Mifepristone

Mifepristone pills

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 peope 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.[1] Serious side effects may include heavy vaginal bleeding, bacterial infection, and birth defects if the pregnancy does not end.[1] If used, appropriate follow-up care needs to be available.[1][2] Mifepristone is an antiprogestogen.[1] It works by blocking the effects of progesterone, making both the cervix and uterine vessels dilate and causing the uterus to contract.[1]

History

Mifepristone was developed in 1980 and came into use in France in 1987.[3] It became available in the United States in 2000.[4] It is on the World Health Organization's List of Essential Medicines.[5][6] Mifepristone was approved by Health Canada in 2015 and became available in Canada in January 2017.[7] Cost and availability limits access in many parts of the developing world.[8][9]

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.[10] This ruling would come into effect a week later.[10] 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.[11][12] 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

See the main article: Abortion debate

Many anti-abortion groups in the United States actively campaigned against the approval of mifepristone[13][14][15] They also say that the drug should be withdrawn.[16]

They cite the following issues they see:[17]

  • 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.[18][19]

Religious and anti-abortion groups outside the United States have also protested mifepristone, especially in Germany[20] and Australia.[21][22]

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 "Mifepristone". American Society of Health System Pharmacists. Archived from the original on 22 December 2015. Retrieved 25 February 2023.
  2. ↑ "Mifepristone Use During Pregnancy". Drugs.com. Archived from the original on 14 March 2018. Retrieved 13 March 2018.
  3. ↑ Corey EJ (2012). "Mifepristone". Molecules and Medicine. John Wiley & Sons. ISBN 978-1-118-36173-3. Archived from the original on 8 September 2017.
  4. ↑ Goldman MB, Troisi R, Rexrode KM, eds. (2012). Women and Health (2nd ed.). Oxford: Academic Press. p. 236. ISBN 978-0-12-384979-3. Archived from the original on 8 September 2017. Retrieved 5 September 2017.
  5. ↑ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  6. ↑ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
  7. ↑ Kingston A (5 February 2017). "How the arrival of the abortion pill reveals a double standard". Maclean's. Archived from the original on 21 February 2017. Retrieved 21 February 2017.
  8. ↑ Hussein J, McCaw-Binns A, Webber R, eds. (2012). Maternal and perinatal health in developing countries. Wallingford, Oxfordshire: CABI. p. 104. ISBN 978-1-84593-746-1. Archived from the original on 8 September 2017.
  9. ↑ Winikoff B, Sheldon W (September 2012). "Use of medicines changing the face of abortion". International Perspectives on Sexual and Reproductive Health. 38 (3): 164–6. doi:10.1363/3816412. PMID 23018138.
  10. ↑ 10.0 10.1 Belluck, Pam (2023-04-07). "Texas Judge Invalidates FDA Approval of the Abortion Pill Mifepristone". The New York Times. Archived from the original on April 8, 2023. Retrieved April 7, 2023.
  11. ↑ "Judge in Washington orders feds to keep abortion pill access". Associated Press. April 7, 2023. Retrieved April 8, 2023.
  12. ↑ Ables, Kelsey; Rosenzweig-Ziff, Dan (April 8, 2023). "Who is Thomas Rice, the Washington judge who ruled mifepristone is safe?". The Washington Post. Retrieved April 8, 2023.
  13. ↑ Cunningham PC, McCoy L, Ferguson CD (28 February 1995). "Citizen Petition to the U.S. Food and Drug Administration". Americans United for Life. Archived from the original on 3 October 2006. Retrieved 20 September 2006.
  14. ↑ Talbot M (11 July 1999). "The Little White Bombshell". The New York Times. Archived from the original on 28 August 2021. Retrieved 20 September 2006.
  15. ↑ "Abortion Foes to Boycott Drugs (Altace) Made By RU-486 Manufacturer". The Virginia Pilot. 8 July 1994. Archived from the original on 20 February 2008. Retrieved 15 September 2006.
  16. ↑ Guthrie S (11 June 2001). "Counteroffensive Launched on RU-486". Christianity Today. Archived from the original on 20 September 2006. Retrieved 20 September 2006.
  17. ↑ Kolata G (24 September 2003). "Death at 18 Spurs Debate Over a Pill For Abortion". The New York Times. Archived from the original on 28 August 2021. Retrieved 20 September 2006.
  18. ↑ Watkins M, Sonka J (2 March 2022). "Kentucky lawmaker apologizes for referencing Jewish women's sex life amid abortion debate". The Courier-Journal. Archived from the original on 29 June 2022. Retrieved 6 March 2022.
  19. ↑ Grasiosi G (4 March 2022). "Kentucky politician sparks outrage with comments on Jewish women's sex in error-laden argument against abortion". The Independent. Archived from the original on 5 March 2022. Retrieved 6 March 2022.
  20. ↑ Allen JL (12 February 1999). "Abortion debates rock Germany: introduction of abortion pill exacerbates controversy". National Catholic Reporter. Archived from the original on 28 May 2005. Retrieved 14 September 2006.
  21. ↑ "Catholic and Evangelical students join Muslims in RU-486 fight". Catholic News. 9 February 2006. Archived from the original on 27 October 2006. Retrieved 18 September 2006.
  22. ↑ "Death Toll Rises to 11 Women". Australians Against RU-486. 2006. Archived from the original on 20 August 2006. Retrieved 20 September 2006.