Comparison

Levonorgestrel vs Ulipristal Acetate: Understanding Your Options

Quick Answer

Levonorgestrel and ulipristal acetate are the two active ingredients used in emergency contraception pills. Levonorgestrel (found in Postinor, Plan B) is effective up to 72 hours and available OTC. Ulipristal acetate (found in Mifestad, Ella) maintains high effectiveness up to 120 hours, making it the better choice when more time has passed.

What Are These Ingredients?

These are the two main active ingredients in emergency contraception pills worldwide:

Levonorgestrel is a synthetic progestin used in many contraceptives since the 1960s. It's well-studied and widely available.

Ulipristal Acetate is a selective progesterone receptor modulator (SPRM) that was specifically developed for emergency contraception in the 2000s.

How They Work Differently

Both prevent pregnancy by affecting ovulation, but in different ways:

Levonorgestrel:
- Delays or prevents the LH surge that triggers ovulation
- Most effective before the LH surge begins
- Less effective once the surge has started

Ulipristal Acetate:
- Blocks progesterone receptors
- Can delay ovulation even after LH surge has begun
- Maintains effectiveness longer in the cycle

Effectiveness Comparison

Here's how effectiveness changes over time:

Hours After Sex	Levonorgestrel	Ulipristal Acetate
0-24 hours	95%	98%
24-48 hours	85%	97%
48-72 hours	58%	95%
72-96 hours	Not recommended	90%
96-120 hours	Not effective	85%

When to Choose Each

Your timing and situation determine the best choice:

Within 24 hours: Either works well, levonorgestrel is more affordable
24-72 hours: Ulipristal acetate has significantly higher effectiveness
72-120 hours: Only ulipristal acetate is effective
On hormonal BC: Levonorgestrel won't interfere with your regular BC
Breastfeeding: Levonorgestrel is considered compatible

Find the right emergency contraception for your situation.

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What this guide means in practice

Side-by-side comparisons cut through the marketing language and product packaging that often makes emergency contraception feel more complicated than it is. The two questions that matter most are which product is effective for your specific timing, and which one fits your access and budget. Everything else — packaging, brand familiarity, pricing format — comes second.

Most comparisons on Ruth focus on Postinor (levonorgestrel 1.5mg) and Mifestad (ulipristal acetate 30mg), the two options most commonly used in the Philippines. Postinor is available over the counter, less expensive, and is most effective in the first 24 hours after unprotected sex. Mifestad typically requires a prescription, is more expensive, but maintains stronger effectiveness across the full 120-hour window.

Comparisons also surface the smaller details that influence outcomes — for example, that body weight, current medications, breastfeeding status, and how close you are to ovulation can all shift the recommendation. A comparison guide should give you confidence in the decision rather than a list of generic facts.

Frequently Asked Questions

Yes, both are FDA-approved and considered safe for most people. Side effects are typically mild and temporary. Neither has long-term health effects.

No. Taking both together may actually reduce effectiveness. Choose one based on your timing and situation.

Levonorgestrel products are typically available over-the-counter. Ulipristal acetate usually requires a prescription or telemedicine consultation.

How Ruth Health supports this decision

Ruth Health was built around the practical realities of emergency contraception in the Philippines. That means treating timing seriously, offering discreet same-day delivery in Metro Manila, and ensuring the right product is dispatched for the patient's situation — including provincial delivery windows where Mifestad's longer effectiveness window matters.

Every order goes through a brief, evidence-based intake. When a clinician should weigh in — for example, when a patient is breastfeeding, on enzyme-inducing medications, or unsure about the time elapsed — that review happens before dispatch. Packaging is unbranded, delivery is tracked, and follow-up support is available through chat for as long as it is helpful.

When the situation has urgent components — severe pain, heavy bleeding, possible sexual assault, or signs of serious health issues — the recommendation is always to seek immediate care at a hospital or clinic, with EC support continuing alongside that care rather than replacing it.

Medical Sources

WHO Emergency Contraception Fact Sheet
FDA labeling for levonorgestrel and ulipristal acetate
ACOG guidance on emergency contraception
Peer-reviewed studies where noted in Ruth content

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