Medication

Q: When was the mifepristone (RU-486) / misoprostol drug regimen first approved in Canada? In other countries?

A: Mifegymiso was approved by Health Canada in July 2015[1]. It was first approved in France and China in 1988, and is now approved for use in over 60 countries[2].

Q: What is the approved MIFE200 / MISO800 dosing regimen in Canada?

A: 200 mg mifepristone (oral) followed by 800 µg of misoprostol 24-48 hours after the dose of mifepristone (buccal, vaginal or sublingual).

Q: If the person who consults me for a medication abortion has an absolute contraindication to using MIFE200 / MISO800, what are the other options for abortion?

A: For pregnancies up to 63 days, you can offer the patient 50 mg methotrexate (oral or intramuscular) followed by 800 µg misoprostol (vaginal or buccal) 3-5 days later, if there are no contraindications[3]. The use of misoprostol only regimens can also be used for pregnancies up to 63 days, although this is less effective than other regimens[4-6]. You can also offer a procedural abortion.

Q: Does medication abortion affect the patient's fertility or future pregnancy outcomes?

A: No. Fertility is rapidly restored after a medical abortion. Patients who have undergone medication abortion have no increased risk of pre-term delivery or low birth weight or low mean length compared with patients that have not had a previous abortion[7].