Ulipristal

Generic Name: ulipristal acetate

Brand Names:

Availability: Easily Available

Drug Class: Progestins

Therapeutic action

  • Hormonal contraceptive, progesterone receptor modulator with agonist/antagonist effects

Indications

  • Emergency contraception after unprotected or inadequately protected intercourse (e.g. forgotten pill or condom breaking)

Forms and strengths

  • 30 mg tablet

Dosage and duration

One 30 mg tablet, whatever the day of the cycle, as soon as possible after unprotected or inadequately protected intercourse and preferably within the first 120 hours (5 days)

Contra-indications, adverse effects, precautions

  • May cause: headache, nausea, vomiting, abdominal pain, dysmenorrhea, disturbance of next menstrual cycle.
  • Re-administer treatment immediately if vomiting occurs within 3 hours of taking treatment.
  • Use with caution in patients taking drugs that might decrease ulipristal effectiveness:
    • omeprazole and antacids containing aluminium or magnesium hydroxide;
    • enzyme-inducing drugs: rifampicin, rifabutine, efavirenz, nevirapine, lopinavir, ritonavir, phenobarbital, phenytoin, carbamazepine, griseofulvin, etc.
  • Avoid combination with hormonal contraceptives: decreased effectiveness of ulipristal and of the hormonal contraceptive if taken immediately after the administration of ulipristal.
  • Pregnancy: in the event of treatment failure (i.e. pregnancy develops) or if used during an undiagnosed pregnancy,there is no known harm for the foetus.
  • Breast-feeding: no contra-indication

Remarks

  • Emergency contraception is intended to prevent pregnancy; it cannot terminate an ongoing pregnancy.
  • If an oral contraceptive pill is missed, use preferably levonorgestrel or a copper intrauterine device as emergency contraception (fewer drug interactions).
  • Start or resume hormonal contraception the 6th day after the administration of ulipristal. Use condoms for:
    • the first 7 days of taking an oral oestroprogestogen pill or an injection of medroxy progesterone or the insertion of an implant;
    • the first 2 days of taking an oral progestogen only pill.
  • There is a risk of treatment failure; carry out a pregnancy test if signs or symptoms of pregnancy(no menstruation, etc.) appear one month after taking ulipristal.

Storage

– Below 25 °C