Emergency Contraceptive- Comparison Guide

What Pharmacists Need to Know

Why This Matters: Emergency contraception is a time-sensitive and highly effective way to prevent unintended pregnancy after unprotected sex or contraceptive failure. Pharmacists are often the first and only point of access for EC—especially in urgent or after-hours situations.

Understanding the differences among EC options allows pharmacists to tailor recommendations based on timing, patient weight/BMI, accessibility, and contraindications.

Emergency Contraception Comparisons 

Pharmacist Counseling Pearls

• Ask about timing, weight, and current medications.
  Timing + BMI can affect choice of method.

  • BMI considerations: 
    • Plan B may be less effective if BMI >25 
    • Ella may be less effective if BMI >35, but still more effective than Plan B in this range 
  • Urgency matters: EC is more effective the sooner it is used. Encourage patients to keep EC at home for immediate access. 

• No age, ID, or gender requirement for OTC levonorgestrel EC.
  Anyone can purchase it without restriction.

• If ulipristal (ella) is used, delay starting or restarting hormonal contraception for 5 days.
  Otherwise, the EC may be rendered less effective.

• EC does not terminate an existing pregnancy and does not affect fertility.
  It prevents or delays ovulation and is not abortifacient.

• If vomiting occurs within 3 hours of oral EC, the dose should be repeated.

• Offer advance provision of EC.
  This increases timely use and prevents gaps in contraception after missed doses or condom breaks.

Billing tip: Emergency contraception may be covered under Medicaid or commercial insurance with a prescription—even for OTC products.

Note: This resource is intended for pharmacists and healthcare professionals. Always refer to the latest clinical guidelines and product labeling for prescribing decisions.