Mifepristone, sold under the brand name Mifeprex and also known as the abortion pill, RU-486, blocks progesterone, a hormone essential to the development of a pregnancy, and thereby prevents an existing pregnancy from progressing.6 Apr 2022
Misoprostol timing: 24-48 hours after mifeprist…
Mifepristone administration: Can be dispensed …
Mifepristone dosage: 200mg (one pill), taken o…
Follow-up visit: 7-14 days after mifepristone, no …
Accurate Information about Abortion Pill, Mifepristone. Mifepristone and Misoprostol are two medications used in the abortion process. Mifepristone works to block the hormone progesterone, which stops a pregnancy from developing. Misoprostol induces cramps in the uterus, causing bleeding and softening of the cervix in order for it to be dilated for evacuation.
Mifeprex is a prescription medication used to terminate a pregnancy. It works by blocking progesterone, a hormone essential for sustaining pregnancy. It induces an abortion by causing the death of an embryo.
The abortion pill is a safe medical procedure that can be used to end a pregnancy. One pill, mifepristone, blocks the hormone progesterone and stops the fertilized egg from attaching itself to the uterus. Another pill, misoprostol, is taken 24-48 hours later and causes uterine contractions that expel the pregnancy along with blood, tissue and other products of conception from your body.
Abortion Pills Name And Image
Medication abortion, also known as medical abortion or abortion with pills, is a pregnancy termination protocol that involves taking two different drugs, Mifepristone and Misoprostol, that can be safely used up to the first 70 days (10 weeks) of pregnancy. Since the U.S. Food and Drug Administration (FDA) first approved the drug in 2000, its use in the United States has quickly grown, with half of abortions at 8 weeks gestation or less being medication abortions. While this protocol involves taking two medications and does not involve a medical procedure, it is subject to many of the same restrictions as other abortion methods, at both the state and federal levels. This factsheet provides an overview of medication abortion, with a focus on federal and state regulations pertaining to its provision and coverage, and the role of the drug in self-managed abortions.
What is a Medication Abortion?
The most common medication abortion regimen in the United States involves the use of two different medications: mifepristone and misoprostol. Mifepristone, sold under the brand name Mifeprex and also known as the abortion pill, RU-486, blocks progesterone, a hormone essential to the development of a pregnancy, and thereby prevents an existing pregnancy from progressing. Misoprostol, taken 24-48 hours after mifepristone, works to empty the uterus by causing cramping and bleeding, similar to an early miscarriage. A follow-up visit is typically scheduled a week or two later, to confirm that the pregnancy was terminated via ultrasound or blood test. Medication abortion is a safe and highly effective method of pregnancy termination if the pills are administered at 9 weeks’ gestation or less, the pregnancy is terminated successfully 99.6% of the time, with a 0.4% risk of major complications, and an associated mortality rate of less than 0.001 percent (0.00064%).
The FDA first approved Mifeprex in 2000, and in 2016, the FDA approved a new evidence-based regimen and drug label, which guides current clinical practice. This regimen approves use of medical abortions for up to 70 days (10 weeks) of pregnancy (Table 1). Until 2019, mifepristone was only sold under the brand name Mifeprex, manufactured by Danco Laboratories. In 2019, the FDA approved GenBioPro, Inc.’s application for generic mifepristone.
|Table 1: FDA Mifepristone and Misoprostol Regimen
|Max. gestational age
|Up to 70 days LMP* (10 weeks)
|200mg (one pill), taken orally
|Can be dispensed via mail or by pharmacy; Dispensed in office in states that ban telehealth for medication abortion.
|800µg (4 pills), taken buccally (placed in cheek) or vaginally
|24-48 hours after mifepristone buccally, or 6-72 hours after mifepristone vaginally
|Taken at home
|7-14 days after mifepristone, no location specified
|By or under the supervision of a prescriber that has been certified by the manufacturer
|Note: *LMP – Last Menstrual Period
|Source: FDA, Mifeprex (mifepristone) Information, February 2018.
Risk Evaluation and Mitigation Strategies (REMS)
In 2011, the FDA added a Risk Evaluation and Mitigation Strategy (REMS) to the dispensing requirements for mifepristone permitting only medical providers who had obtained certification from the manufacturer to prescribe and directly dispense the drug. This requirement not only limited the number of clinicians able to prescribe medication abortions, but also necessitated an in-person visit to a health care setting and meant patients could not obtain the medication from a retail pharmacy or by mail.
In October 2017, the American Civil Liberties Union (ACLU) filed a lawsuit, on behalf of a group of providers, against the FDA challenging the REMS requirements for mifepristone. These plaintiffs cite the low rate of complications associated with medical abortions and assert that other drugs with similar or more serious risks do not have REMS restrictions, and are unduly burdensome on patients trying to access the drug, particularly patients in rural or medically underserves areas. The case is still pending in front of the District Court of Hawaii. During the pandemic, ACOG and other provider groups filed a lawsuit challenging the REMS requirement that mifepristone be dispensed in person in response to the importance of having an alternative to the in-person requirement because of the public health emergency.
On May 7th, 2021, in response to the ACLU lawsuit, the FDA announced in a court filing that a review of the REMS was underway. On December 16, 2021, the FDA removed the in-person dispensing requirement for mifepristone and expanded the distribution to certified pharmacies in addition to certified clinicians. This change allows for distribution of medication abortion by mail in states that do not restrict telehealth for medication abortion. This change to the dispensing requirement came after an extensive scientific review of the safety of medication abortion as prompted by the ACLU and ACOG lawsuits. Despite the change to the in-person requirement, prescribers are still required to be certified by the manufacturers. In April of 2022, Danco Laboratories and GenBioPro (the two manufacturers of mifepristone) are expected to submit proposed protocols to the FDA to describe how they certify pharmacies, after which the FDA has 180 days to review or modify the submissions. Pharmacies may be able to dispense mifepristone by late 2022. Box 2 shows the change in REMS from 2011 to 2021.
Misoprostol at 2 Weeks Pregnancy
Medication abortion — also called the abortion pill — is a safe and effective way to end an early pregnancy.
How does the abortion pill work?
“Abortion pill” is the common name for using two different medicines to end a pregnancy: mifepristone and misoprostol.
First, you take a pill called mifepristone. Pregnancy needs a hormone called progesterone to grow normally. Mifepristone blocks your body’s own progesterone, stopping the pregnancy from growing.
Then you take the second medicine, misoprostol, either right away or up to 48 hours later. This medicine causes cramping and bleeding to empty your uterus. It’s kind of like having a really heavy, crampy period, and the process is very similar to an early miscarriage. If you don’t have any bleeding within 24 hours after taking the second medicine, call your nurse or doctor.
Your doctor or nurse will give you both medicines at the health center. When and where you’ll take them depends on state laws and your health center’s policies. Your doctor or nurse will give you detailed directions about where, when, and how to take the medicines. You may also get some antibiotics to prevent infection.
How effective is the abortion pill?
The abortion pill is very effective. The effectiveness depends on how far along you are in your pregnancy when you take the medicine.
- For people who are 8 weeks pregnant or less, it works about 94-98 out of 100 times.
- For people who are 8-9 weeks pregnant, it works about 94-96 out of 100 times.
- For people who are 9-10 weeks pregnant, it works about 91-93 out of 100 times. If you’re given an extra dose of medicine, it works about 99 out of 100 times.
- For people who are 10-11 weeks pregnant, it works about 87 out of 100 times. If you’re given an extra dose of medicine, it works about 98 out of 100 times.
The abortion pill usually works, but if it doesn’t, you can take more medicine or have an in-clinic abortion to complete the abortion.
When can I take the abortion pill?
Depending on where you live, you may be able to get a medication abortion up to 77 days (11 weeks) after the first day of your last period. If it has been 78 days or more since the first day of your last period, you can have an in-clinic abortion to end your pregnancy.
Why do people choose the abortion pill?
Which kind of abortion you choose all depends on your personal preference and situation. With medication abortion, some people like that you don’t need to have a procedure in a doctor’s office. You can have your medication abortion at home or in another comfortable place that you choose. You get to decide who you want to be with during your abortion, or you can go it alone. Because medication abortion is similar to a miscarriage, many people feel like it’s more “natural” and less invasive.