Mifepristone is an oral medication—also known as Mifeprex or RU-486—used to end early pregnancies when taken in combination with misoprostol. It is FDA-approved and widely used for medication abortion during the early weeks of pregnancy, typically up to 10 weeks (with some medical guidelines allowing use up to 11 weeks).
How Does Mifepristone Work?
Mifepristone works by interfering with the hormone needed to sustain pregnancy.
Progesterone Blocker
Progesterone is essential for maintaining the uterine lining during pregnancy. Mifepristone blocks progesterone, which:
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Stops pregnancy growth
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Causes the uterine lining to break down
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Prepares the uterus for expulsion
Followed by Misoprostol
Misoprostol, taken 24–48 hours later, causes the uterus to contract and bleed, allowing pregnancy tissue to be expelled safely and effectively.
When Is Mifepristone Used?
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Approved use: Typically up to 10 weeks of gestation (some protocols allow use up to 11 weeks)
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Additional medical use: Also prescribed to help manage missed or incomplete miscarriages by assisting the uterus in expelling retained tissue
Effectiveness of Mifepristone
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Mifepristone alone: Success rates range from 54% to 92% within 1–2 weeks
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Combined with misoprostol: Effectiveness increases to 95–98% for early pregnancy termination
The combined regimen is the recommended and most reliable method.
Eligibility and Contraindications
Mifepristone Is Not Recommended If You Have:
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A confirmed or suspected ectopic pregnancy
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Adrenal insufficiency
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Certain bleeding or clotting disorders
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Long-term corticosteroid use
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Severe anemia
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An IUD in place (must be removed first)
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Known allergies to mifepristone or misoprostol
Precautions
People with heart, liver, immune system, or chronic health conditions should consult closely with a healthcare provider before use.
Side Effects of Mifepristone
Common Side Effects
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Vaginal bleeding and cramping (often lasting 9–16 days)
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Nausea, vomiting, or diarrhea
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Fatigue, dizziness
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Fever or chills
About 8% of people may experience bleeding that lasts longer than 30 days.
Rare but Serious Complications
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Hospitalization occurs in only 0.04–0.09% of cases
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Blood transfusions are needed in approximately 0.05% of cases
Warning Signs — Seek Medical Care If You Experience:
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Heavy bleeding (soaking more than two pads per hour for two consecutive hours)
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Fever above 100.4°F (38°C) lasting more than 24 hours
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Severe abdominal pain or foul-smelling vaginal discharge
Step-by-Step Use of Mifepristone
1. Initial Assessment
Pregnancy dating is confirmed through last menstrual period (LMP) or ultrasound, and screening is done for contraindications.
2. Take Mifepristone
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Take one tablet orally with water
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Most people feel well and can continue normal activities
3. Take Misoprostol (24–48 Hours Later)
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Typically four 200 mcg tablets
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Taken buccally, sublingually, or vaginally
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Pain relief (ibuprofen) and anti-nausea medication may be used beforehand
4. Experience and Recovery
Cramping and bleeding usually begin within hours of misoprostol. This experience is similar to a heavy menstrual period or miscarriage. Rest, hydration, heat therapy, and pain relief are helpful.
5. Follow-Up Care
A follow-up check 1–2 weeks later—via telehealth or in person—confirms the abortion is complete and ensures no further treatment is needed.
Why Mifepristone Is a Safe and Trusted Option
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Clinically supported: Recommended by major health organizations such as the WHO, ACOG, and RCOG
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Non-surgical: No anesthesia or instruments required
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Private and accessible: Can often be taken at home and is widely available through telemedicine
Final Thoughts
When used correctly with misoprostol, mifepristone offers a highly effective, medically approved, and non-surgical option for ending an early pregnancy. Proper screening, access to follow-up care, and medical guidance are essential for safety and peace of mind. If you are considering this option, consult a trusted healthcare provider to ensure it is appropriate for your situation and to receive personalized support.