Birth Control

Prescription EC pill (ella)

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What is the prescription-only EC pill (ella)? The prescription EC pill (ella) might be right for you if... How do you use the prescription EC pill (ella)? How much does the prescription EC pill (ella) cost? What are the side effects and benefits of the prescription EC pill (ella)? Where can you get the prescription EC pill (ella)?

What is the prescription-only EC pill (ella)?

Ella is an emergency contraception (EC) pill that you can only get with a prescription. It works to prevent pregnancy by delaying ovulation when it’s taken within five days (120 hours) after having unprotected sex. Ella is more likely than over-the-counter EC to be effective at preventing pregnancy on the fifth day after unprotected sex. You need a prescription to get ella, so you will have to see a health care provider in person or via telehealth. Ella may not work as well for people who weigh 195 pounds or more. (If that’s you, don’t worry—there are other options.)

Quick Facts

Not the most effective kind of emergency contraception, but more effective than over-the-counter EC pills. Good for people who weigh up to 195 pounds.

Effectiveness

If you’re looking for an EC pill, the prescription-only EC pill (ella) is the most effective option. But it’s not as effective as using the IUD as emergency contraception.

Perfect use: Not enough data

Typical use: Not enough data

What are perfect use and typical use?
Hormones

Prescription-only emergency contraception (ella) doesn’t contain hormones, but it does affect your hormones.
Side effects

Temporary changes to your period, nausea, vomiting, breast soreness, dizziness, and headache.
Cost

Anywhere from $0 (with insurance) to around $90.
STI protection

Prescription-only EC doesn’t protect against STIs.
Ongoing effort

One pill then you’re done.

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The prescription EC pill (ella) might be right for you if...

Something went wrong with your usual birth control method.

If the condom broke, your partner didn’t pull out in time, or you forgot to take your pill, insert your ring, or apply your patch—or if there was anything else that went wrong with your birth control method—you may want to use EC.

You weren’t using any birth control at the time you had sex.

If you didn’t use any protection during sex and don’t want to get pregnant right now, the prescription-only EC pill might be for you—as long as it’s been five days (120 hours) or fewer since you had unprotected sex.

You didn’t consent to sex.

If you’ve been raped or coerced by someone who refused to use contraception, and you don’t want to get pregnant, the prescription-only EC pill might be for you. (If you need support, you can call or chat with RAINN, a 24/7 free, confidential national sexual assault hotline.)

It’s proven to be effective in people at your weight.

Studies have shown ella works best for people who weigh less than 195 pounds. Yep, that leaves out a lot of people. If you weigh 195 pounds or more, you can still take ella, but it may be less effective. If you want a more effective emergency contraception option, there are several kinds of IUDs that you can use as EC. No matter your weight, the IUD is the most effective form of emergency contraception.

How do you use the prescription EC pill (ella)?

Ella is a pill made from a medicine called ulipristal acetate. Like the over-the-counter EC pill, it works to prevent ovulation so that pregnancy can’t start. If you don’t ovulate, there’s no egg available for sperm to fertilize. Ella is more effective than the over-the-counter EC pill, but it’s less effective than getting an IUD as EC.

Ella is likely to be as effective on the fifth day after unprotected sex as it is on the first day. That means there’s time for you to see or talk to your health care provider or go online and get ella through a telehealth service. Still, it’s a good idea to take the ella pill as soon as possible after having unprotected sex.

If you’re on birth control pills and use ella, you’ll need to stop taking your birth control pills for 5 days after using ella and use a backup method of birth control, like condoms, until your next period.

How much does the prescription EC pill (ella) cost?

With insurance

If you have health insurance—whether it’s from work, school, your parents, the ACA marketplace, or Medicaid—chances are good that you’ll be able to get ella without having to pay anything out of pocket.

Without insurance

The full price of ella ranges from $50-$90, depending on where you get it. If you need help paying for ella, you may have options. Check with your local family planning clinics to find out if they offer free or low cost EC (most do).

What are the side effects and benefits of the prescription EC pill (ella)?

There are positive and negative things to say about each and every method. And everyone’s different—so what you experience may not be the same as what someone else experiences.

The Positive

There are actually lots of things about prescription-only EC that may be good for your body as well as your sex life.

Offers protection from pregnancy and peace of mind after unprotected sex
More likely to be effective for the entire five-day window after unprotected sex than over-the-counter EC
More likely to be effective than over-the-counter EC for people who weigh between 165 and 194 pounds

The Negative

If you do experience negative side effects with prescription-only EC, they’ll probably go away within 24 hours. Here are some potential side effects of ella:

Nausea
Vomiting
Breast tenderness
Dizziness
Headaches
Changes to your period (lighter, heavier, early, or late)

In addition to possible side effects, ella:

Isn’t as effective as using the IUD as emergency contraception.
Is less effective in people who weigh 195 pounds or more.
Requires a prescription, so you have to see a provider to get it.

Where can you get the prescription EC pill (ella)?

In person

You can visit a health center to get a prescription for ella (or pick it up)—a great option if you’re looking to pay less, because some health centers may offer lower-cost ella to those who qualify. In some states, a pharmacist can also prescribe emergency contraception to you.

Online

It’s easier than ever to get birth control online, including EC. Find out what’s available where you live.