The morning after pill
Emergency contraception and how it works
What is emergency contraception?
The most common form of emergency contraception is a tablet known as 'the ‘morning after pill'. It is most effective at preventing pregnancy when taken the morning after unprotected sex. It can be used after unprotected sex or after regular contraception has failed (e.g. a condom has split). It does not protect you against STIs and will not protect against further pregnancies.
How does the morning after pill work?
There are two types of morning after pill available in Ireland: the levonorgestrel pill (usually supplied under the names Norlevo or Prevenelle) and the ulipristal pill (ellaOne).
Both types of pills may stop unwanted pregnancies by preventing ovulation (and fertilisation, if unprotected sex has happened in the pre-ovulatory phase of your cycle (before the egg has been released). If sex has happened after the pre-ovulatory phase, the emergency contraceptive pill may not be as effective, which is why it should be taken as soon as possible after unprotected sex.
How long after sex can I take the morning after pill?
The levonorgestrel emergency contraceptive pill can be taken up to 72 hours (three days) after unprotected sex, and the ulipristal emergency pill can be taken up to 120 hours (five days). Both are most effective when taken within 12 hours of the unprotected sex, but continue to be effective at a slightly lower rate in the days afterwards.
How effective is the morning after pill?
Both types of pill are over 99% effective when taken correctly and within the time specified, although ellaOne is considered slightly more effective than progesterone pills.
What do I do if I vomit after taking the pill?
If you vomit within three hours of taking the pill, there is a good chance that it won't have broken down and been absorbed into your bloodstream. This can mean it is significantly less effective or may not even work at all, so you should immediately seek medical advice. Your GP or pharmacist may advise you to take another one immediately, or they may discuss fitting an IUD with you.
How can I get the morning after pill?
You can buy either type of pill over the counter in a pharmacy in Ireland without a prescription. The pharmacist will ask you some questions to check that you are not on any other medications that will make the morning after pill less effective and make sure that it is safe for you to take it. You will be charged for the pill.
You can also get the pill subsidised on your medical card, although this will require a prescription from your GP or local Family Planning Clinic. It will only cost you €2.50 on your medical card.
How often can I take the morning after pill?
You can take the levonorgestrel pill twice in one cycle in very extreme circumstances, though this is not recommended. The morning after pill is 'emergency' contraception and should not be used regularly, or to replace regular contraception.
Who can't take the morning after pill?
Most women can take the morning after pill, even those who are allergic to some forms of contraception such as the hormonal patch. If you are breastfeeding, you can take the levonorgestrel pill, though small amounts may be excreted in breast milk so manufacturers advise avoiding breastfeeding for 8 hours after taking the pill. Taking ellaOne is not advised if you are breastfeeding, as the effects on breast milk have not been studied. The manufacturers advise against breastfeeding at least one week after taking ellaOne.
The morning after pill can react with certain medicines, known as 'enzyme inducers'. These can include treatments for HIV, epilepsy and tuberculosis. This also includes the herbal remedy St John's Wort. You should disclose any medications you are taking to your GP or pharmacist before taking the pill – the list above is not exhaustive and other medications may also interact negatively with the morning after pill.
What are the side effects of the morning after pill?
Please read here for details about the side effects of the morning after pill.
What happens if I do get pregnant after taking the morning after pill?
The morning after pill works by preventing ovulation. If ovulation has already occurred, then there is still a chance you can become pregnant. If you think you may be pregnant, you should take a pregnancy test to confirm.
If you take levonorgestrel and become pregnant, you must consult with your doctor to rule out an ectopic pregnancy. Women at risk of ectopic pregnancies (previous ectopic pregnancies or salpingitis) should avoid taking levonorgestrel.
Is the morning after pill the same as having an abortion?
No, emergency contraception prevents ovulation and fertilisation, thus there is no embryo.
Are there any alternatives?
You may be offered the IUD coil or IUS instead of the morning after pill in some cases. This can also be used as emergency contraception and a long-term form of regular contraception once it has been implanted.
ellaOne  No other morning after pill is more effective [Accessed 12th December 2020]
The Journal IE  Irish women can now buy the most effective morning-after pill without a prescription [Accessed 12th December 2020]