Noodanticonceptie Ulipristal Etos (Ulipristal Acetate)

• Ulipristal acetate is a selective progesterone receptor modulator used in the emergency contraception pathway.
• Emergency contraception (up to 5 days after unprotected intercourse): provides a non‑surgical option to prevent pregnancy by delaying or inhibiting ovulation.
• Contraceptive failure management: used when regular hormonal contraception fails, offering rapid pregnancy prevention.
• Missed oral contraceptive dose rescue: effective after a missed scheduled pill, reducing the risk of unintended conception.

• Ulipristal acetate binds competitively to progesterone receptors in the hypothalamus, ovary and endometrium, blocking progesterone‑mediated signaling. This antagonism prevents the luteinizing hormone surge, thereby inhibiting or delaying ovulation, and also alters endometrial receptivity, reducing the likelihood of implantation if fertilization has occurred.

Ulipristal acetate is generally well tolerated, but several adverse reactions have been reported.

Common Side Effects

• Nausea
• Headache
• Abdominal or pelvic pain
• Fatigue or dizziness
• Menstrual irregularities (early, delayed or heavier bleeding)
• Mild allergic skin reactions (rash, itching)

Serious or Rare Side Effects

• Anaphylactic or severe allergic reaction
• Severe abdominal pain suggesting ectopic pregnancy
• Liver enzyme elevation or hepatic injury
• Persistent or worsening menstrual bleeding
• Thromboembolic events (very rare)
• Vision changes or severe headache indicating possible intracranial pressure changes

• When prescribing or dispensing Ulipristal acetate, consider the following safety measures.
• Timing of administration: take as soon as possible, preferably within 120 hours after unprotected intercourse.
• Pregnancy status: avoid use if a confirmed pregnancy is present.
• Breastfeeding: consult a healthcare professional before use.
• Drug interactions: be aware of enzyme‑inducing agents that may lower effectiveness.
• Medical conditions: use with caution in patients with hepatic impairment.
• Store at ambient temperature: keep in the original packaging, protect from moisture and heat.

Ulipristal acetate may interact with several concomitant medications.

Major Interactions (Avoid)

• Rifampicin: strong enzyme inducer that markedly reduces efficacy.
• St. John's wort: herbal inducer decreasing plasma levels.
• Anticonvulsants (e.g., carbamazepine, phenytoin): lower drug exposure.

Moderate Interactions (Monitor Closely)

• Hormonal contraceptives: may experience reduced effectiveness when taken together.
• Antifungal azoles (e.g., ketoconazole): can increase ulipristal levels.
• Certain antibiotics (e.g., tetracycline): minimal effect but monitoring is advised.