What’s the difference between levonorgestrel and ellaOne?

Reviewed by our clinical team

In the UK, there are two types of morning after pill: Levonorgestrel (branded as Levonelle) and ellaOne. Both are available over the counter in pharmacies, as well as in contraception clinics and sexual health clinics. You can also get both types from Online Doctor.

Both these morning after pills work in a similar way and are really effective at preventing pregnancy when they’re taken at the right time. However, there are some differences between the two, which might be important for certain women. 

Key facts about ellaOne

• Must be taken within five days of unprotected sex
• Contains ulipristal acetate, which affects how progesterone works and stops or delays ovulation
• Shouldn’t be taken when breastfeeding
• Can be used more than once in the same cycle
• Second tablet required if you vomit within three hours of taking ellaOne 

Key facts about levonorgestrel/Levonelle

• Must be taken within 72 hours (three days) of unprotected sex 
• Contains levonorgestrel, a synthetic version of progesterone, which is thought to stop or delay ovulation 
• Safe to take when breastfeeding 
• Can be used more than once in the same cycle  
• Second tablet required if you vomit within two hours of taking levonorgestrel

Is levonorgestrel more effective than ellaOne?

It’s generally accepted that ellaOne is more effective at preventing pregnancy than Levonorgestrel. Clinical studies have found that ellaOne is 2.5x more effective than levonelle (the branded version of levonorgestrel) when taken within 24 hours. Learn more about the effectiveness of the morning after pill.

However, the most effective form of emergency contraception is the emergency IUD or coil.

Who should and should not take the morning after pill?

Most women can use the morning after pill. However, some things like the medication you regularly take change whether you can use the morning after pill. 

What is the best morning after pill for women over 70kg?

Levonorgestrel is thought to be less effective in women who weigh over 70kg or who have a BMI over 26. The recommendation for women over this weight or BMI may be to take two levonorgestrel tablets, or one ellaOne tablet. The other alternative is to have an emergency IUD or coil fitted. 

What is the best morning after pill for women taking medications?

Certain medications interact negatively with the morning after pill, including those for HIV, epilepsy and tuberculosis. This is why it’s important to mention if you’re taking any specific medications when you get the morning after pill.

For women taking these kinds of medications, ellaOne can’t be prescribed, but levonorgestrel may be given – usually in a higher dose than normal.

What is the best morning after pill for women who are breastfeeding?

The effects of ellaOne during breastfeeding aren’t known so it’s advised that women who are breastfeeding use levonorgestrel (generic Levonelle). Levonelle is safe to take while breastfeeding, although small amounts can pass into your breastmilk. It’s not thought to be harmful to your baby. Read more about taking the morning after pill while breastfeeding.

What is the best morning after pill for trans women?

The morning after pill can be used by trans people who were assigned female at birth. If you have the potential to become pregnant, have ovaries and a womb you can use ellaOne or levonorgestrel. Read more about contraception options for trans people. 

How should I take routine contraception after taking levonorgestrel or ellaOne?

If you’ve been using routine contraception like the combined pill, there are a few things to bear in mind after taking emergency contraception. If you’re confused about what to do, make sure you speak to a doctor or nurse – and, if in doubt, use condoms. 

Levonorgestrel and regular contraception

After taking levonorgestrel, you should take your next contraceptive pill (or use a new patch or ring) within 12 hours, and then continue using your contraception as normal.

However, for the next few days you’ll need to use barrier contraception (e.g. condoms) during sex:

• For seven days if you’re using the combined pill, patch or ring, or if you’ve had the implant or injection
• For nine days for the combined pill Qlaira 
• For two days for the progestogen-only pill (although the patient information leaflet for your pill may recommend longer) 

ellaOne and regular contraception

After taking ellaOne, you should wait five days and then restart your contraception, following the same rules, regarding barrier contraception, listed above. In the five-day interval, make sure you use barrier contraception.   

What is the emergency IUD and what are its benefits?

The emergency IUD is a small, T-shaped device made from plastic and copper that’s designed to be inserted into the uterus. Once inside your uterus it can be left in for several years. It works by releasing copper, which is a contraceptive and prevents pregnancy.

You can have an IUD fitted up to five days after unprotected sex, usually at a contraception clinic or sexual health clinic. Once it’s been inserted, you can keep it in and use it as ongoing contraception. 

The main advantage of the IUD is that it is the most effective form of emergency contraception. 

Where can I get levonorgestrel and ellaOne?

You can get the morning after pill for free from:

• Contraception clinics
• Sexual health or GUM clinics
• Some GP surgeries
• Walk-in centres
• Minor injuries units
• Pharmacies 

You can also buy it over the counter in pharmacies.  

An easy alternative is to order the morning after pill through Online Doctor. When you make your order we’ll ask a few questions that will help our in-house clinicians decide which pill is best for you. Learn more on where to get the morning after pill. 

Conclusion

The morning after pills ellaOne and levonorgestrel (branded as Levonelle) work in a similar way to prevent pregnancy. However, there are differences. Knowing these differences between the two can help you be more informed and prepared when it comes to using them.  

References

https://www.nhs.uk/conditions/contraception/emergency-contraception/
https://bnf.nice.org.uk/treatment-summary/emergency-contraception.html