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Abortion Pill

The abortion pill(RU486) can be confused with the morning-after pill. It is important to realize that these two medications work in different ways and serve different purposes:

The Morning After Pill

The morning after pill is a high-dosed progesterone pill intended to be taken within 72 hours after unprotected sex to prevent pregnancy.   It may or may not prevent pregnancy depending on where you are in your cycle. It can work in three ways:

  • It may prevent ovulation to prevent fertilization
  • It may affect the lining of your fallopian tubes to prevent sperm from reaching the egg preventing fertilization
  • It may irritate the lining of your uterus making it difficult/harder for the fertilized embryo to implant in your uterus [1]

RU486

What it is

  • RU-486 is an artificial steroid that blocks progesterone, a hormone needed to continue a pregnancy.[2]  Mifepristone is the generic name.  The brand names are Mifeprex or Early Option.
  • It is usually used in combination with Misoprostol (brand name Cytotec) a type of prostaglandin.

When it is Used

  • In March 2016, the FDA approved RU486 to be used within 10 weeks (70 days) after the first day of last menstrual period.[3]   

How it works

  • Mifepristone(Mifeprex/Early Option) blocks the hormone, progesterone, causing the lining of the uterus to break down, making it unable to sustain the life of the growing fetus.[4]
  • Misoprostol(Cytotec), given two days after Mifepristone(Mifeprex/Early Option), causes cramping and significant bleeding[5] causing the uterine lining and the fetus to be expelled. Passage of blood clots and tissue is to be expected.

Important things to consider before choosing a medical abortion:

  • Emotional: Be prepared for the emotional trauma of possibly seeing expelled fetus
  • Beware: There is much misinformation about the Abortion Pill on the Internet.  Never order this medication on the internet.  There is no regulation so you don’t know what you are getting.
  • What is called the “Mexican Abortion Pill” may cause severe cramping, but may be ineffective in ending a pregnancy.
  • The FDA has an approved regimen for this medication. The FDA is aware that many medical practitioners use modified regimens, which may include prescribing different doses of mifepristone and misoprostol, dosing misoprostol on a different day, and/or advising patients that the misoprostol tablets be inserted into the vagina.  While some of the modified regimens have been described in the medical literature, the safety and effectiveness of mifepristone and misoprostol dosing regimens other than the one in currently approved labeling have not been evaluated by FDA.[6]

Possible side effects

In U.S. trials of RU-486/misoprostol, at least 99% of patients experienced at least one of the following:

  • abdominal pain (cramping)
  • nausea
  • headache
  • vomiting
  • diarrhea
  • dizziness
  • fatigue
  • back pain
  • uterine hemorrhage
  • fever
  • viral infections
  • vaginitis
  • rigors (chills/shaking) [7]

Do not take RU486/Mifepristone if:

  • It has been more than 70 days (10 weeks) since your last menstrual period began.
  • You have an IUD.  It must be taken out before you take RU 486.
  • Your provider has told you that you have a pregnancy outside the uterus (ectopic pregnancy).
  • You have problems with your adrenal glands (chronic adrenal failure).
  • You take a medicine to thin your blood.
  • You have a bleeding problem.
  • You take certain steroid medicines.
  • You cannot return for the follow-up visits.
  • You cannot easily get emergency medical help in the 2 weeks after you take Mifeprex.
  • You are allergic to mifepristone, misoprostol, or medicines that contain misoprostol, such as Cytotec or Arthrotec.[8]

[1] Dihle, Vicki L., “The morning-after pill” Focus on the Family, 2014.

[2] I. Spitz et al., “Early pregnancy termination with mifepristone and misoprostol in the United States,” New England Journal of Medicine 1998, 338:1241-47.

[3] http://www.fda.gov/downloads/Drugs/DrugSafety/UCM088643.pdf

[4] http://www.fda.gov/downloads/Drugs/DrugSafety/UCM088643.pdf

[5] http://www.fda.gov/downloads/Drugs/DrugSafety/UCM088643.pdf

[6] http;//www.fda.gov/NewsEvents/Testimony/ucm112562.htm   pg 3-4.

[7] http://www.ru486facts.org/index.cfm?page=sideeffects

ttp;//www.fda.gov/NewsEvents/Testimony/ucm112562.htm   pg. 4.

[8] http://www.fda.gov/downloads/Drugs/DrugSafety/UCM088643.pdf

 

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