What Side Effects Can You Expect from Afterpill?

Afterpill (Levonorgestrel 1.5 mg) is a safe and well-studied emergency contraceptive, but like any medication, it can cause side effects. The good news: most side effects are mild, temporary, and resolve on their own within a few days.

Understanding what to expect can help you feel more prepared and less anxious after taking Afterpill. Here's a comprehensive guide to the side effects, how to manage them, and when to seek medical attention.

Common Side Effects of Afterpill

The following side effects are reported frequently and are considered normal responses to the high dose of Levonorgestrel:

Nausea

Nausea is one of the most commonly reported side effects of Afterpill. It typically occurs within the first few hours of taking the tablet and usually resolves within 24–48 hours.

What to do:

• Take Afterpill with a small snack or meal — it can be taken with or without food, but food may help reduce nausea.
• Avoid lying down immediately after taking the tablet.
• Over-the-counter anti-nausea medication (like meclizine or dimenhydrinate) can help if taken 30 minutes before Afterpill.
• Important: If you vomit within 2 hours of taking Afterpill, contact a healthcare provider — you may need another dose.

Abdominal Pain and Cramping

Mild to moderate abdominal discomfort and cramping are common. This is a temporary hormonal response and usually subsides within 1–2 days.

What to do: Over-the-counter pain relievers like Ibuprofen or Acetaminophen can help. A heating pad may also provide relief.

Fatigue

Feeling tired or drained after taking Afterpill is normal. The hormonal shift can temporarily affect your energy levels.

What to do: Rest when possible. This typically improves within a day or two.

Headache

Headaches are a commonly reported side effect and are usually mild.

What to do: Stay hydrated and use over-the-counter pain relievers as needed.

Changes in Menstrual Bleeding

Afterpill can affect your next period in several ways:

• Heavier or lighter bleeding than usual
• Spotting or breakthrough bleeding between periods
• Period arriving earlier or later than expected (a delay of up to one week is considered normal)

What to do: These changes are temporary and your cycle should return to normal within one to two months. If your period is more than 7 days late, take a pregnancy test.

Dizziness

Some people experience mild dizziness after taking Afterpill.

What to do: Avoid driving or operating machinery if you feel dizzy. This usually resolves quickly.

Breast Tenderness

Tender or sore breasts can occur due to the hormonal effects of Levonorgestrel.

What to do: This is temporary and typically resolves within a few days. Wearing a supportive bra may help.

How Long Do Afterpill Side Effects Last?

Most side effects from Afterpill are short-lived:

• Nausea: 24–48 hours
• Headache: 24–48 hours
• Fatigue: 1–2 days
• Abdominal pain: 1–2 days
• Breast tenderness: A few days
• Menstrual changes: May last through your next cycle

If any side effects persist beyond a few days or worsen significantly, contact your healthcare provider.

Serious Side Effects: When to Call Your Doctor

While rare, some symptoms after taking Afterpill warrant immediate medical attention:

Severe Abdominal Pain

Intense, sharp, or persistent lower abdominal pain — especially on one side — could be a sign of an ectopic pregnancy (a pregnancy outside the uterus). This is a medical emergency.

Seek immediate medical care if you experience:

• Severe or worsening abdominal pain
• Pain on one side of the lower abdomen
• Dizziness or fainting along with abdominal pain
• Shoulder pain (which can be a referred symptom of ectopic pregnancy)

Allergic Reaction

Though extremely rare, an allergic reaction to Afterpill is possible. Call 911 or go to the ER if you experience:

• Difficulty breathing or swallowing
• Swelling of the face, lips, tongue, or throat
• Severe rash or hives
• Rapid heartbeat

Very Heavy Bleeding

While changes in menstrual bleeding are normal, soaking through more than one pad per hour for several hours is not typical and should be evaluated by a healthcare provider.

Side Effects vs. Signs of Pregnancy

Some Afterpill side effects — nausea, breast tenderness, fatigue — can overlap with early pregnancy symptoms. How can you tell the difference?

• Timing: Afterpill side effects usually start within hours and resolve within days. Pregnancy symptoms typically develop weeks later.
• Period check: If your period arrives within a week of when expected, Afterpill likely worked. If it's more than 7 days late, take a pregnancy test.
• When in doubt: A home pregnancy test taken 3 weeks after unprotected intercourse is the most reliable way to know.

Does Afterpill Affect Future Fertility?

No. Afterpill does not affect your long-term fertility. Levonorgestrel works by temporarily delaying ovulation — it does not cause permanent changes to your reproductive system. You can become pregnant in your next cycle after taking Afterpill.

For more on how the medication works, see our guide to Afterpill's mechanism of action.

Can You Take Afterpill More Than Once?

Yes, Afterpill can be used more than once, even in the same menstrual cycle if needed. However, it is not intended as a routine form of birth control. Frequent use may lead to more pronounced menstrual irregularities.

If you find yourself needing emergency contraception frequently, talk to your doctor about a regular contraceptive method. For help finding a provider, see our guide on finding a doctor who can prescribe Afterpill.

Drug Interactions That May Increase Side Effects

Certain medications can interact with Afterpill. While these interactions primarily reduce Afterpill's effectiveness rather than increasing side effects, it's important to be aware of them. Key medications to watch for include Barbiturates, Carbamazepine, Phenytoin, Rifampin, and St. John's Wort.

For a complete list, read our detailed guide on Afterpill drug interactions.

Tips for Managing Side Effects

Here are practical strategies to minimize discomfort after taking Afterpill:

1. Eat a light meal before or with the tablet to reduce nausea.
2. Stay hydrated — drink plenty of water throughout the day.
3. Rest — give your body time to adjust to the hormonal shift.
4. Use OTC remedies — pain relievers for headaches and cramps, anti-nausea medication if needed.
5. Track your period — note when you took Afterpill and when your next period arrives so you can identify any delays.
6. Have a pregnancy test on hand — for peace of mind if your period is late.

What Afterpill Does NOT Cause

There are several common misconceptions about Afterpill side effects worth clearing up:

• It does not cause abortion. Afterpill prevents pregnancy by delaying ovulation — it does not terminate an established pregnancy.
• It does not cause infertility. There are no long-term reproductive effects.
• It does not cause birth defects if taken unknowingly during early pregnancy.
• It does not increase cancer risk based on current evidence.

The Bottom Line

Afterpill is a safe emergency contraceptive with well-characterized, mostly mild side effects. Nausea, headache, fatigue, and menstrual changes are the most common — and all are temporary. Serious side effects are rare but should prompt immediate medical attention.

If you're considering taking Afterpill, don't let fear of side effects delay you — the medication is most effective when taken as soon as possible after unprotected intercourse.

Need help finding Afterpill? Visit MedFinder to locate it in stock near you. For information on cost, see our guide on saving money on Afterpill. And to learn more about the medication itself, check out What Is Afterpill? and our 2026 shortage update.