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5-Days-After-Sex Pill Gets FDA Panel Nod

Experts Advise FDA to Approve a New Emergency Contraceptive Called Ella
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WebMD Health News
Reviewed by Laura J. Martin, MD

June 17, 2010 -- A new emergency contraceptive fully effective for five days after sex should be approved by the FDA, the federal agency's expert advisory panel says.

By 11-0 votes, the panel found Ella to be safe and effective.

The drug, to be called Ella in the U.S., already is approved in Europe and sold there as EllaOne.

Currently, the only other approved emergency contraceptive is Plan B One-Step. Although Ella likely will be available only by prescription, Plan B is approved for over-the-counter sale to women aged 17 and older. Women younger than age 17 must have a prescription.

The two emergency contraceptives work differently:

  • Plan B One-Step contains levonorgestrel, a progestin hormone used in lower doses in many birth control pills.
  • Ella contains ulipristal, a non-hormonal drug that blocks the effects of key hormones necessary for conception.
  • Plan B should be taken as soon as possible after sex. It may work for up to 72 hours, but is ineffective once the hormonal surge that leads to ovulation occurs.
  • Although emergency contraception should not be delayed, Ella's efficacy does not fade for 120 hours (five days) after sex, regardless of whether the hormonal surge has occurred.

One possibly serious drawback to Ella is that it may be less effective in obese women. In a 6-5 vote, the panel said no specific labeling should be required to address this issue.

The most common side effects of Ella are nausea, headache, painful menstruation, abdominal pain, fatigue, and dizziness.

Can Ella Cause Abortion?

Ella belongs to a class of drugs called selective progesterone receptor modulators. The only other approved drug in this class is mifepristone, better known as RU-486. Mifepristone is approved for use as part of a regimen that induces abortion.

Because it is better absorbed by the body than mifepristone, Ella can be used at low doses that prevent conception but that should not cause abortion.

By a unanimous vote, the panel said there was no need for Ella to carry specific labeling warning against off-label use -- the use of a drug for a purpose other than the one for which it was approved. Nor was there a need for the manufacturer to conduct specific physician education on the issue.

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