Formulary
Ulipristal acetate: Indications, Dosing, Side Effects and Interactions
Ulipristal acetate is a synthetic, selective progesterone receptor modulator with a partial progesterone antagonist effect.
MedNext Academy | 3 min read
Ulipristal acetate: Indications, Dosing, Side Effects and Interactions
Ulipristal acetate is a synthetic, selective progesterone receptor modulator with a partial progesterone antagonist effect.
Drug action
Ulipristal acetate is a synthetic, selective progesterone receptor modulator with a partial progesterone antagonist effect.
Indications and dose
**Uterine fibroids (under expert supervision)**
- **Adult** (By Mouth): 5 mg once daily for up to 3 months, to be started during the first week of menstruation, treatment course may be repeated if necessary; re-treatment should start no sooner than during the first week of the second menstruation following completion of the previous course; maximum 4 courses.
**Emergency contraception for ulipristal acetate**
- **Females of childbearing potential** (By mouth): 30 mg for 1 dose, to be taken as soon as possible after coitus, but no later than after 120 hours.
Contraindications
General contra-indications: Breast cancer; cervical cancer; ovarian cancer; severe asthma controlled by oral glucocorticoids; undiagnosed vaginal bleeding; uterine cancer Specific contra-indications: When used for Uterine fibroids Vaginal bleeding not caused by uterine fibroids
Side effects
Common or very common Asthenia; breast abnormalities; dizziness; endometrial thickening; gastrointestinal discomfort; headaches; hot flush; menstrual cycle irregularities; mood altered; myalgia; nausea; ovarian and fallopian tube disorders; pain; pelvic pain; skin reactions; vertigo; vomiting; weight increased Uncommon Alopecia; anxiety; appetite disorder; chills; concentration impaired; constipation; diarrhoea; drowsiness; dry mouth; fever; flatulence; genital abnormalities; hyperhidrosis; increased risk of infection; insomnia; libido disorder; malaise; oedema; urinary incontinence; vision disorders; vulvovaginal disorders Rare or very rare Abnormal sensation in eye; disorientation; dry throat; epistaxis; eye erythema; painful sexual intercourse; syncope; taste altered; thirst; tremor Frequency not known Angioedema; hepatic disorders
Interactions
**Other interactions (8):**
- Potential for other medicinal products to affect ulipristal acetate: Hormonal contraceptives Ulipristal acetate has a steroid structure and acts as a selective progesterone receptor modulator with...
- Thus hormonal contraceptives and progestagens are likely to reduce ulipristal acetate efficacy by competitive action on the progesterone receptor.
- CYP3A4 inhibitors Following administration of the moderate CYP3A4 inhibitor erythromycin propionate (500 mg twice daily for 9 days) to healthy female volunteers, C max and AUC of ulipristal acetate...
- Following administration of the potent CYP3A4 inhibitor ketoconazole (400 mg once daily for 7 days) to healthy female volunteers, C max and AUC of ulipristal acetate increased 2 and 5.9 fold,...
- CYP3A4 inducers Administration of the potent CYP3A4 inducer rifampicin (300 mg twice daily for 9 days) to healthy female volunteers markedly decreased C max and AUC of ulipristal acetate and its...
- Concomitant use of ulipristal acetate and potent CYP3A4 inducers (e.g.
Pregnancy
When used for Emergency contraception: Limited information available-if pregnancy occurs, report to the ellaOne pregnancy registry. M When used for Uterine fibroids: Avoid-limited information available. M
Breast feeding
When used for Emergency contraception: Specialist sources indicate use with caution (very limited information available). Negligible levels present in milk. No interruption to breast-feeding is considered necessary after taking a single dose. Although adverse effects are unlikely, monitor infant for drowsiness, irritability, vomiting, diarrhoea, and poor feeding. When used for Uterine fibroids: Avoid-present in milk but no further information available. M
Hepatic impairment
When used for Emergency contraception: Avoid in severe impairment-no information available. M When used for Uterine fibroids: Avoid-risk of increased exposure. M
Renal impairment
When used for Uterine fibroids: Avoid in severe impairment unless patient is closely monitored-no information available. M
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Ulipristal acetate in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

