group. High eff ectiveness is an important requirement for an ideal emergency contraceptive and research to improve its effi cacy is most welcome. Along with previous research, 2 today’s study shows that
Ulipristal acetate
Emergency Contraception
Levonorgestrel
Unintended Pregnancy
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Ulipristal acetate
Emergency Contraception
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Watson Pharmaceuticals on August 13 announced the approval of ulipristal acetate oral tablets for emergency contraception after unprotected intercourse or a known or suspected contraceptive failure. The selective progesterone-receptor modulator will be marketed as Ella and is expected to be available in pharmacies before the end of the year, the company stated. According to the drug’s FDA-approved labeling, ulipristal is intended for occasional use as emergency contraception and does not replace a woman’s routine contraceptive measures. When taken soon before ovulation, ulipristal postpones follicular rupture, presumably preventing or delaying ovulation, according to the drug’s labeling. Ulipristal should be taken within 120 hours after unprotected intercourse or a known or suspected contraceptive failure; repeated use within the same menstrual cycle is not recommended. The drug is contraindicated in women with known or suspected pregnancy. If pregnancy or lower abdominal pain occurs after taking ulipristal, the woman should undergo an examination to determine whether there is an ectopic pregnancy.
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Emergency Contraception
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Mark I. Nichols, MD, is from the Department of Obstetrics and Gynecology, Oregon Health Sciences University, Portland, Oregon; e-mail: [email protected]. Financial Disclosure The author did not report any potential conflicts of interest.
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Summary Emergency hormonal contraception is used to prevent unintended pregnancy postcoitally. The mechanism of action of the most frequently used hormonal preparations for emergency contraception, levonorgestrel (LNG) and ulipristal acetate (UPA), is still not fully known, but clinical trials indicate that they act by inhibiting or delaying ovulation. LNG has a long history of use for emergency contraception, proven safety and high efficacy if administered in the preovulation period. The newest emergency contraceptive, UPA, available only with a prescription, is indicated within this period of 120 hours after sexual intercourse and the data indicate that UPA does not lose efficacy within this period. Clinical trials showed its noninferiority versus LNG and its effect on the potentially occurring pregnancy is being additionally monitored. However, many misconceptions and controversial opinions about emergency contraception are still present, even among pharmacists. A search of Medline database identified 20 papers published from January 1993 to December 2012, on pharmacists’ knowledge, attitudes and practices related to emergency contraception. In these papers, the attitudes of pharmacists pertaining to the dispensing regime of emergency contraception were different. Research in Australia has shown that personal attitudes and religious convictions influence the practice of dispensing emergency contraception. In the research conducted in New Mexico, 30% of pharmacists were against prescribing emergency contraception for religious or moral reasons. There were no published data in regards to pharmacists’ knowledge, attitudes and dispensing practice in Serbia and such research is highly recommended.
Ulipristal acetate
Emergency Contraception
Levonorgestrel
Intrauterine device
Hormonal contraception
Clinical Research
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Ulipristal acetate
Emergency Contraception
Levonorgestrel
Intrauterine device
Oral contraception
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Emergency contraception is a common practice now. Many categories of drugs are marketed with modifications in dosage, in combination and even in the timing of administration. Recent re-analysis suggests that there is still no uniformity of opinion on the actual mechanism of action and this has often fueled the ethical controversy. This review analyzes the most common emergency contraception drugs: levonorgestrel, mifepristone and ulipristal acetate about their action underlining that the hormonal products, when used in emergency contraception, play different roles depending on the phase of the menstrual cycle during which they are administered.This review aims to examine rigorously the most accredited literature to verify if a evidence-based uniformity of opinions has been achieved about the biological effects of hormones administered after the sexual intercourse.
Ulipristal acetate
Emergency Contraception
Levonorgestrel
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