Morning After Pill: Everything You Need To Know

This article covers everything you know about the morning-after pill.

All the information in this article is updated for 2020.

And here is what you’ll learn in this article:

  • What is a morning-after pill
  • When and how to take it.
  • The brands that are currently available on the market in South Africa
  • How and where to buy it.
  • What to expect after taking it.

And more.

So without wasting time, let’s get started.

What is a morning after pill, anyway?

Morning after pill is a name commonly used for a tablet taken after unprotected sex to prevent pregnancy.

It is also known as an emergency contraceptive pill.

The pill is available over-the-counter in South Africa (i.e. accessible without a doctor’s prescription).

It is sold on the market as Norlevo, Plan B or Escapellemore on these later.

Each emergency contraceptive pill contains a key ingredient called Levonogestrel – a synthetic hormone used in some birth control methods.

In his book, Science and Political Controversy, David Newton notes that Levonorgestrel was first manufactured in the 1960s. And it only started being used as a birth control method in the 1980s.

science and political controvesy

Levonorgestrel is also in the list of World Health Organization’s List of Essential Medicines, he essential medicines needed in a primary health system.

Levonorgestrel belongs to a class of drugs known as progestogens, which are a group of hormones.

Hormones are chemical substances that are produced by the body organs to control other organs. 

Image credit: Major Differences

Think of hormones as messengers.

Messengers who are sent around the body to specific organs and cells to exert a particular function. Or pass a message.

By nature, hormones are available in your body.

And as a woman, hormones play a critical role in preparing your body for pregnancy.

On a monthly basis, your body prepares itself for pregnancy. It first builds up the wall of your uterus. Making it thicker for it to be able to carry a fertilised egg.

From there, it releases an egg (a fertilisation process known as ovulation).

The released egg will get in contact with sperm from your sexual partner. If fertilisation happens, a fertilised egg is the result. And that is the start of the prenatal development (development of the baby).

Source: Wikipedia

Progestogens are one of the significant role players in this whole process.

Here’s how the morning after pill works

In all honesty, no one has a clear understanding of how it works.

That’s strange, right?


Mechannism of action for morning-after pill



But it is believed to work:

  • By preventing the release of an egg from the ovary.
  • Or preventing fertilisation of the egg by sperm (male reproductive cells).
  • It may also work by changing the lining of the uterus (womb) to prevent the development of a pregnancy.
  • Prevent the transport of sperm and ova.


Here are other useful resources:

This is the ONLY time you can take a morning-after pill.

But when can you take it?

Great question.

You can take the morning-after pill if:

  • You had unprotected sex, and you are not using any form of contraception.
  • The condom came off or broke while you were having sex.
  • The vaginal diaphragm slipped out of place, or you removed it too early.
  • You were forced to have sex.
  • You missed at least two or three active birth control pills in a row.
  • You forgot to insert your ring or apply your patch.
  • Your partner didn’t pull out in time during sex – a process known as coitus interruptus
  • You have another reason to think your birth control pill might not have worked.

If you use the pill correctly after you have unprotected sex, you’ll be less likely to fall pregnant.

Top 2 morning after pill brands available in South Africa (and prices)

In South Africa, you can buy a morning-after pill over-the-counter, without a doctor’s prescription. As of writing this article, the cost of each morning after pill pack is about R75.

And there are 2 brands currently registered with the MCC and available on the market.

Namely Norlevo and Escapelle.


Norlevo is made by Actor pharma and it comes with 2 tablets in a box.

NorlevoEach tablet has 0.75mg Levonorgestrel as the active ingredient. With Norlevo, you can either take one tablet immediately and then take another one after 12 hours. Or take two pills at once.


Escapelle is manufactured by Gedeon Richter.  And It comes in a box with just one tablet containing 1.5mg of Levonorgestrel.

escapelle tablets

So which one to take between the 2?

It’s your choice.

You can either take the 1.5 mg single levonorgestrel dose (Escapelle). Or two of the 0.75 mg doses of levonorgestrel taken 12 hours apart (Norlevo).

Both are equally effective.


The ONLY correct way to take the emergency contraceptive pill.

The emergency contraceptive pill should be taken as soon as possible. Within 72 hours after unprotected sexual intercourse.

It is most effective if taken within the first 24 hours.

If you vomit less than 2 hours after you take it, take another dose immediately.

You must continue using your regular method of birth control.

Or consult your doctor immediately and get a daily birth control pill.

Does a morning-after pill work?

How effective is the morning-after pill?

The emergency contraceptive pill should be taken within 24 hours after unprotected sex.

According to a study in the American Journal of Obstetrics and Gynecology:

  • If you take it within 72 hours,  the chances of you being pregnant are reduced by 87% – 90%.
  • Whereas the chances drop by 72% -87% should you take the pill between 72 – 120 hours.

Emergency contraceptive pill study

The morning-after pill is not as effective as your regular contraception. It is only for emergencies.

So don’t take it as your primary form of birth control pill. That’s why it’s called a “morning-after pill.”

Morning after pill: 10 of the most common side effects 

The emergency contraceptive pill has its long list of side effects. Like with any other medication.

In this case, I will only be covering the common ones.

And remember, you might or might not experience.

So here are the most common side effects you might experience:

  • Having extreme tiredness
  • Soreness or tenderness of your breasts, often with a feeling of fullness.
  • Delay of your menses for more than seven days.
  • Having a runny stomach (Diarrhoea)
  • Pain in the lower part of your stomach
  • Vomiting
  • A headache
  • Dizziness
  • Having the urge to vomit
  • Irregular bleeding and spotting

If any of these side effects become worse, please inform your doctor immediately.

Warning: 5 Crucial Things You Should Know Before Taking A Morning-After Pill 

As I have noted above, you may have unusual bleeding but it should disappear within no time.

So before you take the emergency pill, there are a few things I would like to share with you.

And I think they are crucial.

So here they are:

#1 Ectopic pregnancy is possible:

Did you know?  You can still fall pregnant, even after taking the emergency contraceptive pill.

Yes, that is possible. And if you become pregnant, there’s a possibility that it might be an ectopic pregnancy.

But what is an ectopic pregnancy?

According to WebMD:

“In a normal pregnancy, your ovary releases an egg into your fallopian tube. If the egg meets with a sperm, the fertilised egg moves into your uterus to attach to its lining and continues to grow for the next 9 months. But in up to 1 of every 50 pregnancies, the fertilised egg stays in your fallopian tube. In that case, it’s called an ectopic pregnancy or a tubal pregnancy.

ectopic pregnancy

Source: WebMD

So how do you know if it’s ectopic pregnancy?

If you have a sharp pain on the lower part of the stomach. 

Or have a pain in your pelvic area, you should consult your doctor or any other healthcare provider immediately.

READ MOREWhat to Know About Ectopic Pregnancy

Getting help fast is paramount. That can reduce the risk of you having severe bleeding and preserve your fertility.

#2 If you have a liver problem, it’s a no-no.

 If you have a severe liver problem, it is not recommended to take the morning-after pill.


Because the liver plays a crucial role in clearing levonorgestrel out of your body.

metabolism of a drug in a liver

Image credit: Medscape

Your body dislikes medicines.

It regards it as a foreign substance.

If you have a dysfunctional liver, the drug will stay in your body longer.

In turn, you can end up with more undesirable side effects.

#3 Lactose intolerant individual or any other malabsorption conditions:

 If you have one of the following malabsorption conditions:

  • Crohn’s diseases
  • Celiac disease
  • Lactose intolerance
  • Intestinal damage or any other malabsorption syndrome

The morning-after pill might not work.


Because in malabsorption conditions, your intestines aren’t able to absorb specific nutrients into the bloodstream.

As such, malabsorption of the morning-after pill will lead to its ineffectiveness.

#4 Your Menstrual Cycle can be unusual: 

After taking the pill, your periods are usually regular and happen at the expected date. But there is a possibility that your next one will be delayed or have it earlier than usual.


When taking a morning-after pill, you are introducing a high dose of levonorgestrel. As a hormone, levonorgestrel plays a control role on your monthly menstrual cycle.

So the moment you take it, it will come in and disturb the natural flow of things.

#5 Emergency contraceptive pill interacts with other drugs: 

If you are taking any other medicines, especially the ones below:

  • Antifungals (e.g., ketoconazole)
  • Barbiturates (e.g., phenobarbital)
  • Epileptic drugs (that contain oxcarbazepine, phenytoin or carbamazepine)
  • Griseofulvin,
  • ARVs ( e.g. indinavir, nevirapine),
  • Antibiotics such as penicillins (e.g., amoxicillin) and tetracyclines (e.g., doxycycline),
  • TB drugs such as rifampin,
  • St. John’s wort,
  • And more.

Most of these drugs interact with the levonorgestrel and may lessen the effectiveness.


Some of the drugs increase or reduce the metabolism of the pill, making it more or less effective.

Please keep in mind that this is not a complete list of drugs that interact with the pill.

If you are taking any chronic medication, I suggest you inform your healthcare professional. He or she will then tell you if the morning-after pill is the best choice.

Now it’s your turn…

It is clear now that a morning-after pill should only be used in emergency cases.

It is also clear that it is not suitable for everyone. And is not as effective as conventional forms of contraception.

Now that you’ve read about the morning-after pill, I would like to hear from you.

Have you ever used a morning-after pill and how was your experience?

Or maybe you have a question about it.

Either way, leave a comment below.


  1. They are effective.just took one escapelle yesterday and im feeling nauseous n tired

  2. Hello,I had unprotected sex with my partner on Friday night. I only bought the escapelle pill Monday afternoon and took it Monday night.Will I still get pregnant or how long will it take before I start bleeding?How long does escapelle stay in my system?

  3. I had sex with boyfriend He finished 3 times on me and we went to pharmacy next mirning around 11 to get plan b in a week my period was due 12 April since than I been spooting when my period is due. Should I be worried?

  4. mine is a question. I had unprotected sex on the 12th of May n tws the last day of my period and l ovulated let’s say 10 days after. and then again l had unprotected sex on e 3rd of June n on the 4th of June l took the morning after pill. My period is due today (8th of June) what are the chances that l could be pregnant or it’s just a delayed period.

  5. I’ve taken Norlevo 32 hours after unprotected sex. i then took anguscaston table about 20 hrs after the Norlevo and it says on the agnuscaston box that it shouldnt be taken with birth control pills.

    Will this effect the effectiveness of the norlevo? Should I worry?

  6. I’ve taken Norlevo 32 hours after unprotected sex. i then took anguscaston table about 20 hrs after the Norlevo and it says on the agnuscaston box that it shouldnt be taken with birth control pills.

    Will this effect the effectiveness of the norlevo? Im so scared

  7. I used Norlevo an hour after my partner and I had unprotected sex. My worry is that I didn’t take both pills at once (as many people are stressing the importance of this method), rather, I took one after another. Either way, it should not be much of an issue; considering that there isn’t much o long gap between the the times which each one was taken. The more pressing matter is; however, that this happened on the 14th of March, then after 9 days (23rd of March) I got my period. This was very unusual because it was my second period in the same month. In the following 2 months, April and May, I got my periods even though they were irregular; but surprisingly enough, I missed my period in June. It’s July now and I’m very stressed because I only spotted for a day and that was it. What could be the reason? This is so terrifying… My partner made a a doctor’s appointment for me but I’m still so uneasy.

  8. Hi, I had unprotected sex with my partner on a Friday and I took the Plan B morning after pill on Saturday. I had sex with him again on Tuesday and I took the morning after pill again on Wednesday, how effective is the second pill going to be? Are the chances of me falling pregnant higher or will it work?

    • Hi, Natasha

      Thank you, for your question.

      What matters is that on both occasions you took the pill within 72 hours from the time you had unprotected sex. Therefore, there is no reason why it would not work. However, I would advise against the frequent use of the morning after pill as it may cause undesirable side effects. Instead, consult your GP or nearest clinic for better alternatives suitable for you.

  9. Hi. My husband and I had unprotected sex on the 23rd and I had taken escapelle the same day. The next day (today 24th) we had unprotected sex again, should I take another tablet or does the 48/72hour WI do period still apply… Please help… Newly weds not ready for kids just yet

    • Hi Lee-Ann,

      The duration of action of Escapelle (i.e. its half-life) is about 26 hours.

      As I am not certain of the period between when you took the Escapelle (on the 23rd) and having unprotected sex on the 24th, I would suggest you take another pill to be on the safe side. Nevertheless, don’t use morning-after pills frequently as they may eventually cause undesirable side effects.

      FYI, I would advise you to visit your nearest clinic or GP and get a daily contraceptive pill or a patch – It’s a safer option.

  10. Hi, can you please help me. Last Thursday 6th September at around 11.00pm my boyfriend and I had sex and unfourtently the condom broke. I am currently on the pill and I take it every day around the same time range. To be safe we decided that I take a morning after pill. I took escapelle the next day at 13.00. I was supposed to expect my period on the 11th of September but it is late. Already 2 days had passed. I feel period cramps and bloating. Is this a side effect of escapelle? Because I never missed a peroiod whilst on birth control and I am worried that I might be pregnant.
    I really appreciate if you reply to my message.

    Thanks and best regards

  11. Hi there. My husband and I are newly weds and prior to marrying were celibate by church requisition. We got married yesterday and needless to say the wedding night was busy. What is the best morning after pill and the cost their of? Needless to say we will unfortunately have to use condoms until my injection contraceptive is effective.

    • Hi Kagiso,

      Thank you for reading the article and commenting.

      In South Africa, there are currently 2 brands widely available from most of the pharmacies. It’s Norlevo and Escapelle.

      Both brands work well if taken appropriately at the right time. And both have an active ingredient known as Levonogestrel.

      Norlevo = has 2 tablets, each containing 0.75mg Levonogestrel. You can take both of the tablets at the same time. Or 1 tablet immediately and then 1 tablet after 12 hours.

      Escapelle = has 1 tablet containing 1.5mg Levonogestrel. You take it once and you’re done.

      Both cost around +/ – R70 a pack from the major retail pharmacies across the country.

      Congrats on your marriage!! Wishing you a lifetime of love, happiness and fulfilment.

  12. Hi my boyfriend and I had unprotected sex on the 24th of May and I took Norlevo morning after pill dosage on Sunday around 13hour is me being a conscious person I bought a pregnancy test just to see if they worked coz it is said they sometimes do not work, now it says positive is it possible that it might be a false positive pregnancy test or what… I’m really scared your response is of great importance to me.

  13. If i used norlevo now and after 10minutes had sex. Should i get another pill

  14. The condom broke and I got Norlevo and took both tablets at the same time straight away. Will I still get pregnant as I’m not on the pill either?

  15. Hi ,my partner and I had unprotected sex ,so she took the morning after pill and now she’s experiencing abdominal pain and she is even thinking of taking some medicine which will help reduce the abdominal pain, the worry is won’t this medicine interfer with all the process of the morning after pill which can make them to be less effective ?

  16. Hi I took Norlevo just 2 days before my period was due and I never my period. It’s now 5days late. Should I worry?

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