Alternatives to the Morning After Pill If You Can't Fill Your Prescription

Plan B and ella are the best-known forms of emergency contraception, but they are not the only options. Whether you have missed the 72-hour window for Plan B, can't find ella at a pharmacy near you, weigh more than 165 pounds and are concerned about effectiveness, or simply want to understand all your options—this guide is for you.

Option 1: The Copper IUD (Paragard)—The Most Effective Emergency Contraceptive

The copper IUD (brand name Paragard) is the single most effective form of emergency contraception available. When placed by a healthcare provider within 5 days of unprotected sex, it is more than 99% effective at preventing pregnancy. Unlike pills, it is not affected by body weight. After it is placed, it can remain in place and continue to provide highly effective contraception for up to 10 years.

The downside is that you need to see a healthcare provider to have it placed—this typically requires a visit to an OB-GYN, reproductive health clinic, or Planned Parenthood. The procedure takes only a few minutes, but the appointment may be harder to get quickly.

If you are considering the copper IUD for emergency contraception, call your OB-GYN or local Planned Parenthood immediately. Many clinics keep same-day or next-day appointments specifically for this purpose.

Option 2: Ella (Ulipristal Acetate)—Better Than Plan B for Days 3–5

If you are within 72–120 hours of unprotected sex and can't find Plan B, ella is actually the better pill choice at this later time window. Ella is a prescription medication (ulipristal acetate 30 mg) that is effective for up to 5 days and consistently outperforms Plan B at all time points.

You can get ella quickly through telehealth platforms like GoodRx Care, Nurx, Planned Parenthood Direct, and Hers. Many services can write and send the prescription to a local pharmacy within an hour. Ella can also be mailed with overnight shipping.

Option 3: Generic Levonorgestrel—Many Brand Names, Same Active Ingredient

If your local pharmacy is out of Plan B One-Step, ask the pharmacist about generic equivalents. All of these contain the same active ingredient (levonorgestrel 1.5 mg) and work exactly the same way:

• My Way
• Take Action
• Option 2
• Preventeza
• AfterPill
• My Choice
• Aftera, EContra, Her Style, Fallback Solo

These generics are often cheaper than Plan B One-Step—ranging from $10–30 depending on the retailer—and are equally effective. Generic brands can also be purchased online and may be available when brand-name Plan B is out of stock.

Option 4: The Yuzpe Regimen—A Last Resort

The Yuzpe regimen involves taking a higher dose of combination birth control pills (containing both ethinyl estradiol and levonorgestrel) in two doses 12 hours apart. It must be done within 72 hours of unprotected sex. This is considered a last resort because it is less effective than Plan B and causes more side effects (especially nausea and vomiting).

The Yuzpe regimen is only appropriate if no other emergency contraceptive option is available, and must be done with guidance from a healthcare provider, as the exact dosage depends on the specific pill brand. Do not attempt this without medical guidance.

What If It's Been More Than 5 Days?

If more than 5 days have passed since unprotected sex, emergency contraception pills are no longer effective. At this point, you should wait until your next expected period. If your period is more than 3 weeks late, take a home pregnancy test. If the result is positive, contact a healthcare provider to discuss your options.

How to Choose the Right Option

Here is a simple decision framework:

• Within 72 hours + any weight: Take levonorgestrel (Plan B or generic) immediately. If over 165 lbs, prefer ella or copper IUD.
• Within 120 hours: Ella or copper IUD. Ella is effective up to 5 days; copper IUD is the most effective option at any point in the 5-day window.
• Weight over 165 lbs or over 195 lbs: Copper IUD is the best choice; ella is a good second choice for those over 165 lbs.
• Want ongoing contraception: Copper IUD doubles as long-term contraception for up to 10 years.

Having trouble locating any form of emergency contraception? See our guide on finding the morning after pill near you or learn more about what the morning after pill is and how it works.