On 29 July 2015, Health Canada approved the use of the medical abortion drug RU-486 (also known as Mifepristone). In Canada, the Mifepristone (RU-486) and Misoprostol drug regimen is sold under the name Mifegymiso. The medication started to become available to the public in January 2017. Here are some frequently asked questions about Mifegymiso and medical abortion.
What is medical abortion?
Medical abortion uses medication rather than an internal procedure to end a pregnancy.
Where can I obtain a medical abortion?
Up until now, medical abortion was not widely available in Canada but was offered in some clinics and hospitals. Health Canada’s approval of Mifegymiso has the potential to change the landscape of abortion access and make medical abortion care much more easily accessible for those who need it. Click here to find your nearest provider or call Action Canada’s toll-free Access Line at 1-888-642-2725.
What is Mifepristone?
Mifepristone is an anti-hormone used to end a pregnancy. The Mifepristone and Misoprostol regimen is on the World Health Organization’s list of essential drugs. It is considered the “gold standard” for medical abortion.
How does Mifepristone work?
Mifegymiso is the Canadian brand name for the combination of the medications Mifepristone and Misoprostol. Mifepristone is a medication that blocks the effect of progesterone, a hormone that is needed for a pregnancy to continue. Misoprostol is a prostaglandin and causes contractions of the uterus and relaxation of the cervix. This helps push out the contents of the uterus. Mifepristone and Misoprostol work together to end a pregnancy.
In Canada, Mifepristone is packaged in a combination box, 1- Mifepristone 200Mg tablet and 4 – 0.2Mg Misoprostol tablets. First a Mifepristone tablet is taken and then 24 to 48 hours later, Misoprostol tablets are taken. 4 Misoprostol tablets are taken at the same time.
The Mifepristone and Misoprostol regimen is on the World Health Organization’s list of essential drugs. It is considered the “gold standard” for medical abortion.
Is Mifepristone safe?
Mifepristone is already available in 60 countries. Its use was approved in France and in China since 1988 (almost 30 years ago) and has maintained an outstanding safety record throughout the world. In many countries, it is used safely up to 10 weeks of pregnancy and beyond. Just like surgical abortion, trained providers offer the procedure under high quality conditions, which highly diminish the risk of possible complications.
When can I use Mifegymiso?
In Canada, Mifegymiso can currently be prescribed up until 7 weeks gestation (or 49 days) for on-label use. Physicians can prescribe it off-label up to 10 weeks of gestation as it has been used safely and effectively up to that gestational age and beyond.
When will Mifegymiso become available in Canada?
Mifegymiso is now available in Canada. While not every physician or health care clinic offers it, the number of prescribers and pharmacies stocking Mifegymiso is increasing. Many health professionals have already joined communities of practice and have incorporated medical abortion in their services. Click here to find your nearest provider or call the Action Canada for Sexual Health and Rights 24/7 toll-free Access Line at 1-888-642-2725.
How much does it cost?
Mifegymiso’s costs hovers between $300-$450 per package depending on the provider. This means that, without cost coverage, medical abortion using this combination of drugs remains inaccessible for many people in Canada.
Who covers the cost?
Action Canada for Sexual Health and Rights has been calling on all provincial and territorial governments, as well as the Federal government, to promptly ensure that the cost of medication abortion is covered under public health care. So far, New Brunswick, Alberta, Ontario, Quebec and Nova Scotia have responded to the call. New Brunswick, Ontario and Alberta residents can now access Mifegymiso free of charge (though in New Brunswick, abortion services are only available in hospitals). This will also be the case in Quebec and Nova Scotia later this fall. Two federal programs have also followed suit, adding Mifegymiso to their formularies.
If you are in British Columbia, Saskatchewan, Manitoba, PEI or Newfoundland and Labrador, universal cost coverage is not in place. While partial coverage is in place for some residents or limited locations in British Columbia, Saskatchewan and Manitoba, the PEI and in Newfoundland and Labrador governments have yet to announce any coverage at all. The same is true for many Federal patients, including people who are incarcerated with a sentence of more than two years, serving members of the Canadian Forces and eligible veterans. Some private insurers may offer coverage for the medication through their policy, but for the remaining individuals with no private insurance or, in the provinces where it was added to the drug formulary, who are not on some form of social assistance, they are required to pay for the medication themselves.
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