RU486 – The ABORTION PILL (within 10 weeks after LMP)
The most common regime for a medical abortion is a two-step process involving a combination of mifepristone (RU486)
Generic Name: mifepristone (RU486)
Brand Name: Mifprex
Commonly Called: The Abortion Pill (2 & 3) and misoprostol. The FDA has approved the use of mifepristone for use up to 70 days (10 weeks) from your last menstrual period (LMP). Please note: The Abortion Pill is NOT the same thing as the Morning-After Pill.
How Does The Abortion Pill Work?
Day 2 or 3
24-48 hours after taking mifepristone, misoprostol is taken. Misoprostol causes the uterus to contract, expelling the pregnancy. This usually occurs within 2-24 hours of taking it. (4)
What To Expect
After taking misoprostol, the most common side effects include cramps, nausea, weakness, headache, dizziness, diarrhea, vomiting, stomach pain, heavy bleeding (may include large clots in the blood and/or a discernable fetus), and mild fever or chills. These usually occur within 2-24 hours of taking it. Bleeding, spotting, and the passing of blood clots and tissue usually continues for 9-16 days but can continue for 30 days or more. Very rarely, serious and life-threatening bleeding, infections, and other complications can occur following a medical abortion. If you are worried about any side effects and symptoms, you should call your healthcare provider immediately or go to the Emergency Room. (2, 3, 4, 5)
Between 7-14 days after taking the Abortion Pill, you will need to have a follow-up with the provider to ensure that the abortion was complete and that there are no immediate complications. Your provider may choose to do this over the phone by going over your medical history with you, or with a visit to their office. The office visit may include a physical exam, blood test, or an ultrasound. (2, 6)
According to some studies, < 5% of medical abortions done within the first 9 weeks (by LMP) of pregnancy do not completely expel and may require surgical evacuation to empty the uterus. In less than 1% of the time, the pregnancy is not terminated and continues to grow. These ongoing pregnancies may be terminated with another surgical abortion or medication. (5)
Please Note: Medical abortions are not effective for terminating ectopic pregnancies Ectopic Pregnancies: When a fertilized egg implants and grows outside of the uterus. This can cause life-threatening bleeding if left untreated. (7). .
Symptoms of a ruptured ectopic pregnancy (which can be life-threatening if not treated) may be confused with some of the common side effects of a medical abortion, such as abdominal pain and bleeding. (2, 7) Therefore, it is important to have an ultrasound to make sure you have an intrauterine pregnancy before having a medical abortion. While Focus Women’s Center does not provide abortions, we do offer free ultrasounds to some of our patients as part of our Pregnancy Verification and Consultation appointment.
If you are pregnant and considering abortion, find out why Focus Women’s Center should be your first step.
(1) U.S. National Library of Medicine. (2020). Miscarriage. Retrieved from https://medlineplus.gov/ency/article/001488.htm
(2) RxList Inc. (2020). Mifeprex RU486. Retrieved from https://www.rxlist.com/mifeprex-ru486-drug.htm#description
(3) Stacey, D. (2019). The abortion pill- RU486. Retrieved from https://www.verywellhealth.com/ru486-the-abortion-pill-906956
(4) U.S. Food and Drug Administration (FDA). (2016).Medication guide Mifeprex. Retrieved from https://www.fda.gov/media/72923/download
(5) Gynecology and Society of Family Planning Committee on Practice Bulletins, Creinin, M, & Grossman, D. (2014). Medical management of first trimester abortion. The American College of Obstetricians and Gynecologists, 2014(143), 1-18. Retrieved from https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2014/03/medical-management-of-first-trimester-abortion
(6) Guttmacher Institute. (2020). Medication abortion. Retrieved from https://www.guttmacher.org/evidence-you-can-use/medication-abortion
(7) Mayo Foundation for Medical Education and Research. (2020). Ectopic pregnancy. Retrieved https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088
(8) Gotter, A. (2016). Surgical abortion. Retrieved from https://www.healthline.com/health/surgical-abortion
(9) American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice, Pettker, C., Goldberg, J., El-Sayed, Y., Copel, J., & Society for Maternal Fetal Medicine. (2017). Committee opinion: Methods for estimating due date. American College of Obstetricians and Gynecologists, 2017(700), 1-5. Retrieved from https://www.acog.org/-/media/project/acog/acogorg/clinical/files/committee-opinion/articles/2017/05/methods-for-estimating-the-due-date.pdf
(10) Mayo Foundation for Medical Education and Research. (2020). Rh factor blood test. Retrieved from https://www.mayoclinic.org/tests-procedures/rh-factor/about/pac-20394960
(11) Healthwise Staff. (2019). Surgical abortion care. University of Michigan Health System. Retrieved from https://www.uofmhealth.org/health-library/tw5328
(12) American College of Obstetricians and Gynecologists. (2020). Induced abortion. Retrieved from https://www.acog.org/patient-resources/faqs/special-procedures/induced-abortion
(13) American Pregnancy Association. (2020). Surgical abortion procedures. Retrieved from https://americanpregnancy.org/unplanned-pregnancy/surgical-abortions/
(14) Mayo Foundation for Medical Education and Research. (2020). Dilation and curettage (D&C). Retrieved from https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910