Mifepristone (RU 486)

Article Abstract:

Progesterone is a hormone that stimulates the growth of the uterine lining while inhibiting contraction of the organ. Since it possesses these functions, it is essential for implantation of the fertilized egg and for formation of the placenta. A good contragestational drug would be one that binds to progesterone receptors on cells in the uterine lining to prevent them from being affected by progesterone, thus rendering the uterus inhospitable to a fetus. Mifepristone (RU 486) is such a drug. It binds to progesterone receptors but has none of the pharmacological actions of progesterone. The drug is most effective when it is followed by a low dose of a prostaglandin-like compound which has activity on contractility of the uterus. Results of a study of more than 2,000 women in France who took these two drugs, which was described in The New England Journal of Medicine of March 8, 1990, indicate this method is as effective for terminating pregnancy as vacuum aspiration of the uterus, with no more frequent complications due to bleeding. Mifepristone was selected by about 25 percent of the 120,000 women who underwent abortion in France during the last year and approval for this method seems imminent in Scandinavia and the United Kingdom. Approval in the United States, however, may be delayed. New medications are subject to lengthy review by the Food and Drug Administration and no commercial sponsor has stepped forward to initiate the process. Nor are the prostaglandin-like compounds used with mifepristone in France licensed for use in the United States. Many factors work against the development of products that regulate fertility in the United States. Supporters of the drug cite its noninvasiveness in contrast to vacuum aspiration, its lower cost, and its other medical applications. These include contraception before fertilization, use as an agent against diseases such as Cushing's syndrome where excess glucocorticoid (one of the substance mifepristone acts against) is manufactured, and as a treatment breast cancer. Development of a drug with the pharmacological characteristics of mifepristone opens many avenues of therapy for treating endocrine disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Physiological aspects, Progesterone, editorial

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Mifepristone (RU 486) in the United States: what does the future hold?

Article Abstract:

Mifepristone (RU 486) is an antiprogestin compound that when taken with a prostaglandin early in pregnancy induces a complete abortion in about 95% of women. Preliminary studies also suggest that it may be useful in the treatment of meningioma, breast cancer, Cushing's syndrome and glaucoma. Its clinical testing and use in the US however, has so far been blocked by anti-abortion sentiment. Its manufacturer, Roussel-UCLAF, has so far limited marketing and distribution to France, the UK and Sweden. With the pro-choice position of the Clinton administration however, Roussel agreed in Apr 1992 to grant a license to the non-profit group Population Council to choose a US manufacturer. Normally, a prostaglandin is administered either in muscle or in the vagina after the woman takes mifepristone. A recent study found that taking the prostaglandin misoprostol orally appears to be as effective as the intramuscular and intravaginal approaches and may be safer. Furthermore, misoprostol has already been approved for use in the US.

Methods, Abortion

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Mifepristone (RU 486) - an abortifacient to prevent abortion?

Article Abstract:

Mifepristone (RU 486) is used to terminate a pregnancy within 72 hours of unprotected intercourse or contraception failure. It prevents implantation of a fertilized egg in the uterus by blocking the activity of progesterone. Postcoital or emergency contraception has been available since the 1960s, but many women and their doctors do not know about it. Four methods of postcoital contraception are available, but mifepristone is not licensed in the US. A research study found that mifepristone was more effective and had fewer side effects than the standard treatment with estrogen and progestogen for early termination of a pregnancy. Legalization of mifepristone in the US is controversial because some individuals believe that life begins at the moment of conception. Others argue that life does not begin until the egg implants in the uterus approximately eight days after conception.

Health aspects, Contraceptives, Postcoital, Postcoital contraceptives

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