Ezinelle 1.5mg (2 tablets)
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The pill, called Ezinelle, works in just the same way as the more expensive levonorgestrel-based Levonelle: it has to be taken within the 72 hours following intercourse in order to delay ovulation, though it would be advisable to take it as soon as possible (the pill has 95% probability to work if taken within 24 hours, but only 85% within 72.).
However, there are times where it doesn’t work, where a fertilised egg has already implanted into the uterus, as the pill was not designed to act in as an abortive medication.
Is the morning after pill safe?
It is perfectly safe to take the morning after pill. There have been no serious side effects reported nor is the emergency contraception designed to cause an abortion - it will simply help to prevent a pregnancy from occurring in the first place when taken within the time given frame. It’s important to note that if taken when pregnant the high levels of hormones in the pills can potentially affect the development of the foetus, so if you think you could be pregnant then do a test or visit your GP first before purchasing the pill.
Effectiveness of Levonelle and ellaOne
The most effective emergency contraception is provided by having a copper IUD (intrauterine device) inserted. This can be done within 7 days of intercourse and is an alternative to morning after pills. EllaOne is slightly more effective than Levonelle. Studies show, if they are taken in the first 72 hours (3 days) after intercourse, pregnancy rates are close to 2 in 100 with Levonelle and 1.5 in 100 with ellaOne. EllaOne remains effective up to 120 hours (5 days) after intercourse. Levonelle or ellaOne work best if taken early and should be taken as soon as possible after intercourse. If ovulation has already occurred, ellaOne is no longer effective. The timing of ovulation cannot be predicted and therefore ellaOne should be taken as soon as possible after unprotected intercourse.
When and how to re-start your regular contraception.
When to use the morning after pill After intercourse where other contraception has not been used. After intercourse where a condom has failed (split, come off, etc). Where a couple are using withdrawal and this has failed. See details at the bottom of the page about when emergency contraception is needed for women who have missed their regular contraceptive pill. If intercourse has already taken place and a morning after pill is needed a pharmacist or doctor should be consulted straightaway. An online service should NOT be used when immediate treatment is required. There will be a delay of a day or more before tablets are delivered. We are unable to supply contraception online to women aged 55 years and above.
Side effects of Levonelle and ellaOne
While there are no serious side effects associated with using either of these medications as prescribed, they can cause changes to your next period due to the higher dose of hormones being introduced into your system. These shifts can include your period starting earlier or later and being either lighter or heavier than normal though more often than not women experience a normal menstrual cycle after taking the morning after pill.
How morning after pills work
Morning after pills reduce the chance of fertilised eggs implanting in the womb. Cautions Regular contraceptive pills cannot be relied on in the same menstrual cycle after morning after pill has been taken and additional barrier contraception or abstinence is required for the remainder of the cycle (further details). The morning after pill is for use after intercourse, not before. Morning after pills are for occasional emergency use. There are more reliable methods of contraception for routine regular use. There is no increased risk of ectopic pregnancy after taking a morning after pill. However, ectopic pregnancy can still occur. Seek medical advice if there is abdominal pain and vaginal bleeding 4-5 weeks after taking a morning after pill as there is a chance these could be symptoms of an ectopic pregnancy. If a woman becomes pregnant after taking a morning after pill, or was already pregnant when it was taken, there is no evidence of adverse effects.
Each method works in a different way, however, they both act to prevent pregnancy through affecting the hormone known as progesterone.
- Levonelle introduces synthetic progesterone into the system which helps to prevent ovulation
- ellaOne affects the progesterone itself which delays ovulation until the sperm is no longer alive and is therefore unable to fertilise the egg.
Alongside this, the morning after pill is designed to thicken the mucus at the entrance to the womb which makes it more difficult for the sperm to get through to fertilise the egg which would cause you to get pregnant.
It is important to bear in mind that neither Levonelle nor ellaOne are intended to be used as a regular form of contraception. Even though it is good to know that they are available for you should you need them, they are not as effective as using a regular form of contraception such as the coil, the pill or condoms. As well as this, the morning after pill is more expensive than these other forms of contraception which you can usually get from on the NHS.
The active ingredient of Levonelle is excreted in breast milk. Potential exposure of an infant can be reduced by taking Levonelle immediately after feeding. The active ingredient of ellaOne may pass into breast milk for up to 7 days. Breastfeeding should be avoided during this time as risk to the infant cannot be excluded. Alternative treatments Doctors and family planning clinics should be able to insert an IUCD (intrauterine contraceptive device) up to 5 days after unprotected intercourse. This would be more effective than the morning after pill and provides ongoing contraception.
I've missed a pill, do I need emergency contraception?
The risk of getting pregnant after missing pills (including at the beginning of a pack, i.e. starting a pack late) depends on how many pills are missed and when in the pack the pills are missed. Ordinary contraceptive pills (mini pill information below).
The advice here does not apply to the newer pills Qlaira and Zoely, Eloine and Daylette. Please consult the packet insert for these pills. If you forget to take a pill, and it's not more than 24 hours late, it is fine – take it as soon as you remember. If it is more than 24 hours late, this is called a missed pill. This is still not a problem. Take the missed pill as soon as possible (even if means taking two pills at once) and you are still protected. Just continue taking the rest of the pack and your seven-day pill-free break as usual. Missing 2 or more pills (or starting a pack 2 or more days late) can mean the contraceptive is not effective. This is true of the start of the pack. It will have been 9 days since your last pill and the hormone levels will have decreased such that the ovaries are not suppressed and may release an egg.
Take the last missed pill as soon as possible (even if means taking two pills at once) discarding any earlier missed pills. Continue taking the rest of the pack as normal and use additional (barrier) contraception for the next seven days. You will need emergency contraception if you have had unprotected sex in the previous seven days and have missed two or more pills (you are taking your pill more than 48 hours late) in the first week of a pack. Then you should finish the packet and have the usual pill-free interval. If the pills are missed in the second week of a pack (pills 8-14), the contraceptive effect has built up and there is no need for emergency contraception (as long as the pills in the first seven days of the pack were taken correctly). Then finish the packet and have the usual pill-free interval. If the pills are missed in the third week of a pack (pills 15-21), you are protected, but start the next pack of pills straight away without the pill free break. If taking a packet with dummy/placebo pills, throw these away and start the new pack.
You are ONLY protected if you start the next pack without a pill free break, emergency contraception is not required. If more than seven pills are missed, the effect of the pills may have worn off. If you have had intercourse you will be at risk of pregnancy. If it is too late for emergency contraception you will need to see your doctor to test for pregnancy before re-starting the pill on the first day of your period. Qlaira is a pill with 26 active tablets and just two inactive tablets. As there aren't 21 pills, the rules are different, please read and follow the manufacturer's missed pill advice. Zoely has 24 active tablets and 4 inactive tablets. Again special rules apply as per the manufacturer's instruction leaflet.
When and how to restart your regular hormonal contraception
If Levonelle (levonorgestrel 1.5mg) is taken, then your pills are to be continued, a new ring is to be inserted, or a new patch applied within 12 hours of taking your morning after pill. Hormonal contraception cannot be relied upon to provide contraception in the same menstrual cycle after Levonelle has been taken and an additional barrier method of contraception (condoms or caps) should be used for seven days with the patch, the ring, and the combined pill (nine days for Qlaira), and for two days with the progestogen-only pill.
If ellaOne is taken, you should wait for five days after taking ellaOne before taking your pill, inserting a new ring, or applying a new patch. Additional barrier contraception should be used during these 5 days and after re-starting hormonal contraception: with the patch, the ring, and the combined pill for seven days (nine days for Qlaira), and with the progestogen-only pill for two days.
Does Ezinelle cause side effects?
Ezinelle is safe for you as long as you consult a healthcare professional and they approve it for you before you take it. You can do this by visiting a GP surgery, sexual health clinic, or pharmacy.
Ezinelle can cause a number of side effects in some people, these include;
Very common side effects (may affect more than 1 in 10 people),
eg: Feeling sick (nausea). Lower abdominal pain. Tiredness (fatigue). Headache. Irregular bleeding until your next period. Common side effects (may affect up to 1 in 10 people), eg: Being sick (vomiting). Your period might be different. Experiencing the following after taking this medication: Tender breasts. Diarrhoea. Feeling dizzy (remember not to attempt driving if you experience dizziness).
Very rare (may affect up to 1 in 10,000 people):
Abdominal pain. Rash. Hives (urticaria). Itching (pruritus). Swelling of the face (facial oedema). Pain in the hips (pelvic pain). Period pain.
Ezinelle is not suitable for everyone, which is why it’s important to check with a healthcare professional first.
Ezinelle should not be taken by anyone who:
Is under 16, without medical supervision. Is allergic to levonorgestrel or any other ingredients in Ezinelle. Is already pregnant or suspects they may be pregnant. Has: Disease of the small intestine (eg, Crohn’s). Severe liver problems. A history of ectopic pregnancy (where the baby grows somewhere other than the womb). A history of salpingitis (inflammation of the fallopian tubes). A BMI (body mass index) over 26. Is taking any of the following medication: Barbiturates or other epilepsy medications. Medicines for treating tuberculosis. Medicines used to treat HIV. Griseofulvin – an antifungal medication. Any herbal medicine containing St John’s wort. Ciclosporin – an immunosuppressant. If you do experience any side effects then you can report them directly through the ‘Yellow Care Scheme’ at www.mhra.gov.uk/yellowcard.
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