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Mifepristone was developed in 1980 and came into use in France in 1987. [16] It became available in the United States in 2000, for medication abortion, and in 2010, for Cushing's syndrome. [17] [10] [12] It is on the World Health Organization's List of Essential Medicines. [18] Mifepristone was approved in Canada in January 2017. [19] [20]
The mifepristone-misoprostol combination is, by far, the most recommended drug regimen for medical abortions, but other drug combinations are available. Misoprostol alone, without mifepristone, may be used in some circumstances for medical abortion, and has even been demonstrated to be successful in the second trimester. [37]
Examples include the progesterone receptor weak partial agonist mifepristone, the selective progesterone receptor modulator (SPRM) ulipristal acetate, and the silent antagonist aglepristone. [2] [3] In medical abortion, mifepristone is combined with a prostaglandin (e.g., gemeprost), while ulipristal is used for emergency contraception. [4]
The FDA approved mifepristone in 2000 as part of a two-drug regimen to end a pregnancy. Over the course of two decades, the agency loosened restrictions it initially placed on the drug’s use.
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Antiglucocorticoid drugs are a treatment option for Cushing's syndrome, a condition characterized by excessive cortisol production. These medications are primarily used in two scenarios: as preoperative treatment to manage symptoms and reduce surgical risks, and as a long-term solution when surgery has failed or is not feasible.
Ulipristal acetate, sold under the brand name Ella among others, is a medication used for emergency contraception (birth control) and uterine fibroids. [1] [7] [8] As emergency contraception it should be used within 120 hours of vaginally penetrating intercourse. [1]
Common abortifacients used in performing medical abortions include mifepristone, which is typically used in conjunction with misoprostol in a two-step approach. [3] Synthetic oxytocin , which is routinely used safely during term labor , is also commonly used to induce abortion in the second or third trimester .