title: If we can do it for misoprostol, why not for mifepristone? The case for taking mifepristone out of the office in medical abortion.
abstract: Given the highly political nature of abortion in the United States, the provision of medical abortion with mifepristone (Mifeprex®) and misoprostol has always occurred under a unique set of circumstances. The Food and Drug Administration-approved regimen requires clinicians to administer the mifepristone in the office and also requires women to return to the office for the misoprostol. In the US, where off-label drug use is an accepted practice when supportive evidence exists, most clinicians give women the misoprostol at the initial visit for her to take at home, eliminating an unnecessary visit to the office. This commentary suggests that, based on current studies, there is also enough evidence to offer women the option to self-administer mifepristone out of the office and that this is just another feature of off-label use. Six studies, enrolling over 1800 women, found that the option of taking mifepristone out of the office was popular and acceptable among women and providers. Given that it is safe, highly acceptable and not burdensome on providers, outside-office-use of mifepristone should be offered to all women as part of routine medical abortion services.
authors.affiliation: Albert Einstein College of Medicine, 3544 Jerome Avenue, Bronx, NY, 10458, USA. Electronic address: Marji.gold@einstein.yu.edu.
authors.forename: Marji
authors.initials: M
authors.lastname: Gold
authors.affiliation: Gynuity Health Projects, 15 East 26th Street, 8th floor, New York, NY, 10010, USA. Electronic address: echong@gynuity.org.
authors.forename: Erica
authors.initials: E
authors.lastname: Chong
mesh_terms: D000019:Abortifacient Agents / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D015735:Mifepristone / Q000008:administration & dosage*; D016595:Misoprostol / Q000008:administration & dosage*; D056687:Off-Label Use; D009819:Office Visits; D011247:Pregnancy; D012646:Self Administration; D014481:United States; D014486:United States Food and Drug Administration / Q000331:legislation & jurisprudence*
chemical_list: D000019:Abortifacient Agents; D016595:Misoprostol; D015735:Mifepristone