There are two drugs, not one

People say “the abortion pill.” There are two. This page is what those two medicines are, and what the FDA label describes. It is not a set of steps to follow. It is not a vendor list. It is not a booking page.

A nurse can talk with you in chat, or write back on the form. Free and private. You decide. Find a pregnancy center near you if you want a test or scan at their location.

Talk with a nurse — free, private.

Get the facts. You will not be pressured here.

There are two drugs, not one. Mifepristone blocks progesterone, the hormone a pregnancy needs to continue. Misoprostol is the second medicine. The label describes it as causing the pregnancy to be passed from the uterus.

Mifepristone

Mifepristone is a progesterone blocker. FDA materials describe it as a drug that blocks the hormone progesterone needed for a pregnancy to continue.

Current FDA-approved labeling for Mifeprex (and the approved generic) is for medical termination of intrauterine pregnancy through 70 days gestation (10 weeks or less since the first day of the last menstrual period). The Medication Guide says Mifeprex is not approved for ending pregnancies that are further along. A mailed envelope cannot tell you how far along you are. A last-period guess in your notes app is not dating.

“Not approved for later gestations” is not the same sentence as “the pills don’t work after 10 weeks.” This page will not write that slogan.

Misoprostol — two facts, kept distinct

In the FDA-approved Mifeprex regimen, misoprostol is the second medicine. The Mifeprex label describes it as causing the pregnancy to be passed from the uterus.

Misoprostol’s own approved U.S. product (Cytotec) is indicated to reduce the risk of NSAID-induced gastric ulcers. Its boxed warning states that giving it in pregnancy can cause abortion, premature birth, birth defects, or uterine rupture.

That boxed warning is a warning if a pregnancy continues after misoprostol. It is not a set of instructions. This page will not write Cytotec’s ulcer dose as an abortion regimen. Leftover misoprostol is a danger, not a plan. Do not take a friend’s tablets.

What the label describes as a sequence

FDA-approved labeling describes a two-medicine sequence: mifepristone on Day 1, then misoprostol 24 to 48 hours later. The label states effectiveness may be lower if misoprostol is given less than 24 hours or more than 48 hours after mifepristone. The Medication Guide says the pregnancy is likely to be passed from the uterus within 2 to 24 hours after taking both medicines. That is what the label describes. It is not a set of steps to follow, and this page will not turn it into one.

Alabama law makes it unlawful for any person to intentionally perform or attempt an abortion except as the statute itself provides. Pills are not a lawful elective abortion here. We do not sell, ship, or name vendors. This is not legal advice.

If a pack is already on the way, read If a pack is already in the mail before you take anything from it. For more of the law, see Can I get an abortion in Alabama?.

Who the label says should not take this regimen

The FDA label lists these contraindications. This is not a shopping list and not extra conditions added here:

• confirmed or suspected ectopic pregnancy or undiagnosed adnexal mass
• chronic adrenal failure
• concurrent long-term corticosteroid therapy
• history of allergy to mifepristone, misoprostol, or other prostaglandins
• hemorrhagic disorders or concurrent anticoagulant therapy
• inherited porphyrias
• IUD in place (the label says the IUD might interfere and must be removed before treatment)

The Medication Guide also lists pregnancy more than 70 days.

The approved regimen is not treatment for ectopic pregnancy. Pain and bleeding may resemble a ruptured ectopic. A ruptured ectopic can be fatal. A positive test is not a location.

Why a scan first: Why an ultrasound first. How far along: How far along am I?.

What it feels like, and what is an emergency

These medicines are taken outside a clinic. There is no in-state elective clinic to finish what pills started if something is incomplete.

Uterine bleeding happens in almost all patients after both medicines. Bleeding or spotting then lasts 9 to 16 days on average. Abdominal pain and cramping are expected. About 85% report at least one adverse reaction. The label says most people bleed more heavily than they do during a heavy menstrual period. Those hours-to-days figures are after both medicines, not after the first pill alone. Most common (more than 15%): nausea, weakness, fever/chills, vomiting, headache, diarrhea, dizziness.

Soak through two thick full-size sanitary pads per hour for two consecutive hours: that is an ER. If you are crashing before the second hour, do not wait. Fever of 100.4°F or higher lasting more than 4 hours belongs there too. Tell the ER you took the abortion pill — mifepristone, misoprostol, or both, if you know.

Serious and sometimes fatal infections and bleeding occur very rarely. No causal relationship between mifepristone and misoprostol and those events has been established. Prolonged heavy bleeding may be a sign of incomplete abortion. Serious infection can present without fever.

FDA labeling says follow-up about 7 to 14 days after mifepristone is very important. If listed contacts cannot be reached, go to an ER.

On the label’s U.S. trials (n = 16,794), complete medical abortion was 97.4%, surgical intervention 2.6%, ongoing pregnancy 0.7%. The Medication Guide says about 2 to 7 out of 100 women taking Mifeprex will need a surgical procedure because the pregnancy did not completely pass or to stop bleeding. Those are label-trial figures, not a universal rate. Failure rises as gestational age approaches 10 weeks in Table 4.

In Alabama, there is no in-state elective clinic to go back to if the pills fail. That is a practical fact sitting next to the label. Read Failed pills and no clinic. What it can feel like: What it feels like. If you are bleeding now and stable enough to read, If you are bleeding now. If you are not stable, 911.

If you have taken only mifepristone and you want this pregnancy to continue, that conversation lives on Changed your mind after the first pill?.

A nurse is here.

> Emergency. Soak two thick pads an hour for two consecutive hours, fainting, severe pain, or fever of 100.4°F or higher lasting more than 4 hours: 911. If you are crashing before the second hour, do not wait. If you may harm yourself, 988.

A nurse can use an interpreter. We write in English first.

For a map of independent pregnancy centers, see Find a center near you.

---

We do not sell, ship, or name vendors. Independent centers named here are not a chain.

Chat is not medical care. An emergency room is.

Privacy