I-Pill (Levonorgestrel) vs Other Emergency Contraceptives: A Practical Comparison

When a condom breaks or you miss a birth control pill, the clock starts ticking on preventing an unwanted pregnancy. The I-Pill (levonorgestrel) is the most widely known option, but it isn’t the only one. Below you’ll find a side‑by‑side look at the I‑Pill and the main alternatives, so you can decide which method fits your timeline, health profile, and convenience.

What the I‑Pill (Levonorgestrel) Actually Is

I‑Pill is a single‑dose, high‑dose levonorgestrel tablet taken after unprotected sex to delay or prevent ovulation. It became available in the UK in 1999 and is sold over the counter without prescription.

Key Alternatives to the I‑Pill

Four other options dominate the emergency‑contraception market:

• Ulipristal acetate - a prescription‑only pill (brand name Ella) that works up to 5 days after intercourse.
• Copper IUD - a non‑hormonal device inserted by a clinician within 5 days, providing >99% effectiveness.
• Combined oral contraceptive (Yuzpe) regimen - two doses of standard birth‑control pills taken 12 hours apart.
• Emergency contraception (general) - the umbrella term for any method used after unprotected sex to prevent pregnancy.

How Effectiveness Changes With Time

All methods lose potency the longer you wait, but the drop is not uniform.

Numbers come from UK‑based clinical trials and the WHO’s emergency‑contraception guidelines. The copper IUD outperforms every pill‑based option, but it requires a clinician and a small insertion procedure.

Side‑Effect Profile

Understanding how each method feels after taking it helps you pick one you can live with.

• I‑Pill (Levonorgestrel): mild nausea, headache, fatigue, and a possible temporary change in menstrual timing.
• Ulipristal acetate: similar nausea rates, but also occasional dizziness and menstrual irregularity that can last a few cycles.
• Copper IUD: cramping during insertion, heavier periods, and spotting for the first 1‑2months.
• Yuzpe regimen: higher incidence of vomiting (up to 20%); if you vomit within 2h you need another dose.

All methods are safe for healthy adults, but those with hormonal sensitivities often prefer the copper IUD because it contains no hormones.

Special Considerations: Weight, Age, and Drug Interactions

Research shows that levonorgestrel’s efficacy drops for people over 80kg (≈176lb). Ulipristal retains better potency up to 120kg, though data beyond that are sparse. The copper IUD’s effectiveness is unaffected by body weight.

Women taking enzyme‑inducing drugs (e.g., certain antiepileptics or rifampicin) should avoid levonorgestrel and ulipristal, as these medications speed up hormone metabolism.

Adolescents under 16 can safely use any of the pill options, but UK guidelines recommend a clinician‑led discussion for a copper IUD to ensure proper consent and after‑care.

Cost & Accessibility in the UK (2025)

Prices reflect NHS availability and typical pharmacy mark‑ups:

The NHS covers the copper IUD and ulipristal when prescribed, meaning you often pay only a small consultation fee. The I‑Pill and Yuzpe regimen are self‑pay.

Decision‑Making Checklist

• How many hours have passed?
  → ≤24h: any method works; 24‑72h: lean toward ulipristal or copper IUD; >72h: copper IUD is the only reliable option.
• Do you have a hormonal sensitivity or are you breastfeeding?
  → Copper IUD (non‑hormonal) is safest.
• Is your weight over 80kg?
  → Consider ulipristal or copper IUD for better efficacy.
• Can you see a clinician within a week?
  → If yes, copper IUD offers long‑term contraception as a bonus.
• Budget constraints?
  → Yuzpe regimen is cheapest; I‑Pill is moderate; ulipristal and IUD cost more but add effectiveness.

How to Use Each Method Correctly

1. I‑Pill (Levonorgestrel)
   • Take one tablet as soon as possible after intercourse.
   • If you vomit within 2 hours, repeat the dose with a new tablet.
   • Expect your next period within 7‑10 days of the expected date; a delay >1week warrants a pregnancy test.
2. Ulipristal acetate
   • Obtain a prescription, then take a single 30mg tablet.
   • Do not use another hormonal emergency pill within 30 days.
   • Follow up with a pregnancy test 3 weeks later if your period is late.
3. Copper IUD
   • Schedule an appointment at a family‑planning clinic within 5 days.
   • The clinician inserts the IUD; a short‑term cramp regimen (ibuprofen) helps.
   • Check the strings monthly; the device can stay effective for up to 10years.
4. Yuzpe regimen
   • Take two combined oral contraceptive tablets (or equivalent) 12hours apart.
   • If you vomit within 2hours of either dose, repeat that dose.
   • Use a reliable birth‑control method afterward, as the Yuzpe does not provide ongoing protection.

Frequently Asked Questions

Bottom line: the I‑Pill is handy, cheap, and works well within the first 24hours, but its efficacy drops sharply after three days and can be weight‑sensitive. Ulipristal extends the window and stays strong up to five days, while the copper IUD offers near‑perfect protection regardless of weight or timing-at the cost of a clinical visit. Choose the method that matches how quickly you can act, your health considerations, and your budget.