A young woman walks into a chemist shop, asks quietly for “that emergency tablet”, pays around eighty rupees, takes the pill in the car, and then spends the next three weeks worrying. Did it work? Why is her period late by four days? Was the spotting last week her period? Did she throw it up too soon? Should she take another one?
This is one of the most common medical conversations in India that almost never happens with a doctor. The pill is sold across the counter at every chemist shop in the country. Mankind Pharma’s Unwanted-72 and Piramal’s i-Pill together account for the bulk of emergency contraceptive use, and most women take them without ever speaking to a gynaecologist about what to expect.
That is the gap this post is here to close. Not to talk you into or out of taking the pill, but to give you a clear, evidence-based explanation of what these tablets actually do, what counts as a normal reaction, and when something needs medical attention.
This post covers:
- What i-Pill and Unwanted-72 actually contain and how they work
- The 72-hour window, and why earlier is always better
- Side effects you can reasonably expect, and which ones matter
- What to expect from your next period, and when to test
For more on this, read our guide on Copper IUD & Mirena in India.
For more on this, read our guide on Birth Control Pill Side Effects.
- The honest answer on repeat use
- Whether emergency contraception is the same as abortion (it is not)
- When to switch to a regular contraceptive method, and what your options are
What Is Actually in the Pill
Both i-Pill (Piramal Pharma) and Unwanted-72 (Mankind Pharma) contain the same single ingredient: levonorgestrel 1.5 mg, taken as one tablet. Generic equivalents under names like Norlevo, Postinor, and Truston exist as well, with identical composition.
Levonorgestrel is a synthetic progestin, the same family of hormones used in regular oral contraceptive pills, just at a much higher single dose. It has been studied as an emergency contraceptive since the 1990s and is on the World Health Organization’s Model List of Essential Medicines.
As of May 2026, the retail price across major Indian online pharmacies (verified directly on PharmEasy, 1mg, Truemeds, and MediBuddy) ranges from approximately Rs. 60 to Rs. 110 per tablet, depending on brand and discount. It is sold across the counter without a prescription throughout India.
How It Actually Works (And What It Does Not Do)
This is the single most misunderstood part of emergency contraception, so it is worth being precise.
Levonorgestrel works primarily by delaying or inhibiting ovulation. If you have not yet released an egg for that cycle, a high dose of progestin disrupts the normal hormonal surge that triggers ovulation, pushing it back by several days. If the egg is not released, the sperm already inside the reproductive tract eventually die off (sperm typically survive three to five days inside the body), and no fertilisation can occur.
This mechanism is documented in detail by the International Federation of Gynecology and Obstetrics (FIGO position statement on the mechanism of emergency contraception) and in a joint analysis by Trussell and colleagues published in Fertility and Sterility (2006). Multiple subsequent studies have confirmed the same finding.
What the pill does not do:
- It does not prevent implantation of an already-fertilised egg. Studies have not been able to demonstrate any effect on the uterine lining at the doses used.
- It does not terminate an established pregnancy. If you are already pregnant when you take it, it does not cause a miscarriage and does not harm the developing pregnancy.
- It does not affect long-term fertility. There is no evidence that one or several doses of levonorgestrel reduce your chance of conceiving later, when you want to.
This distinction matters because emergency contraception is often confused with the abortion pill (mifepristone plus misoprostol). They are completely different medications, with different mechanisms, different uses, and different prescriptions. The abortion pill terminates an established pregnancy. The emergency pill prevents a pregnancy from starting in the first place.
The 72-Hour Window, and Why Sooner Is Better
The label says “within 72 hours”. This is technically correct but slightly misleading, because effectiveness drops sharply with each passing hour.
A combined analysis of four WHO trials by Piaggio and colleagues (Contraception, 2011, PMID 21664508) showed that the pregnancy rate after levonorgestrel emergency contraception was:
- Approximately 1.5 percent if taken within 24 hours of unprotected sex
- Approximately 2.5 percent if taken between 24 and 48 hours
- Approximately 3.5 percent if taken between 48 and 72 hours
Some efficacy is retained up to 96 to 120 hours after intercourse, but the failure rate climbs noticeably. The practical rule is straightforward: take it as soon as possible after the event. The longer you wait, the more likely it is that ovulation has already happened, and once the egg is released, the pill can no longer prevent fertilisation.
If you have access to it, the copper intrauterine device (Cu-T) inserted within five days of unprotected intercourse is the most effective emergency contraceptive available, with a failure rate below 0.1 percent. This is recommended by the World Health Organization and the American College of Obstetricians and Gynecologists for women who can access a clinic quickly and may also want long-term contraception afterward. Ulipristal acetate is another oral emergency contraceptive used in some countries (more effective than levonorgestrel in the 72 to 120 hour window), but it is not commonly stocked in Indian retail pharmacies as of this writing.
Side Effects: What to Expect, and What Is Normal
The good news first: levonorgestrel at this single dose is one of the most studied medications in reproductive health, and serious side effects are uncommon. A 2014 Cochrane review by Halpern, Raymond and Lopez (Cochrane Database of Systematic Reviews, CD007595) and a 2014 clinical review by Cleland and colleagues (PMID 25254919) both confirm a strong safety profile.
The most common short-term effects, usually settling within 48 hours:
| Effect | Frequency | What it means |
|---|---|---|
| Nausea | About 20 percent | A high progestin dose irritates the gut briefly. Settles in a day. |
| Headache | About 15 percent | Hormonal shift. Paracetamol is safe to take. |
| Breast tenderness | About 10 percent | Same hormonal effect that causes premenstrual breast tenderness. |
| Dizziness | About 10 percent | Avoid driving for a few hours if you feel lightheaded. |
| Fatigue | About 15 percent | Common; rest if you can. |
| Lower abdominal cramping | About 15 percent | Mild, settles in a day. Stronger cramps are unusual. |
| Vomiting | About 1 percent | If you vomit within 2 hours of taking the pill, take another dose. |
| Spotting in the days that follow | Very common | Breakthrough bleeding from the progestin dose. Not your period. |
The “vomit within 2 hours” rule is the single practical instruction most women miss. The pill needs that time to be absorbed from the stomach. If you vomit before then, the dose is unreliable and you should take another tablet.
What is not normal: severe abdominal pain (especially one-sided), heavy bleeding that soaks more than one pad an hour, fainting, severe chest pain, or a swollen tender calf. These are rare with levonorgestrel and almost never occur, but if they do, see a doctor the same day.
Worried about a side effect after taking i-Pill or Unwanted-72? If something does not feel right, WhatsApp Dr. Suganya for a plain-language opinion before assuming the worst. Most reactions are mild and settle on their own, but you do not have to guess.
What to Expect From Your Next Period
This is the question that causes the most anxiety in the weeks after taking the pill, and the answer is: your next period may be earlier or later than usual by up to seven days, and the flow may be different. Both of these are documented and expected.
The progestin dose temporarily shifts your hormonal cycle. Depending on where you were in your cycle when you took the pill, three patterns are common:
- Your period comes a few days early, sometimes with lighter or heavier flow than usual. This is the most common pattern when the pill was taken in the second half of the cycle.
- Your period comes on time or within a day or two of expected, often slightly different in flow or duration.
- Your period is delayed by up to seven days, which is the pattern most likely to cause panic but is also a known effect of the pill and not necessarily a sign that you are pregnant.
The practical rule: if your period is more than seven days late after taking emergency contraception, take a home pregnancy test. Our home pregnancy test guide covers when and how to test for the most reliable result.
Spotting in the days after taking the pill is also common and is not your period. It is breakthrough bleeding caused by the high progestin dose. Do not count it as a period for the purpose of calculating cycle length.
For a deeper look at the many reasons a period might be late beyond pregnancy (stress, illness, weight change, thyroid, PCOS), see our period delay guide.
The Honest Answer on Repeat Use
There is a lot of conflicting information online about whether you can take emergency contraception “again and again”. Here is what the evidence actually says.
Levonorgestrel emergency contraception is safe to take more than once in the same cycle if needed. There is no documented harm from repeat dosing, and the WHO Selected Practice Recommendations for Contraceptive Use (2016) confirm this position. A pill cannot cause infertility, organ damage, or cancer with repeat use, and this concern is one of the most persistent myths around it.
However, “safe” and “ideal” are not the same thing. There are three real problems with using emergency contraception as a regular method:
- It is less effective than every other modern contraceptive. Regular birth control pills, the copper IUD, the hormonal IUD, the contraceptive injection, and condoms used correctly all have lower failure rates per year than relying on repeat emergency contraception.
- Repeated high progestin doses cause repeated cycle disruption. Women using emergency contraception multiple times per cycle often report ongoing irregular bleeding, longer or shorter cycles, and confusion about when their actual period is. This can make it harder to recognise an early pregnancy if one occurs.
- It is more expensive over a year than most regular methods. At Rs. 60 to Rs. 110 per pill used several times a month, the annual cost adds up quickly.
The honest take: if you find yourself reaching for emergency contraception more than once or twice a year, that is a signal to have a conversation with a gynaecologist about a regular method. It does not mean you have done something wrong. It means there is a simpler, more reliable, less stressful option available, and finding the right one is a conversation worth having.
Is Emergency Contraception the Same as Abortion?
No. They are entirely different medications with different purposes.
| Emergency contraception (i-Pill, Unwanted-72) | Medical abortion (mifepristone + misoprostol) | |
|---|---|---|
| Active ingredient | Levonorgestrel 1.5 mg | Mifepristone + misoprostol |
| Purpose | Prevent pregnancy before it starts | Terminate an established pregnancy |
| When it works | Before ovulation, up to 72 to 120 hours after intercourse | After confirmed pregnancy, typically up to 9 weeks |
| Mechanism | Delays or stops ovulation | Ends a pregnancy that has implanted |
| Availability | Over the counter in India | Prescription only, requires medical supervision |
| Side effects | Nausea, spotting, cycle shift | Heavy bleeding, cramping, can be severe |
If you are already pregnant and take an emergency contraceptive pill by mistake, the developing pregnancy is not affected. This has been studied repeatedly and confirmed by the WHO, FIGO, and multiple national gynaecology societies.
Who Should Not Take It, and Who Should Speak to a Doctor First
Levonorgestrel emergency contraception has very few absolute contraindications. The pill can be safely taken by almost any woman of reproductive age, including teenagers, women with diabetes, women with high blood pressure, women who smoke, and women who are breastfeeding.
There are a few situations where a brief medical conversation is sensible before taking it:
- You are on certain epilepsy medications (carbamazepine, phenytoin, oxcarbazepine), the tuberculosis medication rifampicin, or the herbal supplement St John’s Wort. These can speed up the breakdown of levonorgestrel in the liver, reducing its effectiveness. A copper IUD is a better choice in this situation if available.
- You have severe liver disease or active hepatitis. Speak to a doctor before taking it.
- You may already be pregnant. The pill will not work and will not harm the pregnancy, but a pregnancy test is the right next step instead.
- Your last period was more than five weeks ago and you have had unprotected intercourse. A pregnancy test before the emergency pill is the right sequence.
Levonorgestrel does not cause complications with breastfeeding. Small amounts pass into breast milk, but no harmful effects have been observed in nursing infants. Some guidelines suggest expressing and discarding milk for eight hours after the dose as a precaution; this is optional, not mandatory.
When to Switch to a Regular Method
If you and your partner are sexually active and not actively trying to conceive, a regular contraceptive method gives you much better protection, much less cycle disruption, and much less repeated anxiety than rolling the dice on emergency contraception each time.
The main options available in India:
- Combined oral contraceptive pills (the “regular” pill): low daily dose, very effective when taken correctly, requires a brief medical consultation to make sure it is appropriate for you (smokers over 35, women with migraine with aura, or those with high blood pressure typically need a different option).
- Progestin-only pill (the “mini-pill”): a daily option suitable for women who cannot take oestrogen, including breastfeeding mothers.
- Copper IUD (Cu-T): a small T-shaped device placed inside the uterus by a gynaecologist; effective for up to ten years; available free at most government hospitals.
- Hormonal IUD (Mirena, Kyleena): similar device that releases a small dose of progestin locally; very effective; lighter or absent periods; available in private settings at higher cost.
- Contraceptive injection (DMPA, given every three months): a good option for women who want a “set and forget” method but is not ideal long-term as it can affect bone density and delay return of fertility for several months.
- Barrier methods (condoms): the only method that also protects against sexually transmitted infections; essential as part of any sexual health plan and a useful complement to other methods.
There is no single “best” method. The best method is the one you can use consistently, comfortably, and confidently. A conversation with a gynaecologist takes about fifteen minutes and can save years of monthly anxiety.
If you are considering planning a pregnancy in the future, our guide on how to track ovulation explains the body signs that help you understand your fertile window when you stop contraception and start trying.
Where i-Pill and Unwanted-72 Fit in a Healthy Relationship With Your Body
Emergency contraception is a useful, evidence-based, and safe tool when used appropriately. It is not a moral failing, a sign of poor planning, or a reason to feel ashamed. Millions of women across India use it each year, and the global gynaecology community considers it an essential part of women’s reproductive autonomy.
What it is also not is a substitute for ongoing medical care. Whether you are using it occasionally as a backup, considering a regular contraceptive method, or worried about a delayed period after a dose, having a gynaecologist you can speak to honestly, without judgement, makes the entire experience less stressful.
Indian families often treat contraception as a private subject, which can leave women navigating it alone. You do not have to.
Frequently Asked Questions
Is i-Pill or Unwanted-72 the same medicine?
Yes, in terms of active ingredient and dose. Both contain levonorgestrel 1.5 mg as a single tablet. The brands are made by different companies (i-Pill by Piramal Pharma, Unwanted-72 by Mankind Pharma), but the medication inside is clinically equivalent. Generic versions like Norlevo and Postinor are also the same. Price differences reflect branding and pharmacy markup, not effectiveness.
Will the emergency pill affect my future fertility?
No. Multiple long-term studies have shown that one or even repeated doses of levonorgestrel emergency contraception have no impact on your ability to conceive later. Your fertility returns within the same cycle or the next, and your ovaries continue functioning normally. This is one of the most well-established findings in reproductive medicine.
My period is six days late after taking Unwanted-72. Am I pregnant?
Six days late is within the documented range of cycle disruption caused by the pill itself, so it does not necessarily mean you are pregnant. The standard guidance is to wait until day seven and then take a home pregnancy test using your first morning urine for the most reliable result. If the test is negative and your period still has not arrived by day ten, repeat the test or see a doctor for a serum beta hCG blood test, which is more sensitive than a urine test.
Is it safe to take more than one emergency pill in the same month?
Yes, it is safe to take it more than once if needed. The active ingredient has no cumulative harmful effect, and there is no medical maximum. However, repeated doses cause repeated cycle disruption, which makes it harder to track your periods and recognise an early pregnancy. If you have taken emergency contraception more than once or twice in a few months, a conversation with a gynaecologist about a regular method is worthwhile.
I threw up an hour after taking the pill. Do I need to take another one?
Yes. The standard guidance is that if you vomit within two hours of taking levonorgestrel, the dose is not reliably absorbed and you should take a second tablet as soon as possible. If you vomit again, an anti-nausea tablet taken thirty minutes before the next dose can help. If vomiting continues, see a doctor or pharmacist for an alternative.
Can I take the morning-after pill while I am breastfeeding?
Yes. Levonorgestrel is considered compatible with breastfeeding. Small amounts pass into breast milk, but no harmful effects on nursing infants have been observed in studies. Some guidelines suggest expressing and discarding milk for eight hours after the dose as a precaution; most current evidence does not consider this necessary. Continue breastfeeding as usual unless your gynaecologist advises otherwise for an unrelated reason.
Does the emergency pill cause weight gain or affect my mood long-term?
No, not from a single dose. Some women report short-term breast tenderness, bloating, or mood changes in the days after taking it, all of which settle within one cycle. There is no evidence that one or several doses of levonorgestrel cause long-term weight gain or mood disorders. If you are taking it frequently and experiencing ongoing mood changes, a regular contraceptive method that suits your body is usually the better solution.
Emergency contraception is one of those subjects where having a doctor you can ask, without judgement and without panic, makes the entire experience much easier. If you have taken i-Pill or Unwanted-72 and are unsure what is happening with your body, or if you want to talk through a regular contraceptive option that suits you, WhatsApp Dr. Suganya here. You can also download our free period health guide to understand your cycle and what is normal across different life stages.
