Table of ContentsView AllTable of ContentsUseMechanismTimingSide EffectsEfficacyAdvantagesDisadvantagesOther ConsiderationsCostFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Use
Mechanism
Timing
Side Effects
Efficacy
Advantages
Disadvantages
Other Considerations
Cost
Frequently Asked Questions
Update
The availability of mifepristone in the United States has been the subject of recent legal challenges. In April 2023, a federal judge in Texas issued a ruling to suspend mifepristone’s FDA approval. The case went to an appeals court and the Supreme Court, which returned the case to the appeals court.
RU486 is a medication used to induce a miscarriage in a pregnancy less than 10 weeks along. Better known as the abortion pill or Mifeprex (mifepristone), RU486 is only available with a prescription.
An FDA-approved method of medical abortion, Mifeprex is used in combination with Cytotec (misoprostol).First approved in 2000, Mifeprex blocks the hormone progesterone, which is needed for the pregnancy to progress. Cytotec, taken 24 to 48 hours later, is a synthetic prostaglandin that causes uterine contractions (cramps).
Taken properly, the abortion pill is safe and 96.7% effective in terminating a pregnancy.This article discusses how to use Mifeprex (RU486). It also details the side effects, precautions, drug interactions, and cost of the abortion pill.
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How Do You Use RU486?
Using the abortion pill involves a three-step process that involves taking two different medicines that work to end a pregnancy. It is important to note that the abortion pill isnot the same thingas the morning-after pill.
If you choose to use the abortion pill, there arethree steps in the process:
If the abortion pill didn’t work, your healthcare provider will discuss your options with you. You may need an additional dose of medication or a procedure to complete the abortion.
How to Use the Abortion Pill
How It Works
RU486 blocks the progesterone receptors in your body. Progesterone is the hormone responsible for causing the uterine lining to build up and prepare for pregnancy. The mifepristone causes the lining of your uterus to shed—so your pregnancy can no longer continue because the egg will have nothing to stay attached to.
Then, the misoprostol will cause uterine contractions. This allows your uterus to be emptied.
Who Can Use It?
The FDA has approved RU486 for women up to 10 weeks pregnant or up to 70 days after the first day of their last menstrual period. It can be used safely in women of any age, including those under 17 years old.
RU486 Side Effects
You should expect to feel some side effects after using the abortion pill.
These can include:
If you have severe pain or feel faint, get medical attention. And if you have a fever after the day you take the misoprostol, call your healthcare provider.
Contraindications
Mifeprex and its generic mifepristone should not be taken if it has been more than 70 days since the first day of your last menstrual period. The medication is also contraindicated for people with:
Interactions
Mifeprex can negatively interact with certain medications. Before taking RU486, tell your healthcare provider if you are taking any of the following medications:
Length of Time and Efficacy
Within four or five hours after taking the mifepristone, more than half of women’s pregnancies will beterminated. For others, it may take a little longer, but the abortion should take place within a few days. You can expect to see clots of blood when this happens, and the cramping may continue intermittently for a few days.
RU486 helps to terminate a pregnancy without surgery and is 92% to 98% effective when used in combination with misoprostol.When mifepristone is used alone, it is about 64% to 85% effective.
You can become pregnant again right after using the abortion pill, so make sure that you are using backup contraception. Also, know that RU486 does not offer protection against sexually transmitted diseases.
It is normal to have some bleeding or spotting for up to four weeks after using the abortion pill.It is recommended that you do not insert anything into your vagina or have sex for at least seven days after using the abortion pill.
The bleeding after your abortion marks the start of a new menstrual cycle. This means that your normal period should return in four to eight weeks.
Keep in mind that you may have all types of feelings after a medical abortion. Because of the sudden change in your hormone levels, you may become more emotional. It may help to know that most women report that the main emotion they feel afterward is relief, and just about all women who have used the abortion pill would recommend it to a friend.
How Much Does RU486 Cost?
You can check with your private insurance to see if they cover medical abortion. That being said, the abortion pill may cost up to $800, but it usually costs less. The final cost depends on whether or not you need additional tests, healthcare provider visits, and/or exams.
The cost of RU486 can also vary depending on your state. RU486 is available at many Planned Parenthood clinics. Contact a clinic in your area to find out about its availability, pricing, and if you qualify for any discounts.
A Word From Verywell
RU486 has been used for terminating unplanned pregnancies for years and has been an effective medical abortion option for many. Understanding how RU486 works and when it can be used, in addition to having thorough conversations with your healthcare provider about it, can help you know if it is the right choice for you.
Bleeding typically begins two to four hours after Cytotec (misoprostol), the second medication in the series. If bleeding has not started 24 hours after taking it or if bleeding is very light, call your healthcare provider for guidance. In some cases, a second dose of Cytotec may be needed.
Yes, it is safe to drive after taking Mifeprex (mifepristone/RU486), the first medication in the abortion pill series. This means you can drive yourself to your appointment and home again.It is also safe to drive after taking Cytotec (misoprostol). However, the second medication commonly causes cramping and heavy bleeding. Many women prefer to stay home and rest.
Yes, it is safe to drive after taking Mifeprex (mifepristone/RU486), the first medication in the abortion pill series. This means you can drive yourself to your appointment and home again.
It is also safe to drive after taking Cytotec (misoprostol). However, the second medication commonly causes cramping and heavy bleeding. Many women prefer to stay home and rest.
Currently, the FDA has approved mifepristone/RU486, used together with misoprostol, for abortions for up to 10 weeks into a pregnancy (70 days or less since the first day of the last menstrual period).
No, Mifeprex (mifepristone/RU486) is not approved to treat an ectopic pregnancy. Studies show it is not effective in expelling an ectopic pregnancy.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chen MJ, Creinin MD.Mifepristone with buccal misoprostol for medical abortion: a systematic review.Obstetrics & Gynecology. 2015;126.1:12-21. doi:10.1097/AOG.0000000000000897Chen MJ, Creinin MD.Mifepristone With buccal misoprostol for medical abortion: a systematic review.Obstet Gynecol. 2015;126(1):12-21. doi:10.1097/AOG.0000000000000897Food and Drug Administration.Mifeprex (mifepristone) information.Dunn S, Brooks M.Mifepristone.CMAJ. 2018;190(22):E688. doi:10.1503/cmaj.180047Food and Drug Administration.Mifeprex (mifepristone) label.Food and Drug Administration.Questions and answers on Mifeprex.Food and Drug Administration.Questions and answers on mifepristone for medical termination of pregnancy through ten weeks gestation.Planned Parenthood.The Abortion Pill.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chen MJ, Creinin MD.Mifepristone with buccal misoprostol for medical abortion: a systematic review.Obstetrics & Gynecology. 2015;126.1:12-21. doi:10.1097/AOG.0000000000000897Chen MJ, Creinin MD.Mifepristone With buccal misoprostol for medical abortion: a systematic review.Obstet Gynecol. 2015;126(1):12-21. doi:10.1097/AOG.0000000000000897Food and Drug Administration.Mifeprex (mifepristone) information.Dunn S, Brooks M.Mifepristone.CMAJ. 2018;190(22):E688. doi:10.1503/cmaj.180047Food and Drug Administration.Mifeprex (mifepristone) label.Food and Drug Administration.Questions and answers on Mifeprex.Food and Drug Administration.Questions and answers on mifepristone for medical termination of pregnancy through ten weeks gestation.Planned Parenthood.The Abortion Pill.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Chen MJ, Creinin MD.Mifepristone with buccal misoprostol for medical abortion: a systematic review.Obstetrics & Gynecology. 2015;126.1:12-21. doi:10.1097/AOG.0000000000000897Chen MJ, Creinin MD.Mifepristone With buccal misoprostol for medical abortion: a systematic review.Obstet Gynecol. 2015;126(1):12-21. doi:10.1097/AOG.0000000000000897Food and Drug Administration.Mifeprex (mifepristone) information.Dunn S, Brooks M.Mifepristone.CMAJ. 2018;190(22):E688. doi:10.1503/cmaj.180047Food and Drug Administration.Mifeprex (mifepristone) label.Food and Drug Administration.Questions and answers on Mifeprex.Food and Drug Administration.Questions and answers on mifepristone for medical termination of pregnancy through ten weeks gestation.Planned Parenthood.The Abortion Pill.
Chen MJ, Creinin MD.Mifepristone with buccal misoprostol for medical abortion: a systematic review.Obstetrics & Gynecology. 2015;126.1:12-21. doi:10.1097/AOG.0000000000000897
Chen MJ, Creinin MD.Mifepristone With buccal misoprostol for medical abortion: a systematic review.Obstet Gynecol. 2015;126(1):12-21. doi:10.1097/AOG.0000000000000897
Food and Drug Administration.Mifeprex (mifepristone) information.
Dunn S, Brooks M.Mifepristone.CMAJ. 2018;190(22):E688. doi:10.1503/cmaj.180047
Food and Drug Administration.Mifeprex (mifepristone) label.
Food and Drug Administration.Questions and answers on Mifeprex.
Food and Drug Administration.Questions and answers on mifepristone for medical termination of pregnancy through ten weeks gestation.
Planned Parenthood.The Abortion Pill.
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