Introducing ella: A new emergency contraceptive available in the U.S.

Several emergency contraception options—or EC—were already available to us in the states. EC pills are sold at pharmacy counters and sell under brand names like Plan B One-Step or Next Choice. A Copper-T IUD, like the Paragard IUD, is available at a health centers. There’s also the Yuzpe Method where you can use combination birth control pills as EC. And while all these methods of EC can be used up to five days after unprotected sex, they are most effective when used within 72 hours (three days). They work even better within 24 hours.

But the new pill selling under the brand name ella (with a lower-case e) is just as effective on the fifth day as it is on the first. That means women have another extremely reliable 5-day option to prevent an unplanned pregnancy in an emergency situation—up to 120 hours after unprotected sex.

Make no mistake: EC is no substitute for thought-out, before-the-fact birth control. Other methods are much more effective than EC, with the IUD, shot, and implant leading the pack. But if the unexpected happens, it’s nice to have EC on your side.

Where can I get it? How much does it cost? The FDA approved ella in August 2010. It was created by Paris-based HRA Pharma, which has sold the drug in Europe since October 2009 under the name ellaOne. Sales began in U.S. drug stores in December 2010.

Pricing may vary based on where you get ella, but expect to pay about $55 at local pharmacies. If you buy it online, you’ll pay a flat rate of $67 including next-day delivery. We realize it’s expensive to buy online, but it’s worth it if that’s the only way you can get it.

Will I need a prescription? Are there age restrictions? If you want to pick ella up at a local pharmacy, you’ll need to see a provider first and get a prescription for it.

You can also get ella from an online pharmacy. In most states, the online pharmacy can fulfill your prescription without you having to see a doctor first. The website will ask you a few diagnostic screening questions and have their doctor and pharmacist fulfill your order in one step. Please note: Online pharmacies cannot ship ella to North Carolina, Louisiana, Arkansas, Missouri, and Oregon.

Being prescription-only is a good indication that insurance and Medicaid will cover it. That would certainly help many women pay for ella. There are no age restrictions to get it.

Can ella interact with other drugs? No interactions have been found, but some drugs can make ella less effective. According to the manufacturer, the herbal supplement St. John’s Wort; barbiturates; the anti-hypertension drug Tracleer (generic name: bosentan); and certain migraine, seizure, and HIV medicines can inhibit ella’s results. So can the antibiotic rifampin, which is used to treat tuberculosis.

There are a couple instances when a woman should not take ella. Don’t take it if you absolutely know you’re pregnant or if you’re breastfeeding.

How is ella different from other emergency contraception already on the market? Plan B One-Step and NextChoice contain a type of synthetic hormone called progestin. Progestin mimics progesterone, which naturally occurs in women’s bodies and makes pregnancy possible. When you’re pregnant, progesterone tells the ovaries not to release any more eggs and to thicken cervical mucus to immobilize sperm. That prevents a second pregnancy from happening while you’re already pregnant.

Basically, progestin tricks your body into thinking it’s already pregnant. And that jumpstarts your body’s pregnancy-preventing reactions. Birth control pills use this same science (in low, daily doses).

On the other hand, ella acts to suppress progesterone. This delays ovulation for up to five days, giving sperm time to die before an egg is released. (And that’s good because sperm can survive in your uterus anywhere from three to seven days after sex.) It can also thin the lining of your uterus, making it harder for a fertilized egg to be implanted.

Is ella an abortion pill? No. We’ll say it again just to be clear: No. The abortion pill is already on the market and has been since 2000. Mifeprex (generic name: mifepristone, called RU-486 in Europe) is given only in a doctor’s office. It interferes with the actions of progesterone, which in turn interrupts the pregnancy. A second drug is then given to cause the uterus to contract and expel its contents.

While both drugs suppress progesterone, they are not the same and are given in very different dosages. Mifeprex is dosed at 200 or 600 milligrams. ella’s manufacturer says that—at just 30 milligrams—the dose is too low to disrupt an established pregnancy. That means, if a woman becomes pregnant and takes ella before she realizes that she’s pregnant, limited research has shown that ella does not cause birth defects.

How can I stay up to date on ella? Bedsider has updated our emergency contraception information to include ella. We promise to always give you the most current facts so you can stay informed of all your birth control options.