Glossary › Medications › Mifepristone
Medication · Abortion pill
Mifepristone
/ mɪˈfɛprɪˌstoʊn /
RU-486
Mifeprex
The abortion pill
Mife
Mifepristone is a medication used to end a pregnancy up to 10 weeks. It's usually the first step in a two-pill process — followed by misoprostol 24–48 hours later. Together, these two medications are the most trusted and widely used method of medication abortion in the world.
Drug type
Antiprogestogen
Synthetic steroid compound
How far along
Up to 10 weeks
From your last period
Approved since
Year 2000
25+ years of use
Effectiveness
95–98%
When used with misoprostol
Standard dose
200 mg
One tablet, taken by mouth
How does it work?
Mifepristone works by blocking a hormone called progesterone — the hormone your body needs to keep a pregnancy going. Without it, the uterine lining breaks down and the pregnancy cannot continue.
It also helps prepare the uterus to respond to the second medication (misoprostol), which causes cramping and bleeding to pass the pregnancy.
Important to know: Mifepristone is not emergency contraception (like Plan B). It does not prevent pregnancy — it ends one that has already started. These are completely different medications.
How is it used?
Mifepristone is almost always used as part of a two-step process. Here's how it typically works:
1
Take mifepristone 200 mg by mouth — Day 1
Swallowed as a single tablet. You can take it at home. It's fine with or without food. Some light nausea is possible.
2
Take misoprostol 24–48 hours later
Four tablets dissolved in your cheeks or placed vaginally. Cramping and bleeding usually start within 1–4 hours. This step completes the process.
3
Follow-up about 2 weeks later
Confirm the process is complete — via a telehealth check-in or a home pregnancy test. This step helps make sure everything went as expected.
If mifepristone isn't available: Misoprostol can be used on its own (about 80% effective). It's a WHO-approved method and widely used around the world.
How effective is it?
95–98%
Mife + Miso at 9 weeks or earlier — complete without further treatment
93–95%
Mife + Miso between 9–10 weeks — slightly lower as pregnancy progresses
<1%
Ongoing pregnancy rate — surgical follow-up may be needed
2–5%
Incomplete abortion rate — may need additional medication or care
Safety & what to expect
Mifepristone on its own causes very few side effects. Most of what you feel happens after taking misoprostol (step 2). The combination is considered very safe — safer than many everyday medications.
What's normal to expect
- Heavy cramping
- Bleeding (heavier than a period)
- Passing clots or tissue
- Nausea or vomiting
- Diarrhea
- Low-grade fever or chills
- Headache, tiredness
When to get medical care
- Soaking 2+ pads per hour for 2+ hours
- Fever above 101°F lasting over 24 hrs
- Severe pain not helped by ibuprofen
- No bleeding within 24 hrs of misoprostol
- Signs of infection (bad odor, discharge)
- Feeling faint or very weak
Do not use mifepristone if you have:
- A confirmed or suspected ectopic pregnancy — this requires emergency medical care
- An IUD in place (it must be removed first)
- Adrenal issues or long-term steroid use
- A clotting disorder or you're taking blood thinners
- An allergy to mifepristone or misoprostol
Legal & access in the US
Access to mifepristone in the US depends on where you live. In states where abortion is legal, many people can now get it through telehealth and have it mailed directly to their home.
In states with restrictions or bans, access is more limited — but options may still exist through organizations that ship from states with legal protections.
Laws around medication abortion are changing quickly. Always check your current state's access via Plan C (plancpills.org) or the Guttmacher Institute for the most up-to-date information.
Legal status last reviewed: May 2025
Globally: Mifepristone is available in over 80 countries. The World Health Organization includes the mifepristone + misoprostol regimen on its Essential Medicines List.
Common myths — cleared up
Myth: "Mifepristone is the same as Plan B."
Fact: Plan B works by preventing ovulation — it doesn't end a pregnancy. Mifepristone ends an existing pregnancy by blocking progesterone. They're completely different medications used at different times.
Myth: "The abortion pill is dangerous or experimental."
Fact: Mifepristone has been used by tens of millions of people worldwide since the 1980s. Its safety record has been reviewed extensively. Studies show it has a lower complication rate than surgical abortion and is considered safer than many common over-the-counter medications.
Myth: "You have to go to a clinic to get it."
Fact: In states where abortion is legal, certified pharmacies — including mail-order pharmacies — can now dispense mifepristone. Many people access it entirely through telehealth and take both medications at home.
Myth: "Taking mifepristone can affect future pregnancies."
Fact: There is no evidence that mifepristone affects future fertility. Major medical organizations including WHO and ACOG confirm that medication abortion does not increase the risk of miscarriage, preterm birth, or infertility in future pregnancies.
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Order Abortion Pills →Sources & further reading
WHO — Medical management of abortion, 2018. WHO Essential Medicines List — Mifepristone + Misoprostol. who.int
ACOG — Medication Abortion Up to 70 Days of Gestation — Practice Bulletin No. 225. acog.org
Plan C — State-by-state guide to accessing abortion pills. plancpills.org
Guttmacher Institute — Medication Abortion — State policy tracker and research. guttmacher.org
RCOG — Best Practice in Comprehensive Abortion Care. rcog.org.uk
