Mifepristone

**Mifepristone** is a synthetic steroid that is used as a drug. It can be used to cause a medical abortion in the first two months of pregnancy. It can also be used as an emergency contraceptive.  It is often known as **RU-486**, the name it had in early tests. It was discovered by Roussel Uclaf in France in 1980.

When it is used for an abortion, it is usually combined with another drug. It is delivered as a pill that is taken by mouth. When it is used as a form of emergency contaception, the dose is usually lower.

Where it is legal, it is usually sold as a prescription drug. Before taking it, people often need to see a doctor, who can check that the drug is safe to take. In some cases, the drug also needs to be taken while under the supervision of a pharmacist or a doctor.

Other than to end a pregnancy, the drug is also used for people with Cushing's syndrome. These people produce too much Cortisol, and the drug can act against that.

## Side effects

Common side effects include abdominal pain, feeling tired, and vaginal bleeding. Serious side effects may include heavy vaginal bleeding, bacterial infection, and birth defects if the pregnancy does not end. If used, appropriate follow-up care needs to be available. Mifepristone is an antiprogestogen. It works by blocking the effects of progesterone, making both the cervix and uterine vessels dilate and causing the uterus to contract.

## History

Mifepristone was developed in 1980 and came into use in France in 1987. It became available in the United States in 2000. It is on the World Health Organization's List of Essential Medicines. Mifepristone was approved by Health Canada in 2015 and became available in Canada in January 2017. Cost and availability limits access in many parts of the developing world.

## Situation in the U.S.

Especially in the United States, there's a debate whether abortion should be legal, and available to women.

In April 2023, during the _Alliance for Hippocratic Medicine v. US Food and Drug Administration_ lawsuit, federal district judge Matthew J. Kacsmaryk issued a preliminary injunction suspending the approval of mifepristone. This ruling would come into effect a week later.  Also in April 2023, in a lawsuit brought by 17 U.S. states and the District of Columbia, federal district judge Thomas O. Rice issued a temporary injunction that the FDA should not reduce access to mifepristone in these states and the district. Because there are two different laws in two different parts of the United States, it is likely that the U.S. Supreme Court will have to decide on the matter

## Abortion debate

Many anti-abortion groups in the United States actively campaigned against the approval of mifepristone  They also say that the drug should be withdrawn.

They cite the following issues they see:

- Abortion is against their ethical values, therefore a drug that causes aborion should not be taken
- The drug is not safe to take, and there may be unwanted side effects.

In March 2022, during a debate in the Kentucky House of Representatives about anti-abortion legislation, Republican representative Danny Bentley made several false claims, including the assertion that mifepristone had originally been called Zyklon B and had been developed by the Nazis during World War Two. After several Jewish advocacy groups including the American Jewish Committee complained about Bentley's comments, he later apologized for any harm he had caused, stating that he "clearly should have been more sensitive with (his) comments", but failed to correct the false statement regarding the development of the drug.

Religious and anti-abortion groups outside the United States have also protested mifepristone, especially in Germany and Australia.

## Related pages

- Ulipristal acetate
- Levonorgestrel
- Copper coil IUD