Plan B, A to Z: Everything You Need To Know About Emergency Contraception

To get you up to speed, here’s a short timeline from Plan B’s initial approval to the present:

  • 1999: Plan B (levonorgestrel 0.75 mg) is approved and available by prescription only.
  • 2006: Plan B is made available without a prescription at the pharmacy to women 18 and older with a valid ID. A prescription is still required for anyone younger than 17.
  • 2009: Plan B One-Step (levonorgestrel 1.5 mg) is approved, and the FDA rules that it be made available to women 17 and older without a prescription, with proof of age at the pharmacy counter. A prescription is still required for anyone younger than 17 years of age.
  • 2013: The age limit for Plan B One-Step is removed, making the pill available to all women of childbearing potential. The pill is also now accessible on pharmacy and grocery store shelves instead of behind the pharmacy counter.

Today, levonorgestrel 1.5 mg, most commonly known as Plan B One-Step, is available under several brand and generic names, including:

  • Plan B One-Step
  • Levonorgestrel 1.5 mg
  • EContra EZ
  • Take Action
  • My Way
  • AfterPill
  • Preventeza
  • Next Choice One Dose
  • Aftera
  • React
  • Opcicon One-Step
  • Fallback Solo
  • Athentia Next

All of these medications are considered progestin-only contraceptives, as they only contain the progestin hormone, levonorgestrel. Generic levonorgestrel 0.75 mg, which has half the dose of Plan B One-Step per pill and requires two doses within 24 hours after sex, is also available.

Other emergency contraceptive options include ella , which contains an anti-progestin, and the copper IUD (ParaGard), which is hormone-free. 

When should you take Plan B One-Step (or any levonorgestrel 1.5 mg product)?

The main benefit of levonorgestrel 1.5 mg is that you only need to take a one-time dose. You should take is as soon as possible and at least within 72 hours (3 days) of unprotected sex or birth control failure. (Ella and the copper IUD offer a little more flexibility with a 5-day window after sex.)  

How effective are emergency contraceptives?

All of the levonorgestrel 1.5 mg products above have the same strength of levonorgestrel and no other active ingredients, which makes them equally effective. Econtra EZ is just as effective as Plan B One-Step, for example. Taking any of these medications within the first 24 hours after sex will reduce your risk of pregnancy by up to 95%

When you look outside of the progestin-only contraceptives, you begin to see some differences in effectiveness. Ella is more effective than Plan B One-Step; the risk of pregnancy after taking ella within 24 hours after sex is 65% lower than the risk with Plan B One-Step. The copper IUD is the most effective emergency contraceptive—emergency insertion of the copper IUD within 5 days of sex reduces the risk of pregnancy by more than 99%, meaning only 1 in 1000 women who use this method get pregnant. Also, some studies suggest that levonorgestrel emergency contraceptives may lose effectiveness in women who have a BMI over 26, in which case, ella and ParaGard may be better options.

With the exception of the copper IUD, using protection during sex—like birth control pills or condoms—is more effective than emergency contraceptives after sex for preventing pregnancy.

Which emergency contraceptives are available over the counter?

Only the levonorgestrel 1.5 mg products (Plan B One-Step and the others listed above) are available over the counter without a prescription and with no age restrictions.

Generic levonorgestrel 0.75 (previously known as Plan B or Next Choice) requires a prescription if you’re 17 years old or younger. Ella requires a prescription for women of all ages. And copper IUDs must be inserted by your doctor.

What are the most common side effects of emergency contraceptives?

Side effects of levonorgestrel products may include menstrual changes, nausea, lower stomach pain or cramping, tiredness, headache, dizziness, breast pain and vomiting.

Reported side of ella are similar, with headache, stomach pain, nausea, menstrual pain, tiredness and dizziness being the most common.

Side effects associated with the copper IUD (ParaGard) include bleeding between periods, cramps, menstrual pain and heavy bleeding. As with other IUDs, it’s also possible to expel ParaGard from your uterus without noticing it.

You should NOT use emergency contraceptives if you are already pregnant or if you have a known allergy to any of the medications.

For many, choosing an emergency contraceptive comes down to convenience and cost. To find out more about how to choose between Plan B One-Step options, ella, and other emergency contraceptives (and how to save on costs), check out our blog post here.

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