What is Mifepristone?
Mifepristone is an oral medication—known by names such as Mifeprex or RU-486—prescribed to end early pregnancies when taken in combination with misoprostol. It is FDA-approved and widely used in medication abortion up to around 10–11 weeks gestation.
How Does Mifepristone Work?
- Progesterone Blocker: It prevents progesterone from supporting the uterine lining, stopping pregnancy progression.
- Follow-Up with Misoprostol: Taken 1–2 days later, misoprostol induces uterine contractions and bleeding to expel pregnancy tissue.
When to Administer Mifepristone
- Approved Window: Typically used up to 10 weeks (some guidelines allow up to 11 weeks) .
- Additional Use: Also useful for managing missed or incomplete miscarriages by helping to expel retained tissue.
Effectiveness of Mifepristone
- Alone: Mifepristone alone has a 54–92% success rate within 1–2 weeks.
- Combined Regimen: When paired with misoprostol, effectiveness exceeds 95% (often 95–98%) for early pregnancy termination.
Eligibility & Contraindications
- Not Suitable If: You have ectopic pregnancy, adrenal insufficiency, bleeding issues, long-term corticosteroid needs, severe anemia, an IUD in place, or allergies to medications.
- Precautions: Those with heart, liver, or immune conditions should consult closely with a provider .
Side Effects of Mifepristone Pill
- Very Rare Serious Complications: Hospitalization is needed in just 0.04–0.09% of cases; blood transfusions around 0.05%.
- Common Reactions: Cramping, bleeding (lasting ~9–16 days), nausea, vomiting, diarrhea, fatigue, dizziness, and fever/chills.
- Extended Bleeding: About 8% of individuals may bleed for 30+ days.
- Warning Signs: Seek help for heavy bleeding (soaking >2 pads/hr for 2+ hours), fever over 100.4°F, or severe pain/discharge.
Step-by-Step Process
- Initial Assessment: Gestational dating by LMP or ultrasound; screening for contraindications.
- Take Mifepristone: One pill with water. After this, most people feel well and carry on routinely.
- Administer Misoprostol (after 24–48 hours): Usually four 200 µg tablets buccally, sublingually, or vaginally. Ibuprofen and anti-nausea meds may be used beforehand.
- Experience & Recovery: Expect cramping and bleeding within hours; resembles a heavy period or miscarriage. Use pain relief, rest, heat, and hydration.
- Follow-Up: Confirm completion via telehealth or an in-person visit in 1–2 weeks to rule out complications or need for further intervention .
Why is Mifepristone a Safe Choice?
- Backed by Experts: WHO, ACOG, RCOG, and similar organizations recommend this two-pill regimen for early abortion .
- Private & Accessible: Can be taken at home without anesthesia in many cases—offered via telemedicine services, reducing costs and logistical barriers.
Final Thoughts
Mifepristone, when used as directed alongside misoprostol, offers a highly effective, medically endorsed, non‑surgical way to end an early pregnancy. It’s crucial to ensure proper eligibility screening, access to misoprostol, and follow-up support. If you consider this path, partner with a trusted healthcare provider and ensure help is available if needed.
