Emergency contraception
Method to prevent pregnancy after unprotected sex or method failure (broken condom, missed COC >24 h). Per SEGO 2023 and FIGO 2023, first-line is ulipristal 30 mg up to 120 h after intercourse (more effective than levonorgestrel for late timing and BMI ≥30). Levonorgestrel 1.5 mg works up to 72 h. Copper IUD is the most reliable method up to 120 h (>99% efficacy).
ICD-10 Z30.03 drugs
Also known as: Morning-after contraception, Postcoital contraception
Drugs used for this condition
- ACopper intrauterine deviceFirst line · Non-hormonal intrauterine contraceptive deviceEmergency contraception within 120 h post-coitus. Per SEGO 2023 and FSRH 2017, the most effective method (>99% efficacy), especially with BMI ≥30, late presentation, and concurrent need for long-acting method. Office insertion.
- ALevonorgestrelFirst line · Progestogen-only contraceptive (POP + emergency contraception)Emergency contraception 1.5 mg within 72 h of unprotected sex. Per SEGO 2023, second-line after ulipristal but cheaper and OTC. Reduced efficacy at BMI ≥30 – ulipristal or copper IUD preferred. Pregnancy rate 2.2% (vs 1.4% with ulipristal).
- AUlipristal acetateFirst line · Selective progesterone receptor modulator (SPRM)Emergency contraception within 120 h of unprotected sex or method failure. Per SEGO 2023 and FIGO 2023, first-line. Single 30 mg oral tablet ASAP. Pregnancy rate 1.4% (vs 2.2% for levonorgestrel). Preferred for BMI ≥30. After dosing – barrier method backup for 5 days, then resume usual contraception.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit