When You Can't Get Ella, You Still Have Options

If you've been prescribed Ella but can't find it at your pharmacy — or you can't get a prescription in time — don't panic. Ella is the most effective emergency contraceptive pill, but it's not your only option. Several alternatives can help prevent pregnancy after unprotected sex.

In this article, we'll cover what Ella is, how it works, and the best alternatives available in 2026.

What Is Ella?

Ella is the brand name for Ulipristal Acetate, a selective progesterone receptor modulator used as emergency contraception. It's the only emergency contraceptive pill that remains effective for up to 120 hours (5 days) after unprotected sex.

Ella was FDA-approved in 2010 and is manufactured by Laboratoire HRA Pharma (now part of Perrigo Company). It requires a prescription, which is one reason it can be harder to find than over-the-counter options.

How Does Ella Work?

Ella works by delaying or preventing ovulation — the release of an egg from the ovary. It binds to progesterone receptors in the body and blocks the hormone progesterone from acting, which postpones the luteinizing hormone (LH) surge that triggers ovulation.

This mechanism is what makes Ella effective even on days 4 and 5 after unprotected sex, when other emergency contraceptive pills become less reliable. For a deeper dive, read our article on how Ella works.

Emergency Contraception Alternatives to Ella

If you can't find or access Ella, here are the best alternatives, ranked by effectiveness.

1. Copper IUD (Paragard) — Most Effective

The copper intrauterine device (IUD), sold under the brand name Paragard, is the most effective form of emergency contraception available. When inserted by a healthcare provider within 5 days of unprotected sex, it reduces the risk of pregnancy by more than 99%.

Key facts about the Copper IUD:

• Effective for up to 5 days after unprotected sex (same window as Ella)
• More than 99% effective at preventing pregnancy
• Provides ongoing birth control for up to 10 years
• Does not contain hormones
• Requires insertion by a healthcare provider (OB/GYN, family medicine doctor, or clinic)
• Can cost $0 with insurance or up to $1,000 without insurance

The copper IUD is the gold standard for emergency contraception, but the catch is that you need a same-day appointment with a provider who can insert it. Call your OB/GYN, a Planned Parenthood clinic, or a community health center to see if they can fit you in.

2. Plan B One-Step (Levonorgestrel 1.5 mg) — Most Accessible

Plan B One-Step is the most well-known emergency contraceptive pill. It contains Levonorgestrel, a synthetic progestin that works by delaying ovulation.

Key facts about Plan B:

• Available over the counter — no prescription or age restriction
• Most effective within 72 hours (3 days) after unprotected sex
• Effectiveness decreases with time (about 89% within 72 hours)
• Less effective than Ella on days 3-5
• May be less effective for individuals weighing over 165 lbs
• Costs approximately $25-$50 at most pharmacies

Plan B is available at virtually every pharmacy, grocery store, and even some convenience stores. It's the fastest option if you need emergency contraception right now.

3. Generic Levonorgestrel Options — Budget-Friendly

If Plan B's price tag is a concern, several generic Levonorgestrel options contain the same active ingredient at a lower price:

• Take Action — typically $10-$35
• My Way — typically $10-$30
• AfterPill — available online for around $20 with shipping
• Morning After Pill by Cadence OTC — another affordable option

These work identically to Plan B. The active ingredient, dosage, and effectiveness are the same. The only difference is the brand name and the price.

4. Higher-Dose Birth Control Pills (Yuzpe Method)

In a pinch, certain combination birth control pills can be used as emergency contraception. This is called the Yuzpe method. It involves taking a higher-than-normal dose of regular birth control pills containing both estrogen and progestin.

Important notes:

• This is less effective than Plan B or Ella (about 75% effective)
• Causes more side effects, especially nausea and vomiting
• Requires specific pill brands and dosing — talk to your doctor or pharmacist
• Should only be used when other options are unavailable

This is a last-resort option, but it's worth knowing about if you already have birth control pills at home and can't access anything else.

Quick Comparison

• Ella: Prescription only, effective 5 days, most effective EC pill, ~$40-$90
• Copper IUD: Requires provider insertion, effective 5 days, most effective overall, $0-$1,000
• Plan B: OTC, effective 3 days, widely available, ~$25-$50
• Generic Levonorgestrel: OTC, effective 3 days, budget option, ~$10-$35
• Yuzpe Method: Uses existing birth control pills, least effective, last resort

Final Thoughts

While Ella is the most effective emergency contraceptive pill, it's not always easy to find. If you can't get Ella, the copper IUD is actually more effective, and Plan B is available without a prescription at nearly every pharmacy.

The most important thing is to act quickly — all forms of emergency contraception work better the sooner you take them. Don't let the search for the "perfect" option delay you from using what's available.

If you want to be prepared for the future, consider getting an advance prescription for Ella and keeping it at home. Use Medfinder to find pharmacies that stock it, and read our guide on how to find Ella in stock near you.

For more about Ella's side effects and interactions, check out Ella Side Effects and Ella Drug Interactions.