More evidence-concordant FDA guidelines increase access to mifepristone

As covered in the New York Times, this week the Food and Drug Administration relaxed the guidelines for taking mifepristone (Mifiprex, formerly RU-486), a pill that induces abortion, reviving one of the most contentious issues of the abortion debate. The change brings the directions for taking the drug, mifepristone, in line with what has become standard medical practice in most states: reducing the dosage to 200 milligrams from 600 milligrams, decreasing the number of visits a woman must make to a doctor to two from three, and extending the period when she can take the pill to 10 weeks of pregnancy from seven weeks.

Medication-induced abortions are increasingly common–accounting for a quarter of all abortions in 2011 according to the most recent figures from the Guttmacher Institute–and thus limiting their access has been a target of the anti-abortion movement. In some states, they have succeeded in passing laws restricting use of mifepristone, including requiring medical professionals who administer the drug to be licensed physicians, rather than nurses or physician assistants and requiring the prescribing doctor to be present with the patient when she puts the medication in her mouth. Laws requiring physicians to adhere to the FDA guidelines on the label have also passed in Arkansas, Oklahoma, and Arizona, but have been blocked by court order. Several states required that physicians adhere to the FDA guidelines which used to be based on a regimen for mifepristone developed in Europe in the late 1980s. In this week’s action, the FDA updated their regimen to reflect newer evidence supporting a simpler regimen that has been shown to be just as effective while using less medication, resulting in fewer side effects and requiring fewer visits to the provider.