The Abortion Pill - RU486

RU486 - Abortion Pill
Abortion Pill - RU486. Getty Images

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

The name "abortion pill" is a little misleading because it actually refers to using two different medicines to end your pregnancy. It is considered to be a medical abortion.

How Do You Use It?

If you choose to use the abortion pill, there are three steps to using it.

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

How It Works

RU486 blocks the progesterone receptors in your body (the hormone that is in charge of causing the uterine lining to build up and prepare for pregnancy). So, RU486 (mifepristone) basically 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 abortion pill is FDA-approved for women who are up to 7 weeks pregnant (this is the same as it being 5 weeks since conception) or up to 49 days after your last menstrual period. Although some healthcare providers will still use this method for women who are more than 7 weeks pregnant, using RU486 at this time is considered off-label (meaning, it is no longer FDA approved).

Side Effects

You should definitely 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
  • Mild fever or chills

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


  • Effective.
  • Less intrusive and painful to the body than surgical abortion.
  • Some women feel like it is a more natural abortion option since it feels very similar to a miscarriage.
  • Private.
  • Can be used early in a pregnancy.


  • 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 doctor, and there is still a possibility that it may not work.
  • If the abortion pill has not ended your pregnancy, there is a chance that there may be birth defects.

Other Considerations 

You can become pregnant again right after using the abortion pill, so make sure that you are using back-up contraception.

It is normal to have some bleeding or spotting for up to four weeks after using the abortion pill. For the first week afterwards, you should only use pads if you are bleeding. It is recommended that you not insert anything into the vagina or have sex for at least seven days after using the abortion pill.

The bleeding from the abortion pill marks the start of a new menstrual cycle. This means that your normal period should return in 4 to 8 weeks.

The abortion pill is NOT the same thing as the morning-after pill.

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 afterwards is relief. And just about all women who have used the abortion pill would recommend it to a friend.

It may also be helpful to bring somebody that you trust with you to your doctor's appointments.


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 may need additional tests, doctor visits, and/or exams.

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  2. Dunn S, Brooks M. Mifepristone. CMAJ. 2018;190(22):E688. doi:10.1503/cmaj.180047

  3. Spitz, I.M., Bardin, C.W., Benton, L. & Robbins, A. (1998). Early pregnancy termination with mifepristone and misoprostol in the United States. New England Journal of Medicine. 1998; 338(18):1241-47. doi:10.1056/NEJM199804303381801