Executive summary
- Most effective: copper IUD — within 5 days of first UPSI in cycle or within 5 days of estimated ovulation.
- Oral EC: ulipristal acetate 30 mg stat (up to 120h) or levonorgestrel 1.5 mg stat (licensed to 72h; local policies vary).
- Key checks: timing, cycle/ovulation, enzyme inducers, breastfeeding, and plan for ongoing contraception.
Quick-start rules (high-yield)
- After levonorgestrel: hormonal contraception can usually start immediately; condoms until effective (method-specific timing per CKS).
- After ulipristal: delay hormonal contraception for 5 days and use condoms/abstinence; then condoms for a further period after starting (method-specific).
Safety-netting and follow-up
- Pregnancy test if next period >7 days late/abnormal or pregnancy symptoms.
- Offer STI testing based on risk; always consider safeguarding and coercion.
- Enzyme inducers reduce oral EC efficacy — copper IUD is preferred when feasible.
Frequently asked questions
Is the copper coil always best?
It is the most effective EC and provides ongoing contraception. Access and suitability can be barriers.
What if I vomit after EC?
Vomiting soon after dosing may require a repeat dose—seek advice promptly.
Transparency
This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.