The Ella pill (morning-after pill) available online

Also known by the generic name ulipristal acetate, Ella is the most effective morning-after pill available in the U.S. Our board-certified telemedicine doctors can prescribe emergency contraception with convenient virtual visits.* If you’re concerned about having unprotected intercourse or experienced a known contraceptive failure, such as a broken condom, talk to a doctor as soon as possible. Your reproductive health and peace of mind are our top priority.

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Get prescribed the Ella pill discreetly from the privacy of your home*

Talk to a doctor online to get the Ella pill at any time, day or night

Can be taken within five days following an unprotected encounter

*Prescriptions are provided at the doctor’s discretion. Learn how you can save up to 80% with our prescription discount card.

What is Ella, and how does it work to prevent pregnancy?

The Ella pill has been approved in the U.S. since 2010. Taken within five days of unprotected sex or suspected failure of contraception, Ella has an effectiveness rate of about 98% as an emergency contraception method. The effectiveness is even higher, 99%, when taken within 24 hours. The active ingredient of Ella, ulipristal acetate, is up to 2.5 times more effective than morning-after pills containing levonorgestrel. Although the Ella pill can be taken up to 120 hours (five days) after unprotected sex, its effectiveness is maximized the sooner it is taken after unprotected sex.

The Ella emergency pill prevents pregnancy by delaying ovulation and preventing sperm from meeting the egg. Ulipristal, the active ingredient of Ella, blocks the effects of progesterone so that ovulation is delayed or stopped during that cycle.  By delaying the release of the egg until the sperm dies (up to five days), no egg is fertilized.  

The sooner Ella is taken, the more likely the egg will be stopped or delayed before sperm can reach it. If you have already ovulated, Ella will not be effective. Since it can be hard to know when ovulation occurs, the sooner you take Ella, the better.

Our PlushCare online doctors provide compassionate emergency contraceptive care

  • Immediate consultations: We provide quick access to a doctor online for your EllaOne prescription.

  • Fast prescription services: Our telehealth physicians can prescribe the morning-after pill directly following the consultation if you qualify.

  • Follow-up and support: Our online doctors provide follow-up consultations to address any side effects or concerns post-treatment, ensuring continuity of care.

  • Cost-effective: With insurance coverage, a prescription for Ella or other emergency contraception options can be partially or fully covered.

  • Comprehensive healthcare:  Our doctors offer holistic reproductive healthcare through virtual medical appointments. In addition to emergency contraception, they can also discuss ongoing contraceptive options, sexual health screenings, and other relevant health issues.

  • Emotional support: Our caring medical doctors provide a supportive and non-judgmental environment.

Ella vs. other morning after-pills

Ella (ulipristal acetate) is just one of several morning-after pills for emergency contraception. Two common alternatives are Plan B and generic levonorgestrel, which both contain the active ingredient levonorgestrel. These medications serve the same general purpose: to prevent pregnancy after unprotected intercourse. 

However, they differ in their active ingredients, the way they work, and the time window in which they are effective. Your doctor will offer personalized guidance on Ella, Plan B, or generic levonorgestrel to help you make informed decisions based on your unique circumstances.

  • Ella vs. Plan B

    While both are effective emergency contraceptives, Ella is significantly more effective. Ella is 65% more effective at preventing pregnancy than Plan B, when it's taken within 24 hours. If taken within 72 hours, Ella is still 42% more effective than Plan B. Ella works during a longer window (five days vs. three days) and is less affected by BMI.  

    Feature

    Ella

    Plan B and other forms of levonorgestrel

    Active ingredient

    Ulipristal acetate

    Levonorgestrel

    Effectiveness Window

    Up to 5 days (120 hours)

    Best within 72 hours

    Method of action

    Delays/prevents ovulation and thickens cervical mucus, making it harder for sperm to pass through

    Delays/prevents ovulation and thickens cervical mucus, making it harder for sperm to pass through

    Effectiveness with BMI

    Highly effective for a BMI of less than 35, possibly reduced effectiveness with a BMI of over 35

    Reduced effectiveness with a BMI of over 30

    Prescription status

    Requires prescription

    Available over-the-counter, with generic levonorgestrel available by prescription

    Potential side effects

    Nausea, abdominal pain, fatigue, headache

    Nausea, abdominal pain, fatigue, headache

    Medication interactions

    Certain medications can reduce effectiveness

    Fewer medication interactions compared to Ella

Ulipristal dosage: 1 tablet within 5 days (120 Hours) of unprotected sex

Ella is available in a single-dose tablet form, with each tablet containing 30 milligrams of the active ingredient, ulipristal acetate. The recommended dosage is one tablet, taken orally as soon as possible but no later than 120 hours after unprotected sex or contraceptive failure. It can be taken with or without food.

If a woman vomits within three hours of taking the medication, it is advised to take another tablet as soon as possible. The Ella pill can be taken at any point during the menstrual cycle. 

The Ella contraceptive pill is a progestin-only emergency contraceptive and does not contain estrogen. This makes it a good option for those who can't take medications that contain estrogen.

What are the pros and cons?

Ella

Pros

  • Flexible: Ella is effective for a larger window of time than other morning-after pills, up to 120 hours (five days) post-intercourse. 

  • Accessible: Ulipristal is quickly available with a prescription, especially through online doctor consultations.

  • Estrogen-free: Unlike some combined oral contraceptives, Ella is a progestin-only emergency contraceptive and does not contain estrogen, making it a good choice for women who cannot take estrogen-based medications.

  • Suitable for one-time emergency contraception: Ella is an effective backup option when condoms fail or when regular contraception is not used.

Cons

  • Side effects: Ella may cause mild, temporary side effects such as headache, nausea, and abdominal pain. 

  • Changes in menstrual cycle: It is common for Ella to cause the next menstrual cycle to be different. It may come late, come early, or be lighter or heavier than usual. It may also be a normal cycle. If there is no cycle within a week of when a cycle was expected, a pregnancy test should be done.

  • Not for regular use: Ella is not intended as a primary method of birth control. It is specifically designed for emergencies only.

  • Drug interactions: Ella may have potential interactions with other medications, in particular certain HIV medicines, anti-seizure medicines, or St. John's Wort, which could reduce its effectiveness.

  • Does not prevent STIs: Like all forms of emergency contraception, Ella does not protect against HIV and other types of STIs.

Potential Ella side effects: are there any dangers of the morning-after pill?

  • Like all medications, the ulipristal pill may have side effects. Not everyone experiences side effects, and most people do not have any side effects. Talk to your doctor or pharmacist if you have any concerns. Common side effects may include: 


    If you develop severe abdominal or pelvic pain three to five weeks after taking Ella, seek in-person medical care immediately to be evaluated for ectopic pregnancy.

  • Ella’s potential impacts on your menstrual cycle

    The Ella emergency contraception pill may temporarily cause some changes to your menstrual cycle, including: 

    • Menstrual delay: Ella may cause a delay in the onset of menstruation. It's common for the next period to be a few days late after taking Ella.

    • Changes in menstrual flow: Some women may experience changes in their menstrual flow, such as heavier or lighter bleeding than usual.

    • Spotting or bleeding: Unscheduled spotting or bleeding may occur between periods after taking Ella.

    • Menstrual irregularities: In some cases, women might notice temporary changes in their menstrual cycle patterns, including irregularities in cycle length.

    • Return to normal cycle: Typically, these changes are temporary, and menstrual cycles return to normal in the subsequent cycles.


    If you do not get a menstrual cycle within seven days of when you were expecting it, you should take a pregnancy test.

  • Higher BMI or body weight may reduce the effectiveness of ulipristal

    A higher BMI may make emergency contraceptives, including Ella, less effective. Emergency contraception pills containing levonorgestrel, such as Plan B, are less effective if your BMI is more than 30. Ella has been shown to remain highly effective for people with a BMI up to 35.

    HRA, the manufacturers of Ella, released the following statement regarding BMI and the morning-after pill: “There is no conclusive evidence to suggest that ellaOne® becomes ineffective if the person taking it is above a specific weight.”

Precautions and contraindications

  • Pregnancy and breastfeeding

    Ella is not considered safe for breastfeeding mothers. No form of emergency contraception should be used by people who know or suspect that they are currently pregnant.

  • Interaction with medications

    Some medications may interact with Ella, affecting its efficacy. Specific medications that may interact with Ella include certain anticonvulsants, antifungals, and anti-HIV drugs. Acyclovir, an antiviral medication used to treat herpes infections, is not known to have significant interactions with ulipristal. Responses to medications can vary, so it’s advisable to inform your doctor about all current medications.

  • Hormonal birth control and Ella

    Being on hormonal birth control, such as oral contraceptives, patches, or hormonal IUDs, does not significantly impact the efficacy of Ella. Emergency contraceptive pills work independently of ongoing hormonal contraception and can be used in case of contraceptive failure or unprotected intercourse.

  • Herbs and supplements

    Certain supplements like St. John's Wort may interact with ulipristal. St. John's Wort is known to induce liver enzymes, which could affect the metabolism of medications, including ulipristal acetate. If you take St. John's Wort or other supplements, talk to your doctor before using Ella.

Ella FAQs

  • How do I quickly get a prescription for Ella?

    You can get an ulipristal prescription here with PlushCare through our online healthcare appointments. You may also choose to see your primary care physician, a gynecologist, or a family planning clinic.

    Ella ranges from approximately $40 to $70 or more, depending on your location, pharmacy, and insurance coverage. If you have insurance, it may be fully covered, while those without insurance will need to pay out of pocket. Prices are subject to change, so check with your local pharmacy for the most up-to-date pricing information.

  • How long does the Ella pill stay in your system?

    Ella is typically eliminated from the body within a few days. However, individual factors can influence the clearance rate. The effects are generally short-term, so it won’t have a long-lasting impact on your body’s hormones. 

  • What is the success rate of the Ella pill during ovulation?

    Ella can be taken during the ovulation part of your cycle; however, no emergency birth control is effective if the egg has already been released.  That’s why it’s essential to take the prescription emergency contraception as soon as possible after unprotected intercourse for optimal results.

  • Can Ella make you skip a period?

    While Ella may temporarily change your menstrual cycle, it does not necessarily result in skipping a period for everyone. Individual responses to emergency contraception can vary, and regular menstrual patterns are expected to resume in subsequent cycles.

  • Do emergency contraceptive pills cause weight gain?

    There is no substantial evidence to suggest that emergency contraceptive pills, including Ella, cause significant weight gain. Weight changes following the use of emergency contraception are generally minimal and not consistently reported in research studies.

  • I took the morning-after pill and then had unprotected sex. What is the maximum delay in periods after taking the morning-after pill?

    While the morning-after pill, including Ella, is effective in preventing pregnancy after unprotected sex, it may cause temporary disruptions to your menstrual cycle.  Using the morning-after pill may delay your period by up to one week. If you don't get your period within three to four weeks of taking the morning-after pill, take a pregnancy test.

  • I took the morning-after pill and am still bleeding one week later. Should I be concerned?

    It is not uncommon to experience irregular bleeding or changes in your menstrual pattern after taking emergency contraception. Some bleeding may occur around the expected time of the next menstrual period or earlier. However, see a doctor immediately if you have bleeding or spotting lasting longer than a week. Also, seek medical attention immediately if you develop severe lower abdominal pain three to five weeks after taking the morning-after pill. These symptoms can be caused by a miscarriage or by an ectopic pregnancy.

How to get the Ella pill online

Step 1

Book an appointment to discuss the Ella pill.

Book a same-day appointment from anywhere.

Step 2

Talk to your doctor online about emergency contraception.

Visit with a doctor on your smartphone or computer.

Step 3: pick up at local pharmacy

Step 3

Pick up the Ella pill, if prescribed.

Prescriptions are provided at the doctor’s discretion. We can send prescriptions to any local pharmacy.

Ella pill pricing details

To get the Ella pill, join our monthly membership.

Paying with insurance

Membership

$16.99/month

First month free

Visits

Copay

30 days of free membership

  • Same-day appointments 7 days a week

  • Unlimited messages with your Care Team

  • Prescription discount card to save up to 80%

  • Exclusive discounts on lab tests

  • Free memberships for your family

  • Cancel anytime

Visit price with insurance

Often the same as an office visit. Most patients with in-network insurance pay $30 or less!

  • We accept these insurance plans and many more:

    • Humana
    • Aetna
    • United Healthcare

Paying without insurance

Membership

$16.99/month

First month free

Visits

$129

30 days of free membership

  • Same-day appointments 7 days a week

  • Unlimited messages with your Care Team

  • Prescription discount card to save up to 80%

  • Exclusive discounts on lab tests

  • Free memberships for your family

  • Cancel anytime

Visit price without insurance

Initial visits are $129.

Book an appointment

If we're unable to treat you, we'll provide a full refund.

Sources:

PlushCare is dedicated to providing you with accurate and trustworthy health information.

  1. PubMed®. "Safety and effectiveness data for emergency contraceptive pills among women with obesity: a systematic review" Accessed on December 16, 2023 at https://pubmed.ncbi.nlm.nih.gov/27234874/

  2. National Center for Biotechnology Information. “Ulipristal Acetate (ella)”  Accessed on December 16, 2023 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138379

  3. Yale Health Center. Emergency Contraception – “Morning After Pill” Accessed on December 16, 2023 at https://yalehealth.yale.edu/topic/emergency-contraception-morning-after-pill

  4. Ella®. Accessed on December 16, 2023 at https://www.ella-now.com/

  5. OHSU. “Does the morning-after pill work for high-BMI women?” Accessed on December 16, 2023 at https://www.ohsu.edu/womens-health/does-morning-after-pill-work-high-bmi-women

  6. University Health Services. Accessed on December 16, 2023 at https://uhs.fsu.edu/sites/g/files/upcbnu1651/files/docs/Birth%20Control%20Pill%20Factsheet_a.pdf

  7. FDA. Accessed on December 16, 2023 at https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022474s000lbl.pdf

PlushCare content is reviewed by MDs, PhDs, NPs, nutritionists, and other healthcare professionals. Learn more about our editorial standards and meet the medical team. The PlushCare site or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment.