Mifepristone, also known as Mifeprex or RU-486, is an FDA-approved medication commonly used to safely end early pregnancies. It's typically taken with misoprostol to complete a medication abortion—a non-invasive alternative to in-clinic procedures. The two-pill regimen is up to 98% effective for pregnancies up to 10 weeks of gestation, according to FDA prescribing data for mifepristone.
Mifepristone has been used by millions of people in the U.S. for over two decades, with a strong safety record and widespread medical support. In this guide, we break down how it works, what to expect, and how to access it discreetly through Hey Jane.
How mifepristone works
Mifepristone is an oral medication used to induce abortion. Mifepristone blocks the hormone progesterone, which is a hormone that is needed to continue a pregnancy. Blocking progesterone causes the pregnancy to stop growing. The second medication used for medication abortion treatment, misoprostol, is taken 1-2 days after mifepristone. Misoprostol causes cramping and bleeding to empty the uterus and complete the abortion.
What is mifepristone used for?
Mifepristone is used in medication abortion to end pregnancies up to 10 weeks gestational age. By blocking the hormone progesterone, mifepristone ends the pregnancy. Mifepristone, along with misoprostol, is also used to medically manage miscarriages, especially in cases of missed miscarriage where a developing pregnancy has no electrical activity but there’s been no bleeding or cramping.
What are the negative effects of mifepristone?
Mifepristone may cause side effects like chills, dizziness, headache, and stomach cramps. More severe side effects requiring medical attention include allergic reactions, heavy vaginal bleeding, a high fever, stomach pain, fatigue, nausea, vomiting, and diarrhea.
What are the side effects of mifepristone?
Most of the time, people feel fine after taking mifepristone. Some people have mild cramping or bleeding. Either way, it’s fine—whether you have bleeding or not. Read our guides on abortion pain and bleeding after an abortion for more information.
To complete the abortion, you will take the second medication, misoprostol, even if you have started bleeding after taking mifepristone. Some other uncommon side effects of mifepristone include:
- Dizziness
- Weakness or fatigue
- Nausea, vomiting, diarrhea
Serious side effects are very rare, occurring in less than 0.5% of people taking this medication alone. (And this number is even lower for Hey Jane patients, occurring in less than .16% of patients.) Vaginal bleeding or spotting is normal for up to 30 days following a medication abortion treatment, but if you’re bleeding through more than two pads an hour (edge to edge) for at least two hours in a row, or if you otherwise feel ill, contact your provider. If other side effects increase in intensity or return, you should also speak with your provider to ensure there are no complications.
For more information on side effects following taking mifepristone or having a medication abortion, visit FDA Mifepristone Information.
What is a medication abortion?
A medication abortion is a medical treatment that generally involves taking two medications, mifepristone and misoprostol, to stop a pregnancy from growing and empty theuterus, similar to an early miscarriage. Medication abortion is typically performed before 10 weeks in gestational age, and often feels like a heavy, crampy period.
Many people choose medication abortion over a procedural option because they prefer to have their abortion at home or in another comfortable setting, sometimes without a visit to a clinic. Medication abortion feels more natural than the procedural option for some people, as well. The reason why people choose which option is best for them is a very personal choice that only they can make.
To see if a medication abortion may be right for you, you’ll generally begin by calculating your gestational age either via last missed period date, ultrasound, or by using date of conception. Then, a provider would gather your health history to confirm treatment is safe for you before prescribing you the FDA-approved abortion medications.
How quickly is mifepristone absorbed?
It can take 1-2 hours for the oral administration of a 200—or 600-milligram (mg) mifepristone tablet to be absorbed by the body.
How long does a medication abortion take?
A medication abortion takes between 1-3 days to complete but some symptoms, like vaginal bleeding or spotting, may last for a few weeks after the treatment is over. First, you’ll connect with a provider—either in person or virtually—who’ll prescribe the abortion medications. Next, you’ll take one tablet, mifepristone. Some people experience vaginal bleeding or cramping after this first medication alone, some people don’t; both are okay. Either way, you must take the second medicine (misoprostol).
Between 6-48 hours after taking mifepristone, you’ll take four tablets of misoprostol, a medication that causes uterine cramping and bleeding to empty the uterus. Generally, you’ll experience vaginal bleeding within about 4-6 hours after taking the misoprostol, and heavy bleeding can last for a few hours. The amount you bleed will vary depending on your gestational age.
Recent studies have found that medication abortion via telehealth is just as safe and effective as medication abortion via in-clinic care. Additional evidence supports that pregnant people are able to self-manage medication abortion treatment without a clinic visit, especially if they have thorough information about what to expect before, during, and after. In some cases, a follow-up may be necessary to confirm that the treatment was successful or to rule out complications should there be any ongoing issues following the procedure.
What is a procedural abortion?
Procedural abortions are performed in a clinic or hospital and are 99% effective in ending a pregnancy. You may hear a procedural abortion referred to as a "surgical abortion" but that is not quite accurate.
In the majority of procedural abortions, the pregnancy is removed from the uterus using light suction (which is why they're sometimes called a suction or aspiration procedure). These procedures are used in pregnancies up to 14-16 weeks after your last menstrual period.
A procedural abortion after 16 weeks is usually done with a dilation and evacuation procedure. This procedure generally involves cervical dilation, but does not require cutting or scraping.
How long can I wait to have an abortion?
The sooner you make a decision regarding your pregnancy, the more options you’ll have for treatment. Your options can vary depending on your gestational age and the laws of your state.
Medication abortions are FDA-approved for pregnancies up to 10 weeks after your last menstrual period, so if you prefer that route, you’ll need to make your decision earlier in the pregnancy. Some states have restrictions on medication abortions, so moving forward with a medication abortion prior to 10 weeks gestational age is recommended. After that, you’ll require a procedural abortion, the allowed timing of which may vary by state.
Procedural abortions generally offer more time but it’s good to check the laws of your state to ensure you’re a candidate. You can visit this website here to determine the options in your state.
Buying mifepristone and misoprostol together online?
Mifepristone is an important part of medication abortion because it is the medication that stops the pregnancy from growing and increases the success of the treatment. It works by blocking a hormone called progesterone. Misoprostol, is taken 6-48 hours following the mifepristone pill and causes cramping to empty the uterus in a few hours.
If you’re looking for how to get misoprostol and mifepristone online to complete your medication abortion safely and completely, we recommend using a trustworthy online telehealth service like Hey Jane.
Hey Jane makes getting mifepristone and misoprostol together affordable and simple by offering medication abortion services online via secure chat with one of our medical providers. Begin by confirming that you’re eligible for a medication abortion. Next, you’ll connect with a provider and we’ll get a good picture of your needs, prescribe your medications, and answer any questions you might have.
How to get mifepristone at home
Hey Jane provides fast, safe, effective telehealth medication abortion services in 23 states. To see if you're eligible for treatment, start by filling out our intake form here.
Once we confirm your eligibility and medical history, you'll consult with a provider in 1 business day over chat, phone, or video call. If prescribed, medications will be mailed in discreet packaging in 2-3 business days.
Medication abortion now accounts for more than half of all abortions in the US, with 1 in 6 abortions done via telehealth. Laws around using telehealth services to begin your medication abortion process change frequently, which you can learn about here (or find more options available to you here).
For more information, check out our Frequently Asked Questions page for answers to common questions and our guide to abortion cost and notable laws across states.
Why do people choose Hey Jane for mifepristone?
Hey Jane is a virtual medication abortion provider offering FDA-approved mifepristone and misoprostol by mail in 23 states where telemedicine abortion is legal. Hey Jane eliminates the need to travel to an in-clinic provider. We also offer flexible ways to pay so that mifepristone is affordable with or without insurance—including HSA/FSA funds, payment plans, and financial assistance through its abortion fund partner program.
FAQS about mifepristone
1. Can I take mifepristone alone without misoprostol?
No—mifepristone alone causes the pregnancy to stop growing, but it doesn’t complete the abortion. Misoprostol is needed to help the uterus cramp and empty. In fact, many people do have misoprostol-only abortions (typically if they are allergic to mifepristone) which is still very effective. Howver, using both medicines together makes treatment more effective and typically less crampy.
Sources: FDA — Q&A on Mifepristone · ACOG — Practice Bulletin 225
2. How long after taking mifepristone should I expect symptoms?
Some people have light bleeding or cramping within hours of taking mifepristone, while others feel no change until they take misoprostol 6–48 hours later. In general, most people are able to continue their normal activities after mifepristone. Both responses are normal.
Sources: Cleveland Clinic — Medical Abortion · Yale Medicine — Medication Abortion Q&A
3. What should I avoid after taking mifepristone and misoprostol?
It's helpful to avoid inserting anything into the vagina (like tampons or penetrative sex) until bleeding has slowed, since it is easier to see how much you are bleeding when using menstrual pads. It's also good to allow your body time to rest and heal, and you can return to normal activities like driving, exercise, and sex whenever you feel ready.
Sources: Mayo Clinic — Mifepristone (oral route) · ACOG — Practice Bulletin 225
4. How effective is telehealth for getting mifepristone?
Research shows that receiving mifepristone and misoprostol through telehealth is just as safe and effective as in-person care, as long as you meet eligibility criteria and take treatment according to instructions. With Hey Jane, you’ll connect with a licensed medical provider over chat, phone, or video call before being prescribed treatment. You can also message our clinical care team throughout treatment, or call our 24/7 nursing line to speak with medical experts throughout the process. Learn more about how getting mifepristone and misoprostol works with Hey Jane.
Sources: Yale Medicine — Medication Abortion Q&A · ACOG — Practice Bulletin 225 · Nature Medicine Journey — Effectiveness and safety of telehealth medication abortion in the USA
5. Will I need a follow-up appointment after using mifepristone?
Most patients don’t need an in-person follow-up. You’ll typically take a home pregnancy test about 4 weeks later to confirm the abortion worked. If results are unclear or symptoms are unusual, your provider may recommend further evaluation.
Sources: FDA — Q&A on Mifepristone · Cleveland Clinic — Medical Abortion
For more information, check out our Frequently Asked Questions page for answers to common questions and our guide to abortion cost and notable laws across states.
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