Ulipristal Acetate: Uses, Dosage, and Emergency Contraception Guide

Summary of Key Points

Ulipristal acetate is a medication used to treat conditions such as uterine fibroids, endometriosis, and is also utilized for emergency contraception. It works by modifying the effects of progesterone, a hormone that plays a crucial role in the menstrual cycle. Ulipristal acetate helps alleviate symptoms like heavy menstrual bleeding and hormonal imbalances. Always consult a healthcare provider before starting or adjusting your dosage. You can also schedule a telemedicine appointment with one of our providers for personalized care.

Names of Medication

US Brand Name: Ella (Ulipristal acetate)

The ‘generic name’ refers to the active ingredient in the medication, listed in parentheses. Generic names are non-branded and are often used interchangeably with brand names.

Pharmacologic Category

Selective Progesterone Receptor Modulator (SPRM)

Ulipristal Acetate Dosage

Ulipristal acetate is prescribed for a variety of conditions. Below are the recommended doses for adults. Always consult your healthcare provider before making any changes to your medication. If needed, you can schedule a telemedicine appointment with us for further guidance.

Ulipristal Acetate for Uterine Fibroids

Recommended dose: 5 mg once daily for up to 3 months. Treatment may be repeated after a break, depending on your healthcare provider’s advice.

Ulipristal Acetate for Endometriosis

Recommended dose: 5 mg once daily for up to 3 months. The duration of treatment may vary based on your healthcare provider’s recommendation.

Ulipristal Acetate for Emergency Contraception

Recommended dose: 30 mg taken as a single dose within 120 hours (5 days) after unprotected intercourse or contraceptive failure.

Ulipristal Acetate for Heavy Menstrual Bleeding

Recommended dose: 5 mg once daily for up to 3 months. Treatment may be repeated depending on your symptoms and your doctor’s advice.

Ulipristal Acetate for Hormonal Imbalance

Recommended dose: 5 mg once daily for up to 3 months. Your healthcare provider may adjust the treatment based on your specific condition.

Ulipristal Acetate for Ovarian Cysts

Recommended dose: 5 mg once daily for up to 3 months. Treatment may be extended based on your doctor’s evaluation.

Ulipristal Acetate for Menstrual Disorders

Recommended dose: 5 mg once daily for up to 3 months. Consult your healthcare provider for further guidance.

Ulipristal Acetate for Polycystic Ovary Syndrome (PCOS)

Recommended dose: 5 mg once daily for up to 3 months. Your doctor will determine if additional treatment is necessary.

Ulipristal Acetate for Uterine Adenomyosis

Recommended dose: 5 mg once daily for up to 3 months. Treatment may be repeated after a break if needed.

Ulipristal Acetate for Infertility

Recommended dose: 5 mg once daily for up to 3 months. Consult your healthcare provider for personalized treatment options.

Dosage Forms and Strengths

Tablet: 5 mg

Tablet: 30 mg (for emergency contraception)

Administration Instructions for Ulipristal Acetate

Ulipristal acetate should be taken orally, with or without food. For emergency contraception, take the medication as soon as possible after unprotected intercourse, but no later than 120 hours. For other conditions, take the medication at the same time each day to maintain consistent hormone levels. If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose. Do not double up on doses.

Contraindications for Ulipristal Acetate

A contraindication is a specific situation or condition where a medication should not be used because it may cause harm. If you have any of the following conditions, you should not take Ulipristal acetate, or you should consult your healthcare provider to discuss alternative options.

Pregnancy: Ulipristal acetate is not safe during pregnancy as it may harm the developing fetus. It is primarily used as an emergency contraceptive, so it should not be taken if you are already pregnant.

Severe liver disease: People with severe liver disease should avoid Ulipristal acetate because the liver plays a key role in breaking down the medication. Impaired liver function can lead to drug accumulation, increasing the risk of side effects.

Unexplained vaginal bleeding: If you have abnormal or unexplained vaginal bleeding, Ulipristal acetate should not be used until the cause is identified. This ensures the bleeding is not due to a serious condition like cancer.

Allergy to Ulipristal acetate: If you have a known allergy to Ulipristal acetate or any of its ingredients, you should not take this medication, as it could cause a severe allergic reaction.

Drug Interactions with Ulipristal Acetate

Ulipristal acetate can interact with other medications, which may reduce its effectiveness or increase the risk of side effects. Inform your healthcare provider about all medications you are currently taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Ulipristal acetate:

Rifampin (Rifadin): This antibiotic can decrease the effectiveness of Ulipristal acetate by speeding up its breakdown in the liver.

Phenytoin (Dilantin): This anti-seizure medication may reduce the effectiveness of Ulipristal acetate by increasing its metabolism.

Carbamazepine (Tegretol): Another anti-seizure drug that can lower the effectiveness of Ulipristal acetate by affecting how it is processed in the body.

St. John’s Wort: This herbal supplement can reduce the effectiveness of Ulipristal acetate by speeding up its breakdown in the liver.

Ketoconazole (Nizoral): This antifungal medication may increase the levels of Ulipristal acetate in the body, potentially leading to more side effects.

Ulipristal Acetate in Pregnancy

Is it safe to take Ulipristal acetate when pregnant?

No, Ulipristal acetate is not safe to use during pregnancy. As an emergency contraceptive, its purpose is to prevent pregnancy after unprotected intercourse or contraceptive failure. If you are already pregnant, taking Ulipristal acetate could potentially harm the developing fetus. If you suspect you might be pregnant, it’s important to consult your healthcare provider right away. If you’re uncertain, our telemedicine providers are available to help you determine the best course of action.

Ulipristal Acetate While Breastfeeding

Is it safe to take Ulipristal acetate while breastfeeding?

Ulipristal acetate is not recommended for use while breastfeeding. Although only small amounts may pass into breast milk, the effects on a nursing infant are not fully understood. If you are breastfeeding and require emergency contraception, it’s best to consult your healthcare provider for safer alternatives. Our telemedicine providers can also assist you in making an informed decision.

Estimated Cost of Ulipristal Acetate

The cost of a 30-day supply of Ulipristal acetate without insurance typically ranges from $40 to $60, depending on the pharmacy and your location. With a GoodRX coupon, you may be able to reduce the price to around $35. Prices can vary, so it’s a good idea to check with your local pharmacy or use a prescription discount service for the best deal.

Possible Alternatives to Ulipristal Acetate

Depending on your specific condition, there may be alternative treatments or lifestyle adjustments that can help manage your symptoms. Always discuss these options with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are also available to help you explore these alternatives.

Uterine Fibroids

Alternative treatments for uterine fibroids include hormonal therapies such as GnRH agonists or progestin-releasing IUDs. Surgical options, like myomectomy, may also be considered. Additionally, lifestyle changes, such as maintaining a healthy weight and managing stress, may provide some relief.

Endometriosis

For managing endometriosis, hormonal therapies like birth control pills or GnRH agonists are commonly used. In some cases, surgery may be necessary to alleviate symptoms. Regular physical activity and a balanced diet may also help improve your overall well-being.

Emergency Contraception

Other emergency contraception options include levonorgestrel (Plan B One-Step) or a copper IUD. It’s important to consult your healthcare provider to determine which option is best suited for you.

Heavy Menstrual Bleeding

For heavy menstrual bleeding, hormonal birth control, tranexamic acid, or nonsteroidal anti-inflammatory drugs (NSAIDs) may be effective. If heavy bleeding leads to anemia, iron supplements can also be beneficial.

Hormonal Imbalance

Treatment for hormonal imbalances depends on the underlying cause. Options may include hormone replacement therapy (HRT), birth control pills, or lifestyle modifications such as stress management and a nutritious diet.

Ovarian Cysts

Birth control pills may help prevent the formation of new ovarian cysts. In some cases, surgery may be required to remove larger cysts. Maintaining a healthy weight and engaging in regular exercise may also help manage symptoms.

Menstrual Disorders

Menstrual disorders can often be managed with hormonal treatments, lifestyle changes, and stress management techniques. Speak with your healthcare provider to determine the most appropriate treatment for your specific condition.

Polycystic Ovary Syndrome (PCOS)

Treatment options for PCOS include hormonal birth control, metformin, and lifestyle changes such as weight loss and regular physical activity.

Uterine Adenomyosis

Hormonal treatments, such as birth control pills or GnRH agonists, may help manage symptoms of uterine adenomyosis. In more severe cases, surgery may be necessary.

Infertility

Treatment for infertility depends on the underlying cause. Options may include fertility medications, lifestyle changes, or assisted reproductive technologies such as in vitro fertilization (IVF).

Recent Updates on Ulipristal Acetate Research

Recent research has focused on the long-term safety and effectiveness of Ulipristal acetate, particularly for the treatment of uterine fibroids. Some studies suggest that Ulipristal acetate may reduce fibroid size and help control symptoms over extended periods. However, concerns about potential liver toxicity have led to stricter monitoring guidelines in certain countries. Ongoing research is exploring the possibility of using lower doses of Ulipristal acetate to minimize side effects while maintaining its therapeutic benefits. For the most up-to-date information, consult your healthcare provider or schedule a telemedicine appointment with one of our providers to discuss your treatment options.

James Kingsley

Learn More