Plan B EC - "The Morning After Pill"

• In July 2009, the FDA approved Plan B One-Step to replace Plan B. Plan B One-Step is available at pharmacies without a prescription for men and women age 17 or older. The original Plan B is no longer being sold.

History:

Plan B EC was originally manufactured by Barr Pharmaceuticals. On December 23, 2008, Teva Pharmaceuticals announced it acquisition of Barr. Plan B is now being marketed as Plan B One-Step by Teva Women’s Health, a subsidiary of Duramed Pharmaceuticals.

• The FDA approved Plan B (also called the morning after pill) as the first progestin-only emergency contraceptive available in the US on July 28, 1999.

• August 24, 2006: The FDA approved the sale of Plan B OTC to those age 18 and older.
  
  
• November 2006: Barr began shipping nonprescription packages of Plan B to pharmacies across the US.
  
  
• March 23, 2009: the US District Court for the Eastern District of NY ordered the FDA to allow 17-year-olds to buy Plan B OTC under the same conditions that the EC was already available to women 18 and up.
  
  
• April 22, 2009: the FDA announces that 17-year-olds can buy Plan B OTC.
  
  
• On July 13, 2009, the FDA approved the new Plan B One-Step, the first one pill dose EC that is now available OTC to those age 17 and up.
  
  
• For: A Detailed History of Plan B

Plan B actually consists of two EC pills; each pill contains the progestin hormone levonorgestrel. The EC pills can be taken 12 hours apart or at the same time.

Morning After Pill Confusion:

Many people call emergency contraception or Plan B, the morning after pill. The name "morning after pill" can often lead to some confusion since Plan B EC pills do not necessarily have to be taken the morning after unprotected sex occurs. In fact, you can use emergency contraception any time (usually up to 3-5 days) after unprotected sex -- not just the "morning after."

Also, you take at least two EC pills when you use Plan B, so there is not just one pill (as the name morning after pill implies). But, many people refer to EC as the morning after pill, so in this article, emergency contraception, EC, and the morning after pill will all refer to Plan B – the two EC pills that can be taken after unprotected sex to prevent pregnancy.

As of August 2009, Plan B will no longer be available. Plan B One-Step can be obtained OTC at local pharmacies for those 17 or older. Females under the age of 17 will need a prescription for Plan B One-Step from their doctor. The new morning after pill is sold behind the counter in retail pharmacies, so that age can be verified.

As a precaution, those girls under 17 can ask their doctor about getting a prescription for Plan B One-Step ahead of time -- just in case an emergency occurs. This way, these girls will already have the EC prescription to be filled immediately and won't need to wait for a medical appointment.

According to the manufacturer, in order to reduce the risk of an unplanned pregnancy, Plan B EC should be started up to 3 days (72 hours) after unprotected sex or contraception failure -- with the first pill being taken as soon as possible and the second pill taken 12 hours later. The sooner Plan B is used, the better the chances of preventing pregnancy.

Note: In general, though, emergency contraception could be initiated up to 5 days (120 hours) after unprotected sex, so the morning after pill may still be useful to take (hopefully to decrease your chances of pregnancy) for up to 5 days after unprotected sex.

There have been no reports of serious complications among the millions of women who have used the morning after pill. Side effects caused by progestin-only emergency contraception will usually decrease within one – two days. These side effects include:

• Nausea and vomiting – although the risk for this is much lower with progestin-only EC (versus combination EC). Nausea occurs approximately 23% of the time while vomiting happens in approximately 6% of progestin-only EC users. You can use anti-nausea medicine, such as Dramamine or Bonine, one hour before taking EC if you are concerned about being nauseous (though these medications may make you feel drowsy). Many women also find it helpful to take the morning after pill with a full stomach.
  
  
• A woman may experience breast tenderness due to EC
  
  
• Dizziness and/or headaches are also common

• Plan B may change the amount, duration, and/or timing of a female’s next period about 10-15% of the time. This side effect is typically minor, and menstruation will usually occur a few days earlier or later than anticipated.
  
  
• Frequent use of EC may cause periods to become irregular and unpredictable.
  
  
• A woman should inform her healthcare provider that she had taken emergency contraception should she become pregnant following its use, so her doctor can test for the existence of an ectopic pregnancy.

Plan B is most effective the sooner it is started. Studies have shown that a single administration of two full doses of Plan B EC is just as effective as taking 2 doses, 12 hours apart.

If started within 72 hours of unprotected sex, Plan B reduces the risk of pregnancy by at least 89%. According to the manufacturer, “About 7 out of every 8 women who would have gotten pregnant will not become pregnant. Plan B works even better if taken within the first 24 hours after unprotected sex.” Put another way, only 1 out of 100 women will become pregnant after taking the morning after pill if started within three days.

Plan B EC will not continue to prevent pregnancy during the rest of a woman’s cycle, so additional contraceptive methods should be used.

Plan B Cost:

There is a wide variation in cost for emergency contraception.

• One pack of of Plan B One-Step can range from $35-$45

There are also costs associated with doctor’s visits should a female require a prescription form of the morning after pill.

STD Protection:

Plan B EC offers no protection against sexually transmitted infections.

Read A Quick Recap of EC. Then, test your knowledge by taking our Emergency Contraception Quiz!

_{Source:
Duramed Pharmaceuticals. (2006). Plan B(Levonorgestrel) Tablets, 0.75 mg.}