Yes. Vomiting after taking the morning-after pill can be a side effect of emergency contraception. The most important question is how soon after taking the tablet you vomited, because vomiting too soon may mean the medicine was not fully absorbed.
For South African products, check the patient information leaflet for the exact emergency contraceptive you took. SAHPRA-approved patient leaflets for both levonorgestrel 1.5 mg emergency contraception and ELLA 30 mg (ulipristal acetate) state that if vomiting occurs within three hours of taking the tablet, another tablet is required. Because instructions can depend on the product, contact a pharmacist, doctor or other healthcare professional promptly rather than guessing what to do.
If the vomiting is severe, keeps happening, or is accompanied by severe abdominal pain, difficulty breathing, fainting, swelling of the face or throat, blood in the vomit or signs of dehydration, seek urgent medical attention.
How vomiting after Morning after Pill can be linked to medicines or supplements
The morning-after pill itself can cause nausea or vomiting.
Emergency contraceptive pills used in South Africa may contain different active ingredients. Two examples are levonorgestrel and ulipristal acetate. The SAHPRA-approved leaflet for Levonorgestrel 1.5 Unicorn lists nausea and vomiting among frequently reported side effects. The South African leaflet for ELLA, which contains ulipristal acetate, lists nausea, abdominal discomfort and vomiting as frequent side effects that may affect up to 1 in 10 people.
Other symptoms can occur at around the same time, including headache, dizziness, abdominal or pelvic discomfort, tiredness, breast tenderness and changes in the timing or amount of menstrual bleeding.
However, vomiting after the morning-after pill does not automatically prove that the tablet caused it. Vomiting can have many other causes, including a stomach infection, food-related illness, another medicine or supplement, or pregnancy. The timing of the symptom, other symptoms and any medicines you have taken can help a healthcare professional assess what is happening.
You can also see the broader guide to vomiting after taking medicine and browse the Symptom-Led Side Effects hub for related symptoms.
Timing is especially important
Try to establish:
- what morning-after pill you took and its active ingredient;
- what time you swallowed it;
- what time you vomited;
- whether you vomited once or repeatedly; and
- whether you have been able to keep fluids down since then.
For the SAHPRA-approved levonorgestrel 1.5 mg product cited above, the leaflet instructs users who vomit within three hours to contact a healthcare professional immediately for another tablet. The ELLA leaflet likewise states that another tablet should be taken as soon as possible if vomiting occurs within three hours.
If you are unsure of the product, cannot find the leaflet or do not know exactly when you vomited, speak to a pharmacist or doctor as soon as possible.
Medicines and product categories that may be associated with this symptom
When vomiting happens after emergency contraception, the morning-after pill is one possible cause, but it is worth considering everything else taken around the same time.
Tell your pharmacist or doctor about prescription medicines, over-the-counter medicines, vitamins, herbal products, traditional medicines and supplements. This matters not only because another product might contribute to nausea or vomiting, but also because some medicines can interact with emergency contraception and affect how well it works. SAHPRA patient information for both levonorgestrel and ulipristal emergency contraception advises discussing other medicines with a healthcare professional.
Do not assume that taking an additional medicine for nausea is automatically appropriate. A pharmacist or doctor can check whether it is suitable alongside the emergency contraceptive and any other medicines you use.
If you regularly experience symptoms after medicines, the broader medication side effects guide can help you understand what information to collect before speaking to a healthcare professional.
Red flags: when this symptom may need urgent medical attention
One episode of vomiting may settle without becoming serious, but repeated or severe vomiting can cause dehydration.
Seek urgent medical care if you:
- cannot keep fluids down;
- are passing much less urine than usual or have very dark urine;
- become confused, unusually drowsy or faint;
- have blood or material resembling coffee grounds in your vomit;
- develop severe or worsening abdominal pain; or
- have severe or persistent vomiting. (MedlinePlus)
Call for emergency medical help if you develop difficulty breathing, swelling of the face, lips, mouth or throat, or fainting, particularly if these symptoms occur with a rash or other signs of an allergic reaction. Serious reactions require urgent assessment.
Severe abdominal pain needs particular attention
Severe abdominal pain after emergency contraception should not simply be assumed to be a normal side effect, especially if pregnancy is possible.
South African patient information for levonorgestrel advises medical assessment if pregnancy occurs after emergency contraception and highlights severe abdominal pain because a healthcare professional may need to exclude an ectopic pregnancy, where a pregnancy develops outside the uterus. The ELLA leaflet similarly advises medical review if pregnancy occurs, particularly where there is severe abdominal pain or bleeding.
Seek medical attention promptly for severe pain, faintness or significant bleeding.
What to track before speaking to a doctor or pharmacist
Having a few details ready can make it easier for a healthcare professional to advise you.
Write down the name of the morning-after pill, active ingredient and strength if these appear on the package. Record when you had unprotected sex or contraceptive failure, when you took the emergency contraceptive and exactly how long afterwards you vomited.
Also note whether:
- vomiting has happened more than once;
- you have diarrhoea, abdominal pain, fever, dizziness or bleeding;
- you can keep water or other fluids down;
- you have taken any other medicines, supplements or traditional remedies;
- your next period is late, unusually light or unusually heavy; or
- there has been further unprotected sex since taking emergency contraception.
Emergency contraceptive pills do not provide ongoing protection against pregnancy from unprotected sex that occurs afterwards. Both the South African levonorgestrel and ELLA information warn that pregnancy can still occur following subsequent unprotected sex.
Period changes can also occur after emergency contraception. If your period becomes significantly delayed or unusual, check the instructions supplied with your particular product and speak to a pharmacist or doctor about whether a pregnancy test is appropriate. The exact follow-up advice differs between products.
What not to do without medical advice
Do not assume that vomiting means the morning-after pill definitely failed, but do not ignore vomiting that occurred soon after taking it either.
Avoid taking extra tablets based only on guesswork. Check the leaflet for your exact product and contact a pharmacist, doctor or other healthcare professional promptly if you vomited within the product’s repeat-dose window.
Do not stop regular prescription medication because you suspect it contributed to your symptoms unless a healthcare professional tells you to do so. Instead, provide the pharmacist or doctor with a complete list of everything you take.
You should also not rely on the morning-after pill as your regular method of contraception. Emergency contraception is intended for emergency use, and it does not protect against sexually transmitted infections.
Related side-effect guides and reporting options in South Africa
If you think the vomiting was caused by a medicine, you can discuss it with your doctor or pharmacist even if the reaction was not severe.
Suspected medicine side effects can also be reported in South Africa. SAHPRA-approved patient information for ELLA specifically provides a route for reporting suspected adverse reactions to SAHPRA. Reporting suspected reactions helps medicine-safety authorities gather information about how medicines behave in real-world use.
See the guide on how to report side effects in South Africa for the local reporting process.
Is vomiting after the morning-after pill a common side effect?
Vomiting is a recognised side effect of emergency contraceptive pills, although how frequently it occurs depends on the product.
The South African ELLA patient leaflet classifies vomiting, nausea and abdominal discomfort among frequent side effects that may affect up to 1 in 10 people. A SAHPRA-approved levonorgestrel 1.5 mg leaflet also lists nausea and vomiting among frequently reported effects.
How long can vomiting after the morning-after pill last?
There is no single duration that applies to everyone. A brief episode may settle, but ongoing vomiting should not simply be attributed to the emergency contraceptive.
Seek medical advice if the vomiting persists, becomes severe or you cannot keep fluids down. Vomiting lasting longer than 24 hours, severe abdominal pain, blood in the vomit or signs of dehydration are reasons to obtain medical assessment. (MedlinePlus)
Should I stop the medicine?
The morning-after pill is generally taken as a one-off emergency treatment, so there is usually no ongoing course to stop.
If you take other regular medicines, do not stop or change them on your own because vomiting occurred after emergency contraception. Ask a doctor or pharmacist to review the timing, your medicines and the product you used.
If you vomited within three hours of taking a South African levonorgestrel 1.5 mg emergency contraceptive or ELLA, contact a pharmacist or doctor promptly because the relevant SAHPRA-approved leaflets contain specific instructions about another tablet.
When should I seek help?
Speak to a pharmacist or doctor promptly if you vomited soon after taking the morning-after pill, are unsure whether it was absorbed, have repeated vomiting, develop unusual bleeding, have a significantly delayed period or think you may be pregnant.
Seek urgent medical attention for severe abdominal pain, fainting, difficulty breathing, swelling of the face or throat, blood in the vomit, severe dehydration or persistent vomiting.
This information is for general education and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. The correct action after vomiting can depend on the exact emergency contraceptive product and when the vomiting occurred.