Ulipristal Acetate [For emergency contraception]

Introduction

Ulipristal Acetate is a synthetic selective progesterone receptor modulator (SPRM) used for emergency contraception. It works by delaying ovulation and preventing pregnancy when taken after unprotected intercourse. It is marketed under the brand name Ella and is available as a single oral tablet for emergency contraception within 120 hours (5 days) after unprotected sex or contraceptive failure.

Uses

Ulipristal Acetate is primarily used as an emergency contraceptive to prevent pregnancy after unprotected sexual intercourse or contraceptive failure (such as a broken condom). It is effective when taken up to 5 days after the event, providing a longer window than traditional levonorgestrel-based emergency contraceptives.

Brand Name	Ulipristal Acetate [For emergency contraception]
Type
Weight
Generic	Ulipristal Acetate [For emergency contraception]
Manufacturer
Available in	English বাংলা

Mechanism of Action

Ulipristal Acetate works by inhibiting or delaying ovulation. It binds to the progesterone receptor and inhibits the action of progesterone, preventing the release of an egg from the ovary. Additionally, it may alter the endometrium, preventing implantation of a fertilized egg.

How Long Does It Take to Work?

Ulipristal Acetate begins to work soon after ingestion. It is most effective when taken as soon as possible after unprotected intercourse but can be taken up to 120 hours (5 days) after. Its ability to prevent pregnancy decreases slightly as time passes, but it is still effective throughout the 5-day window.

Absorption

Ulipristal Acetate is rapidly absorbed after oral administration. The peak plasma concentration (C_max) is reached approximately 1 hour after ingestion. Its absorption may be slightly affected by food, particularly fatty meals, which can delay the absorption process.

Route of Elimination

Ulipristal Acetate is metabolized in the liver, primarily by the enzyme CYP3A4. It is excreted in the urine and feces, with about 90% of the drug eliminated within 7 days, mostly as metabolites.

Dosage

One 30 mg tablet must be taken as soon as possible but no later than 120 hours of unprotected intercourse or contraceptive failure, with or without food. If vomiting occurs within 3 hours of intake, then another tablet needed to be taken. Ulipristal Acetate can be taken at any time of menstrual cycle.

The standard dosage for Ulipristal Acetate used for emergency contraception is a single oral tablet containing 30 mg of Ulipristal Acetate, taken as soon as possible after unprotected intercourse or contraceptive failure. It can be taken up to 120 hours (5 days) after the event.

Administration

Ulipristal Acetate is administered orally as a single 30 mg tablet. It can be taken with or without food. The tablet should be swallowed whole with water, and it is recommended to take it as soon as possible after unprotected sex for maximum effectiveness. If vomiting occurs within 3 hours of taking the pill, a repeat dose may be necessary.

Side Effects

Common side effects of Ulipristal Acetate include headache, nausea, abdominal pain, dysmenorrhea (painful menstruation), fatigue, and dizziness. Less common side effects may include delayed menstruation, mood changes, and breast tenderness.

Toxicity

Ulipristal Acetate is generally well-tolerated at the recommended dose. Overdose is unlikely, but symptoms could include more pronounced side effects such as severe headache, nausea, or abdominal pain. In case of overdose, symptomatic treatment is recommended.

Precautions

Ulipristal Acetate should not be used as a regular form of contraception. Women with severe liver dysfunction or certain enzyme deficiencies should consult a healthcare provider before use. It is not recommended for use in women who are already pregnant, and it is not intended for use as a long-term contraceptive method.

Interaction

Ulipristal Acetate may interact with drugs that induce the CYP3A4 enzyme, such as rifampicin, phenytoin, carbamazepine, and St. John's Wort, which can reduce the effectiveness of Ulipristal Acetate. It may also interact with other hormonal contraceptives, potentially reducing their efficacy, and should not be used in combination with emergency contraceptive pills containing levonorgestrel.

Disease Interaction

Patients with severe liver impairment should avoid using Ulipristal Acetate, as its metabolism may be significantly affected. It is also contraindicated in women with known hypersensitivity to the drug or any of its components.

Drug Interaction

Ulipristal Acetate may interact with medications that induce or inhibit CYP3A4. Drugs like ketoconazole and itraconazole (CYP3A4 inhibitors) can increase the levels of Ulipristal Acetate in the body. Meanwhile, drugs such as rifampin, carbamazepine, and phenobarbital (CYP3A4 inducers) may decrease its effectiveness.

Food Interactions

While Ulipristal Acetate can be taken with or without food, high-fat meals may delay the absorption of the drug. This does not significantly reduce its effectiveness, but patients are generally advised to take the tablet on an empty stomach for faster absorption.

Pregnancy Use

Ulipristal Acetate is not intended for use during an existing pregnancy. However, studies show that it does not harm an existing pregnancy if inadvertently taken by a pregnant woman. Ulipristal should not be used to terminate a confirmed pregnancy.

Lactation Use

Ulipristal Acetate is excreted in breast milk. Women are advised to avoid breastfeeding for one week after taking the medication. During this period, stored breast milk or formula can be used to feed the infant.

Acute Overdose

There is limited data on the effects of acute overdose with Ulipristal Acetate. However, doses higher than 30 mg have been well-tolerated in clinical studies, with only mild or moderate side effects. Symptomatic treatment should be provided in the event of an overdose.

Contraindication

Ulipristal Acetate is contraindicated in women with a known hypersensitivity to the drug or any of its components. It is also contraindicated for women who are already pregnant and should not be used as a regular contraceptive method.

Use Direction

Ulipristal Acetate should be taken orally as a single 30 mg tablet as soon as possible, but no later than 120 hours after unprotected sex or contraceptive failure. It should not be used more than once during the same menstrual cycle. If vomiting occurs within 3 hours of taking the pill, another dose should be taken.

Storage Conditions

Ulipristal Acetate should be stored at room temperature (20-25°C) in its original packaging, away from moisture and heat. It should be kept out of reach of children and protected from light.

Volume of Distribution

Ulipristal Acetate has a large volume of distribution, indicating that it is widely distributed in tissues throughout the body. The volume of distribution is estimated to be around 1000 liters.

Half Life

The half-life of Ulipristal Acetate is approximately 32 hours, allowing it to maintain its effectiveness over a prolonged period after ingestion. This long half-life supports its use as an emergency contraceptive up to 5 days after unprotected intercourse.

Clearance

Ulipristal Acetate is primarily cleared by hepatic metabolism via the CYP3A4 enzyme. Its clearance rate is dependent on liver function, and clearance may be reduced in patients with hepatic impairment. Most of the drug and its metabolites are eliminated via the feces, with a smaller portion excreted in the urine.

See in details version Ulipristal Acetate [For emergency contraception] also Ulipristal Acetate [For emergency contraception] in bangla

Some Frequently Asked Questions About Ulipristal Acetate [For emergency contraception]

1. What is Ulipristal Acetate?

Ulipristal Acetate is an emergency contraceptive pill used to prevent pregnancy after unprotected sex or contraceptive failure.

2. How does Ulipristal Acetate work?

It works by delaying ovulation, preventing fertilization, and altering the uterine lining to reduce the chances of implantation.

3. Is Ulipristal Acetate the same as a regular birth control pill?

No, it is used only for emergency contraception and not as a regular birth control method.

4. How soon should I take Ulipristal Acetate after unprotected sex?

It should be taken as soon as possible, preferably within 24 hours, but it remains effective up to 120 hours (5 days) after intercourse.

5. Is Ulipristal Acetate more effective than levonorgestrel emergency contraceptive pills?

Yes, it is more effective than levonorgestrel (Plan B) and works better when taken later in the 5-day window.

6. Can Ulipristal Acetate be taken more than once in a menstrual cycle?

It can be taken more than once, but frequent use is not recommended as a regular contraceptive method.

7. Does Ulipristal Acetate cause an abortion?

No, it does not terminate an existing pregnancy; it only prevents pregnancy before implantation.

8. Can Ulipristal Acetate be used as a regular contraceptive?

No, it is meant for emergency use only and should not replace regular birth control methods.

9. Will Ulipristal Acetate affect my fertility in the long term?

No, it does not have long-term effects on fertility.

10. Can I take Ulipristal Acetate while breastfeeding?

It is not recommended while breastfeeding. If taken, avoid breastfeeding for at least 24 hours after use.

11. Does Ulipristal Acetate work if I have already ovulated?

No, it is less effective if ovulation has already occurred.

12. Can I take Ulipristal Acetate with other contraceptive pills?

It may interact with hormonal contraceptives, reducing effectiveness. Wait at least 5 days before restarting regular birth control.

13. How effective is Ulipristal Acetate in preventing pregnancy?

It is about 85% effective in preventing pregnancy when taken within 5 days after unprotected sex.

14. What are the common side effects of Ulipristal Acetate?

Common side effects include:

• Nausea
• Headache
• Fatigue
• Abdominal pain
• Irregular menstrual bleeding

15. Can Ulipristal Acetate delay my period?

Yes, it may cause a delay of a few days or even a week.

16. What should I do if my period is more than a week late after taking Ulipristal Acetate?

Take a pregnancy test and consult a doctor.

17. Can Ulipristal Acetate be taken with alcohol?

There is no direct interaction, but alcohol may impair judgment and increase the risk of unprotected sex.

18. Can Ulipristal Acetate cause birth defects if pregnancy occurs?

No, there is no evidence that it causes birth defects if pregnancy continues.

19. Can I take Ulipristal Acetate after missing a birth control pill?

Yes, if you had unprotected sex, but you should resume regular contraception after 5 days.

20. Does Ulipristal Acetate protect against sexually transmitted infections (STIs)?

No, it does not protect against STIs.

21. What should I do if I vomit after taking Ulipristal Acetate?

If you vomit within 3 hours of taking it, you should take another dose.

22. Can Ulipristal Acetate be taken during menstruation?

It is not necessary if you are already on your period.

23. Can Ulipristal Acetate be used by women of all ages?

It is generally recommended for women of reproductive age, but adolescents should consult a doctor.

24. Is a prescription required for Ulipristal Acetate?

In many countries, it requires a prescription, but availability varies.

25. Can men buy Ulipristal Acetate for their partners?

Yes, men can purchase it for their partners where permitted.

26. Can Ulipristal Acetate interact with medications?

Yes, it may interact with:

• Rifampin
• Carbamazepine
• Phenytoin
• St. John’s Wort

27. Can I use Ulipristal Acetate with an intrauterine device (IUD)?

An IUD can be inserted after using Ulipristal Acetate but should be delayed for at least 5 days.

28. Can I exercise after taking Ulipristal Acetate?

Yes, there are no restrictions on physical activity.

29. Can I take Ulipristal Acetate with antibiotics?

Some antibiotics may reduce its effectiveness. Consult a doctor before use.

30. Can I take Ulipristal Acetate if I have PCOS?

Yes, but consult your doctor if you have concerns about irregular cycles.

31. What happens if I take Ulipristal Acetate too late?

It may be ineffective if taken after ovulation or beyond 5 days after unprotected sex.

32. Can Ulipristal Acetate cause mood changes?

Some women report mood swings, but they are usually temporary.

33. Does Ulipristal Acetate cause bloating?

Bloating is a possible but uncommon side effect.

34. Can I take Ulipristal Acetate while traveling?

Yes, but check regulations in the country you are traveling to.

35. Is Ulipristal Acetate halal?

Check with a religious authority, as opinions may vary.

36. Does Ulipristal Acetate contain hormones?

It is a selective progesterone receptor modulator, not a traditional hormone.

37. Can Ulipristal Acetate be used for menstrual regulation?

No, it is only for emergency contraception.

38. Does Ulipristal Acetate affect future pregnancies?

No, it does not impact future pregnancies.

39. Can I take Ulipristal Acetate if I have diabetes?

Yes, but discuss with your doctor if you have concerns.

40. Can I take Ulipristal Acetate if I have high blood pressure?

Yes, but consult your doctor if you have severe hypertension.