Emergency contraception is a category, not a single product. Canada has three options. They work through different mechanisms, have different effectiveness profiles, different time windows, and different access pathways. They are not interchangeable. Here's how to pick.
At a glance
Plan B
- Levonorgestrel · over-the-counter, no prescription
- Window: up to 72 hours, best within 24 hours, usable up to 120 hours with declining efficacy
- Effectiveness reduced above ~70 kg
- ~$40 without insurance
- Best for: first 24 hours, convenience, lower body weight
Ella
- Ulipristal acetate · prescription (pharmacist can prescribe)
- Window: up to 120 hours (5 days), particularly effective on days 3 to 5
- Better effectiveness at higher BMI than Plan B
- ~$50 with prescription
- Best for: days 1 to 5, higher BMI, closer to ovulation
Copper IUD
- Non-hormonal · prescription plus clinic insertion
- Window: within 5 days of unprotected sex
- Over 99% effective regardless of cycle timing or body weight
- Ongoing protection up to 10 years
- Best for: maximum effectiveness plus long-term contraception
Plan B (levonorgestrel): the OTC option
Plan B is a single 1.5 mg levonorgestrel tablet, available over the counter. It primarily works by delaying or preventing ovulation. It does not disrupt an established pregnancy.
Effectiveness by timing
- Within 24 hours: ~95%
- 24 to 48 hours: ~85%
- 48 to 72 hours: ~58%
- 72 to 120 hours: usable but substantially reduced
Plan B shows reduced effectiveness for individuals over ~70 kg. Lower serum levonorgestrel levels at higher weights correlate with reduced ovulation suppression. If you're above this threshold, ella is generally a better choice.
Ella (ulipristal acetate): the prescription option
Ella requires a prescription, which our pharmacist can write after a 10-minute walk-in consultation. It binds to progesterone receptors, delaying or inhibiting ovulation, and works closer to the LH surge than levonorgestrel.
Advantages over Plan B
- Maintains consistent effectiveness across the full 120-hour window
- Significantly more effective for higher BMI
- More effective when taken closer to ovulation
Important: ella interacts with hormonal contraception. If you use a progestin-based method, the two can reduce each other's effectiveness. Ask your pharmacist about timing.
Copper IUD: the most effective option
The copper IUD is the most effective EC available, with a failure rate under 1% when inserted within 5 days. Effectiveness is consistent regardless of cycle timing or body weight, unlike either oral option.
It releases copper ions that are toxic to sperm and creates an environment hostile to fertilisation. As a bonus, it provides ongoing contraception for up to 10 years, which makes it the most resource-efficient choice if you also want a long-term method.
How to choose
- First 24 hours, convenience matters: Plan B (over-the-counter)
- Days 1 to 5, especially day 3 onward: ella has the better oral effectiveness
- Body weight over 70 kg: ella over Plan B
- Long-term contraception also wanted: copper IUD covers both bases
- Maximum effectiveness without weight or timing limits: copper IUD
How much do Plan B and ella cost in Edmonton?
- Plan B: ~$40 OTC. Many private drug plans cover it.
- ella: ~$50 with prescription. Alberta Blue Cross and most employer plans cover it. Direct billing available.
- Copper IUD: $60 to $150 device cost plus insertion fees. Alberta Blue Cross covers under most plans.
Common questions
Does EC cause an abortion?
No. All three options prevent fertilisation or ovulation. They do not disrupt an established pregnancy.
Will EC affect long-term fertility?
No. Fertility returns to baseline immediately after the oral options, and immediately after IUD removal.
Will EC affect my regular birth control?
Plan B and copper IUD don't. Ella may interact with progestin-containing methods.
Can I use EC repeatedly?
EC is for occasional emergencies, not a primary contraceptive method. Frequent use is a signal to talk through ongoing options with your pharmacist.
Walk in
Plan B is on our shelves at Acme Drug Mart, no prescription needed. Ella needs a 10 minute pharmacist consultation, with no appointment and no doctor referral. (780) 443-0202.