From review of current available evidence, the guideline development group (GDG) concluded that levonorgestrel could be less effective in women weighing >70 kg or with a BMI >26 kg/m2.
In these patients, if a copper intrauterine device is not indicated or not acceptable, the GDG recommends that such women can be offered uliprisatal. If uliprisatal is not suitable, a double dose (3 mg) of levonorgestrel can be used.
The GDG also concluded that ulipristal could potentially be less effective for women >85 kg or with a BMI >30 kg/m2. For women weighing >85 kg or with a BMI >30 kg/m2, it is not known whether ulipristal or double dose levonorgestrel is more effective. Double dosing of ulipristal is not currently recommended.