Emergency Contraception Is a Category, Not a Product
In Canada, three distinct emergency contraception (EC) options are available: Plan B (levonorgestrel), ella (ulipristal acetate), and the copper IUD. They work through different mechanisms, have different effectiveness profiles, different ideal use-case windows, and different access pathways. They are not interchangeable — understanding the distinctions helps you choose the right option for your situation.
At a Glance: All Three Options
Plan B
ella
Copper IUD
Plan B (Levonorgestrel): The Over-the-Counter Option
Plan B is a single 1.5 mg levonorgestrel tablet available over the counter at Acme Drug Mart without a prescription. It is the most accessible EC option in Canada.
Plan B works primarily by delaying or preventing ovulation. It does not disrupt an established pregnancy. If ovulation has already occurred before the pill is taken, it is unlikely to be effective — which is why timing matters significantly.
- Within 24 hours: approximately 95% effective at preventing pregnancy
- 24–48 hours: approximately 85% effective
- 48–72 hours: approximately 58% effective
- 72–120 hours: can be used, but effectiveness drops substantially
Plan B is less effective for individuals whose body weight exceeds approximately 70 kg (154 lbs). Research consistently shows reduced serum levonorgestrel levels at higher body weights, which correlates with reduced ovulation suppression.
Ella (Ulipristal Acetate): The Prescription Option
Ella requires a prescription, which can be issued during a walk-in consultation with Acme Drug Mart’s prescribing pharmacist. The consultation takes about 10 minutes.
Ella works by binding to progesterone receptors, which delays or inhibits ovulation with greater effectiveness closer to the LH surge (the hormonal event that triggers ovulation) than Plan B. This pharmacological difference translates to measurably better real-world effectiveness, particularly in the 3–5 day window after unprotected sex.
Key advantages over Plan B:
- Maintains consistent effectiveness throughout the full 120-hour window — Plan B effectiveness falls steeply after 72 hours
- Significantly better for individuals with higher BMI — studies show ella retains superior effectiveness at higher body weights where Plan B performance is markedly reduced
- More effective when taken closer to the timing of ovulation in the cycle
Important note: Ella interacts with hormonal contraception. Progestin-based methods (pill, patch, ring, implant) may reduce ella’s effectiveness if taken concurrently. Your pharmacist will advise on how to manage regular contraception around ella use.
Copper IUD: The Most Effective Option
The copper IUD is the most effective form of emergency contraception available, with a failure rate of less than 1% when inserted within 5 days of unprotected sex. Crucially, its effectiveness does not vary with timing within the cycle, or with body weight — unlike either oral option.
The copper IUD works by releasing copper ions that are toxic to sperm and also create a hostile environment for fertilization and implantation. It does not disrupt an established pregnancy.
The copper IUD is the only emergency contraception option that simultaneously provides ongoing long-term contraception — up to 10 years depending on the model. For individuals who need EC and are also considering long-term contraception, it is the most resource-efficient choice.
Insertion is a brief procedure coordinated through Meadowlark Place Professional Centre clinics. Acme Drug Mart can write the prescription and initiate the referral — same-week insertion is typically achievable.
How to Choose
- First 24 hours, convenience is the priority: Plan B is available immediately over the counter.
- Days 1–5, particularly if it is day 3 or later: ella is the superior oral option. Walk in to Acme Drug Mart for the prescription.
- Higher body weight (>70 kg): ella is preferred over Plan B at any point in the window.
- Ongoing long-term contraception needed: Copper IUD provides both emergency and long-term protection. Requires same-week clinic insertion.
- Maximum effectiveness, no weight or timing caveats: Copper IUD.
Cost and Insurance
Plan B: approximately $40, purchased over the counter. No prescription required, covered by many private drug plans as an OTC product under pharmacy benefits.
ella: approximately $50 with a pharmacist prescription. Alberta Blue Cross and most private employer benefit plans cover prescription EC. Direct billing is available at Acme Drug Mart.
Copper IUD: device cost $60–$150 depending on the brand, plus insertion fees through the clinic. Alberta Blue Cross covers copper IUDs under most plans. Direct billing for the device is available at Acme Drug Mart.
Common Questions
Get Emergency Contraception Now
Plan B is available over the counter at Acme Drug Mart. For ella, walk in for a pharmacist prescription — no appointment needed. Call (780) 443-0202 or come in to Unit 103, 15508 87 Ave NW.
Find UsThis article provides general health information and is not a substitute for an individual clinical consultation. Emergency contraception effectiveness data is based on published clinical trial results; real-world outcomes may vary. All costs noted are approximate and subject to change. Always inform your pharmacist of current medications, particularly hormonal contraceptives, before taking ella. If you have questions about which option is right for your situation, our pharmacists are available for confidential walk-in consultations.