For now, the FDA still will require girls 17 and younger to get a prescription to buy the pills, called Plan B. Beginning later this year, women - and men buying for their partners - who are 18 and older may buy the pill without a prescription.
Advocates say easier access could halve the nation's 3 million annual unplanned pregnancies, reducing in turn the number of abortions. The compromise decision will hinder that goal, they said.
"While we are glad to know the FDA finally ended its foot-dragging on this issue, Planned Parenthood is troubled by the scientifically baseless restriction imposed on teenagers," Planned Parenthood President Cecile Richards said. "The U.S. has one of the highest rates of teen pregnancy in the Western world. Anything that makes it harder for teenagers to avoid unintended pregnancy is bad medicine and bad public policy."
An estimated 41 countries allow emergency contraceptives to be sold without a prescription, Planned Parenthood said. It wasn't immediately clear how many, if any, have age restrictions.
U.S. opponents worry that greater availability of the pills will increase promiscuity and promote use of the pills by sexual predators.
"If the FDA thinks that enacting an age restriction will work, or that the drug company will enforce it ... then they are living in a dream world," said Wendy Wright, president of Concerned Women for America, which led the opposition.
As a condition of approval, the drug's manufacturer, Barr Pharmaceuticals Inc., agreed to use anonymous shoppers and other methods to check whether pharmacists are enforcing the age restriction.
"I'm sure the FDA will follow through on that and make sure these important conditions are established and enforced," said White House spokeswoman Dana Perino.
Barr hasn't said what the non-prescription pills will cost when they go on sale, perhaps as early as November. They now cost $25 to $40 in prescription form.
The pills will be sold only from behind the counter at pharmacies, not at convenience stores or gas stations. Pharmacists will check photo identification.
Plan B contains a concentrated dose of the same drug found in many regular birth control pills.
If a woman takes Plan B within 72 hours of unprotected sex, she can lower the risk of pregnancy by up to 89 percent. Plan B is different from the abortion pill: If a woman already is pregnant, Plan B has no effect.
The FDA's long delay in deciding on Barr's application ensnared President Bush's nominee to head the regulatory agency, Dr. Andrew von Eschenbach. Following the FDA's announcement Thursday, Sens. Hillary Rodham Clinton, D-N.Y., and Patty Murray, D-Wash., said they would lift their block on the nomination, making it likely von Eschenbach will win confirmation as FDA chief, perhaps next month.
That won't settle the drawn-out Plan B controversy. The Center for Reproductive Rights said a lawsuit filed last year to do away with all age restrictions would continue.
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