What to Expect Before, During, and After Taking RU486

Dosage, Side Effects, and Cost

RU486 - Abortion Pill
Abortion Pill - RU486. Getty Images

The abortion pill, also known as RU486, has been widely and safely used in the United States for years. It is FDA-approved as a method of medical abortion. The brand name for RU486 is Mifeprex, and its generic name is mifepristone. To use RU486, you must see a medical professional.

Using the abortion pill involves a two-step process that involves taking two different medicines that work to end a pregnancy. It is important to note that the abortion pill is not the same thing as the morning-after pill.

How Do You Use RU486?

If you choose to use the abortion pill, there are three steps in the process:

  1. First, at your healthcare provider's office or medical clinic, you will be given RU486 (mifepristone) to take by mouth. You may also be asked to take an antibiotic at this time.
  2. Next, 24 to 48 hours after taking the mifepristone, you will need to take a second medicine by mouth, usually at home. It is called misoprostol. Make sure that your healthcare provider gives you instructions for how and when to take the misoprostol.
  3. Last, after about two weeks, you will need to have a follow-up appointment with your healthcare provider. This is very important because your practitioner will make sure that the abortion pills have worked. Your healthcare provider will probably give you a blood pregnancy test or an ultrasound to make sure you are no longer pregnant.

If the abortion pill didn't work, your healthcare provider will discuss your options with you. You may need an additional dose of medication or a procedure to complete the abortion.

How It Works

RU486 blocks the progesterone receptors in your body. Progesterone is the hormone responsible for causing the uterine lining to build up and prepare for pregnancy. The mifepristone causes the lining of your uterus to shed—so your pregnancy can no longer continue because the egg will have nothing to stay attached to.

Then, the misoprostol will cause uterine contractions. This allows your uterus to be emptied.

Who Can Use It?

The FDA has approved RU486 for women up to 7 weeks pregnant (or 5 weeks since conception) or up to 49 days after their last menstrual period. Although some healthcare providers will still prescribe RU486 for women who are more than 7 weeks pregnant, this use is considered off-label (meaning it is not FDA-approved at this stage).

RU486 Side Effects

You should expect to feel some side effects after using the abortion pill.

These can include:

  • Cramping
  • Nausea
  • Vomiting and diarrhea
  • Heavy bleeding (there may be large clots in the blood)
  • Stomach pain
  • Fatigue
  • Mild fever or chills on the day you take the misoprostol

If you have severe pain or feel faint, get medical attention. And if you have a fever after the day you take the misoprostol, call your healthcare provider.

Length of Time and Efficacy 

Within four or five hours after taking the mifepristone, more than half of women's pregnancies will be terminated. For others, it may take a little longer, but the abortion should take place within a few days. You can expect to see clots of blood when this happens, and the cramping may continue intermittently for a few days.

RU486 helps to terminate a pregnancy without surgery and is 92% to 98% effective when used in combination with misoprostol. When mifepristone is used alone, it is about 64% to 85% effective.

Advantages

  • Effective
  • Less intrusive to the body than surgical abortion
  • Considered by some people to be a more natural abortion option since it feels similar to a miscarriage
  • Private
  • Can be used early in a pregnancy

Disadvantages

  • Some people are morally opposed to this method since conception and implantation have already taken place.
  • Mifepristone may not be an option for women with liver or kidney problems, anemia, diabetes, Rh-negative blood, or those who are very overweight.
  • This method requires several visits to the healthcare provider, and there is a possibility that it may not work.
  • If the abortion pill has not ended your pregnancy, there is a chance of birth defects if you carry the baby to term.

Other Considerations 

You can become pregnant again right after using the abortion pill, so make sure that you are using backup contraception. Also, know that RU486 does not offer protection against sexually transmitted diseases.

It is normal to have some bleeding or spotting for up to four weeks after using the abortion pill. It is recommended that you do not insert anything into your vagina or have sex for at least seven days after using the abortion pill.

The bleeding after your abortion marks the start of a new menstrual cycle. This means that your normal period should return in four to eight weeks.

Keep in mind that you may have all types of feelings after a medical abortion. Because of the sudden change in your hormone levels, you may become more emotional. It may help to know that most women report that the main emotion they feel afterward is relief, and just about all women who have used the abortion pill would recommend it to a friend.

How Much Does RU486 Cost?

You can check with your private insurance to see if they cover medical abortion. That being said, the abortion pill may cost up to $800, but it usually costs less. The final cost depends on whether or not you need additional tests, healthcare provider visits, and/or exams.

The cost of RU486 can also vary depending on which state you live in. As RU486 is available at many Planned Parenthood clinics, you can contact a clinic in your area to find out about its availability and its pricing for your state.

Frequently Asked Questions

 What’s the difference between RU486 and Plan B?

Plan B is an emergency contraception drug that's taken by mouth to prevent an unintended pregnancy after unprotected sex or contraceptive failure (like a broken condom or a displaced IUD). Plan B is not an abortion pill and it will not work if you are already pregnant. RU486 is a medical abortion option that is taken by mouth and used when a woman is already pregnant.

Can I buy an abortion pill from the pharmacy?

No, you can not buy an abortion pill over the counter from pharmacies. You can only get it by prescription from a healthcare provider's office, Planned Parenthood center, or abortion clinic.

When can you get an abortion?

An abortion typically occurs during the first trimester of pregnancy (the first 12 weeks). A provider may give an abortion in the second trimester, usually for specific instances, but this is harder to obtain and happens infrequently.

A Word From Verywell

RU486 has been used for terminating unplanned pregnancies for years and has been an effective medical abortion option for many. Understanding how RU486 works and when it can be used, in addition to having thorough conversations with your healthcare provider about it, can help you know if it is the right choice for you.

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3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Dunn S, Brooks M. Mifepristone. CMAJ. 2018;190(22):E688. doi:10.1503/cmaj.180047

  3. Food and Drug Administration. Questions and answers on Mifeprex. Updated April 13, 2021.