Can't find Ulipristal (Ella) in stock? Learn about effective alternatives including Plan B, the copper IUD, and other emergency contraception options.
Your doctor prescribed Ulipristal (Ella), but the pharmacy doesn't have it. The clock is ticking. What are your options?
First, don't panic. While Ulipristal is an excellent emergency contraceptive, it's not the only one. There are several effective alternatives, each with their own strengths and limitations. In this guide, we'll cover what Ulipristal is, how it works, and the best alternatives if you can't get your prescription filled in time.
Ulipristal Acetate — sold under the brand name Ella — is a prescription emergency contraceptive that belongs to a class of drugs called selective progesterone receptor modulators (SPRMs). It was approved by the FDA in 2010 and is considered one of the most effective oral emergency contraceptives available.
Ella comes as a single 30 mg tablet and is effective for up to 120 hours (5 days) after unprotected intercourse or contraceptive failure. It's more effective than Plan B, particularly on days 3 through 5 after intercourse.
For a complete overview, see What Is Ulipristal? Uses, Dosage, and What You Need to Know.
Ulipristal works by blocking progesterone receptors in the body. Progesterone is a hormone that plays a key role in ovulation and preparing the uterus for pregnancy. By blocking progesterone's effects, Ulipristal delays or prevents the release of an egg from the ovary (ovulation).
This mechanism is what makes Ella effective even later in the fertile window compared to Levonorgestrel-based options. For a deeper dive, read How Does Ulipristal Work? Mechanism of Action Explained.
There are several reasons you might need to consider an alternative to Ulipristal:
Plan B One-Step is the most widely available emergency contraceptive in the United States. It's available over the counter without a prescription, without age restrictions, and at most pharmacies, grocery stores, and even online.
How it works: Plan B contains Levonorgestrel, a synthetic progestin that works primarily by delaying ovulation. It comes as a single 1.5 mg tablet.
Effectiveness: Plan B is most effective when taken within 72 hours (3 days) of unprotected intercourse. Its effectiveness decreases significantly after that window. Studies suggest Plan B may be less effective in women weighing over 165 pounds.
Cost: Plan B typically costs between $25 and $50 over the counter. Generic versions (like Take Action, My Way, or Aftera) may cost as little as $10–$15.
Pros: No prescription needed, widely available, fast to obtain.
Cons: Less effective than Ulipristal after 72 hours, may be less effective for higher-weight individuals.
The copper IUD (Paragard) is the most effective form of emergency contraception available. When inserted within 5 days of unprotected intercourse, it prevents pregnancy in more than 99% of cases.
How it works: The copper IUD releases copper ions that are toxic to sperm, preventing fertilization. It also creates an inflammatory response in the uterus that makes implantation difficult.
Effectiveness: Greater than 99% effective as emergency contraception. It can also serve as ongoing birth control for up to 10–12 years.
Cost: The upfront cost can be $500–$1,300 without insurance, but most insurance plans cover it fully under the ACA. Planned Parenthood and community health centers may offer it on a sliding scale.
Pros: Most effective EC option, provides long-term contraception, hormone-free.
Cons: Requires a clinic visit for insertion, not as instantly accessible, may cause heavier periods.
The Yuzpe method uses regular combined oral contraceptive pills (containing both estrogen and progestin) in specific higher doses as emergency contraception. This is an older method, but it remains an option when dedicated EC products aren't available.
How it works: Two doses of certain birth control pills are taken 12 hours apart. The specific number of pills depends on the brand. Your doctor or pharmacist can tell you the correct dosing for your particular pill.
Effectiveness: The Yuzpe method is less effective than both Plan B and Ulipristal, preventing about 56–86% of expected pregnancies. It also causes more nausea and vomiting.
Cost: If you already have birth control pills on hand, this method is essentially free.
Pros: Uses pills you may already have, available immediately if you have a current prescription.
Cons: Less effective, more side effects (nausea, vomiting), requires knowing the correct dosing for your specific pill brand.
Before giving up on Ulipristal entirely, consider that several telehealth platforms can prescribe Ella and ship it directly to you, sometimes with overnight delivery. Services like Wisp, Nurx, and PRJKT RUBY specialize in reproductive health and can often get a prescription and shipment processed the same day.
This isn't technically an "alternative" medication, but it's an alternative pathway to getting Ulipristal when local pharmacies can't help. Learn more in our guide on how to find Ulipristal in stock near you.
If you can't find Ulipristal (Ella) in stock, you still have strong options. Plan B is the quickest and most accessible alternative for most people. The copper IUD is the most effective option overall. And telehealth services can often get Ella shipped directly to you if local pharmacies fall short.
Whatever you choose, act quickly. All emergency contraceptives work better the sooner you take them. Use Medfinder to check local availability, and talk to your healthcare provider about which option makes the most sense for your situation.
You focus on staying healthy. We'll handle the rest.
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