Clinical Differences at a Glance
- Time Window: Plan B / Escapelle (Levonorgestrel) works up to 72 hours (3 days). Ella (Ulipristal Acetate) remains highly effective for up to 120 hours (5 days).
- Ovulation Timing: Ella is capable of stopping ovulation even when the luteinizing hormone (LH) surge has already begun, whereas Levonorgestrel loses efficacy once the surge starts.
- Weight & BMI Efficacy: Levonorgestrel has reduced effectiveness in women weighing over 70 kg (BMI > 25). Ella retains high efficacy up to 85 kg (BMI < 30).
- Prescription Status in Malaysia: Levonorgestrel (Escapelle/Postinor-2) is Group C Poison (available directly from pharmacists). Ella is Group B Poison (requires medical practitioner consultation or doctor prescription).
- Cost in Malaysia: Ella is a newer, patented medication (RM 85 – RM 120) compared to Levonorgestrel (RM 18 – RM 28).
When an emergency happens, taking the right morning-after pill makes all the difference. In Malaysia, patients often ask whether they should opt for the standard over-the-counter Levonorgestrel pill or invest in Ella.
Here is an evidence-based clinical breakdown to help you make an immediate, informed decision.
Direct Comparison: Ella (Ulipristal) vs Plan B (Levonorgestrel)
| Parameter | Ella (Ulipristal Acetate 30mg) | Plan B / Escapelle (Levonorgestrel 1.5mg) |
|---|---|---|
| Timeframe After Sex | Up to 120 hours (5 days) without loss of efficacy on Days 4–5 | Up to 72 hours (3 days); efficacy drops sharply after 48h |
| Mechanism of Action | Selective progesterone receptor modulator (SPRM) | Synthetic progestin hormone |
| Effectiveness Near Ovulation | Delays follicle rupture even when LH has begun rising | Only delays ovulation before LH surge begins |
| Higher Weight / BMI (>70kg) | Effective up to 85 kg (BMI < 30) | Reduced efficacy if > 70 kg |
| Price Range in Malaysia | RM 85.00 – RM 120.00 | RM 18.00 – RM 28.00 |
When Should You Choose Ella?
- It has been more than 48–72 hours since sex: If 3 days have already passed, Levonorgestrel is no longer reliable. Ella is the only oral emergency contraceptive approved for use up to Day 5.
- Your body weight is 70 kg or more: Studies published in The Lancet show that levonorgestrel is up to 3 times less effective in women with a BMI over 25. Ella provides significantly superior protection.
- You suspect you were close to ovulating: If sex occurred during the fertile window (e.g. Day 11–15 of a 28-day cycle), Ella is substantially more likely to postpone follicular rupture.
Important Drug Interaction: Starting Birth Control After Ella
Because Ella is a progesterone receptor blocker, taking regular hormonal birth control pills immediately afterwards can neutralize Ella and cause both medications to fail. You must wait at least 5 days after taking Ella before restarting regular birth control pills, and use barrier condoms for 14 days.
Check Your Timing with Our Pharmacists
Unsure how many hours have passed or which pill is right for your body? Consult our licensed female healthcare providers in Malaysia today.