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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]
In 2000, GenBioPro's generic version of mifepristone was approved for medication abortion, as part of a two-drug regimen in combination with misoprostol. In 2023, GenBioPro sued the FDA to obtain a legal judgement confirming that mifepristone could continue to be sold, in spite of anti-abortion laws passed in some states.
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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Misoprostol is used for the prevention of NSAID-induced gastric ulcers.It acts upon gastric parietal cells, inhibiting the secretion of gastric acid by G-protein coupled receptor-mediated inhibition of adenylate cyclase, which leads to decreased intracellular cyclic AMP levels and decreased proton pump activity at the apical surface of the parietal cell.
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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]