Alternatives to Plan B One-Step If You Can't Fill Your Prescription

You've had unprotected sex or experienced a contraceptive failure and need emergency contraception — but Plan B One-Step is out of stock, too expensive, or not the right option for your body weight or situation. What now?

The good news: there are several effective alternatives to Plan B One-Step, ranging from OTC generics to prescription options to IUD insertion. This guide breaks down every option so you can make the right choice quickly.

Option 1: Generic Levonorgestrel Tablets (OTC — Same as Plan B)

The simplest and most accessible alternative is any generic 1.5 mg levonorgestrel emergency contraceptive. These are chemically identical to Plan B One-Step — same active ingredient, same dose, same efficacy — and are available over-the-counter without a prescription.

FDA-approved generic options include:

My Way — commonly found at Walgreens and Walmart; price ~$30–$40

Take Action — available at CVS, Walgreens, Rite Aid; price ~$35–$40

Aftera — available at CVS (~$39.99) and other retailers

Next Choice One Dose — single-tablet version available at major pharmacies

EContra EZ / Preventeza / Opcicon One-Step — available online and at select pharmacies

AfterPill — available online at $20 + $5 shipping; a lower-cost option if you have time for delivery

Bottom line: if Plan B One-Step is unavailable, any 1.5 mg levonorgestrel tablet is an equivalent substitution. Don't pay extra for the brand name.

Option 2: ella (Ulipristal Acetate) — Prescription, Up to 5 Days

ella (ulipristal acetate 30 mg) is a prescription-only emergency contraceptive pill approved by the FDA in 2010. It is a strong alternative to Plan B One-Step in two key situations:

You're between 72–120 hours (3–5 days) after unprotected sex. ella maintains its effectiveness up to 120 hours, unlike levonorgestrel which loses significant efficacy after 72 hours.

Your BMI is above 26–30. ella performs better at higher body weights than levonorgestrel-based pills, with effectiveness maintained up to BMI ~35.

How to get ella: You need a prescription. Options include calling your OB/GYN, visiting urgent care, or using a telehealth platform (Nurx, Hers, Planned Parenthood Direct, or RedBox Rx). Ella typically costs $40–$68 without insurance. Many insurance plans cover it at no cost-sharing when prescribed.

Important: Do not use ella if you've taken a hormonal contraceptive in the last 5 days. The two can interfere with each other and both may become less effective.

Option 3: Copper IUD (ParaGard) — Most Effective EC Available

The copper IUD (brand name ParaGard) is the single most effective form of emergency contraception. When inserted by a healthcare provider within 5 days of unprotected sex, it is more than 99% effective at preventing pregnancy.

Key advantages over Plan B One-Step:

Works equally well regardless of body weight or BMI

Effective up to 5 days after unprotected sex

Provides ongoing contraception for up to 10 years after insertion — no ongoing medication needed

Over 99% effective — far higher than any oral EC pill

Drawbacks: Requires an in-person visit with a healthcare provider for insertion. Upfront cost can be $500–$1,300 without insurance, though most insurance plans cover it fully under the ACA. Not practical for everyone in an emergency.

Option 4: Levonorgestrel IUD (Liletta, Mirena) as EC

Like the copper IUD, a levonorgestrel-releasing IUD (such as Liletta or Mirena) can also be used as emergency contraception if inserted within 5 days of unprotected sex. This is an off-label use but is supported by evidence. A levonorgestrel IUD provides ongoing hormonal contraception for 3–8 years depending on the brand.

Like the copper IUD, this option requires an in-person provider visit and is most suitable for someone who also wants ongoing long-term contraception.

Comparison: Plan B One-Step vs. Alternatives

Plan B One-Step / generics: OTC, no prescription needed, 75–89% effective within 72 hours, best for BMI under 26, costs $11–$50

ella (ulipristal acetate): Prescription required, effective up to 120 hours, better at higher BMIs (up to ~35), costs $40–$68, may be covered by insurance

Copper IUD (ParaGard): Requires provider visit, >99% effective within 5 days, works at any weight, provides 10 years contraception, costly upfront but often covered by insurance

Levonorgestrel IUD (Liletta/Mirena): Off-label EC use, provider insertion required within 5 days, provides 3–8 years hormonal contraception

What NOT to Use as Emergency Contraception

Some common misconceptions:

Regular birth control pills: Taking extra daily birth control pills is not a reliable EC method. Do not attempt this without guidance from a healthcare provider.

Mifepristone (RU-486): Mifepristone is a medication abortion drug, not emergency contraception. It is not a substitute for Plan B.

"Douching" or other myths: There is no evidence these approaches prevent pregnancy. Only FDA-approved EC methods are effective.

Bottom Line

Plan B One-Step is the most accessible emergency contraceptive in 2026, but it's not the only one. Generic levonorgestrel tablets work identically and cost less. ella is more effective at higher BMIs and offers a longer window. The copper IUD is the most effective option overall. See our guide on how to find Plan B One-Step in stock near you if you're still hoping to locate the brand name first.