Ulipristal Tablets - Uses, Contraindications, and Side Effects

Introduction

Emergency contraception (EC) refers to the methods used to avoid pregnancy after sexual intercourse. Emergency contraceptive pills are tablets that must be used within five days or earlier as they are more effective when taken as soon as possible after the sexual act. There is no age for using these pills, as any girl or woman of reproductive age may require emergency contraception to avoid unwanted pregnancy. However, there are some eligibility criteria. Therefore, a gynecologist or a healthcare professional must be consulted before using any method of contraception.

What Are Ulipristal Tablets?

Ulipristal acetate tablets are emergency contraception pills indicated to prevent pregnancy after an unprotected sexual act. It belongs to the class of medications called progesterone receptor modulators or progestins. It can be used up to five days after unprotected intercourse. These are available as 30 mg tablets and can also be used when regular birth control pills are missed, other birth control methods have failed (birth control pills, patches, or rings), or have not been properly used (slipped or broken condom), or after a sexual assault. However, it must not be used regularly.

How Effective Are Ulipristal Tablets?

Ulipristal acetate tablets were approved by the United States Food and Drug Administration (USFDA) in August 2010 and by the European Medicines Agency (EMA) in May 2009. The efficacy of Ulipristal acetate was assessed in 941 women in comparison to 958 women who were given Levonorgestrel. The trials demonstrated that Ulipristal was not inferior to Levonorgestrel. However, the efficacy can also depend on the menstrual cycle, as the drug may be less effective if ovulation has already occurred. After the treatment with Ulipristal, females are recommended to use the barrier method of contraception, such as condoms, until their next menstrual period or resume other hormonal contraceptives only after five days of taking Ulipristal as it can reduce the effectiveness of both medications.

How Do Ulipristal Tablets Work?

When taken before ovulation, Ulipristal acetate acts by binding to the progesterone receptor and stops the sudden increase in luteinizing hormone (LH) thereby postponing follicular rupture and inhibiting or causing a delay in the ovulation process. Any alterations in the endometrium (lining of the uterus) that affect implantation can also contribute to the efficacy of the drug. The body rapidly absorbs Ulipristal, and the terminal half-life is approximately 32 hours.

How Should Ulipristal Tablets Be Taken?

Ulipristal tablets must be taken orally with or without food immediately or as soon as possible after unprotected sex or a failure of other contraceptives is suspected (within 120 hours or five days). It must be taken exactly by following the instructions on the prescription label or as directed by the doctor. The doctor must be contacted immediately if vomiting occurs in less than three hours after taking the tablet, and another dose may be required in case of an overdose. These tablets can be stored at room temperature, away from direct light and moisture, and out of reach of children. Unused or unneeded medicines must be carefully disposed of to ensure that pets and children do not consume them.

What Are the Contraindications of Ulipristal Tablets?

• Ulipristal tablets are contraindicated in the known case of pregnancy or if pregnancy is suspected.

• Animal studies have demonstrated the presence of Ulipristal acetate in breast milk, but it is not known if Ulipristal is excreted in human milk. However, as many drugs are excreted in human milk, Ulipristal tablets must not be consumed by breastfeeding mothers.

• Girls must not use Ulipristal tablets before menarche, and it is not recommended for postmenopausal women.

• These tablets may not be recommended in people with liver or kidney impairment as adequate studies have not been conducted in such patients.

What Are the Side Effects of Ulipristal Tablets?

Side effects of Ulipristal tablets include:

• Itching and rashes.

• Swelling of the eyes, tongue, throat, or face.

• Severe abdominal pain.

• Spotting or bleeding between the menstrual periods.

• Pain during menstruation.

• Headache.

• Tiredness.

• Dizziness.

• Nausea.

What Are the Precautions Required While Taking Ulipristal Tablets?

• Ulipristal tablets are not intended to terminate an existing pregnancy. Therefore, the doctor recommends a pregnancy test before starting the treatment and also a follow-up physical or pelvic examination if there is any doubt or suspected pregnancy.

• The doctor must be informed if the patient is pregnant or suspects pregnancy or lactating before taking Ulipristal tablets. If used in such cases, it may be a potential hazard to the fetus.

• This medication is only for occasional use and must not be taken regularly as a contraceptive; it must not be taken within the same menstrual period.

• Ulipristal tablets do not provide protection against human immunodeficiency virus (HIV) infection, acquired immunodeficiency syndrome (AIDS), or any other sexually transmitted diseases (STDs).

• Patients must inform the doctor if they have had a history of ectopic pregnancy (pregnancy occurs outside the uterus).

• Ulipristal can cause variations in the next menstrual cycle; it may begin earlier or can get delayed. However, the doctor must be consulted if it gets delayed for more than one week after the expected date. The menstrual cycle usually returns to the regular pattern in the subsequent cycles.

• The patients must inform the doctor if they are allergic to Ulipristal or its components or any other medications before starting the treatment.

• The doctor must be informed if the patient is under medications such as Itraconazole, Rifampin, Phenytoin, Carbamazepine, or Topiramate or taking any other medicines, over-the-counter drugs, nutritional or herbal supplements (especially St.John’s wort) before initiating treatment; as certain drugs may interact with Ulipristal and reduce its efficiency or cause side effects.

Conclusion

Ulipristal tablet is a prescription medicine recommended for preventing pregnancy after unprotected sexual intercourse. It is known to be 60 to 85 percent effective and is available across various countries. It works by preventing or delaying ovulation. Ulipristal is a well-tolerated drug and a reasonable alternative to Levonorgestrel. However, it must not be used regularly, and it is always better to consult a doctor before taking any contraceptive pills.