What Is Mifepristone? Uses, Dosage, and What You Need to Know in 2026

Mifepristone is one of the most talked-about medications in the United States — and also one of the most misunderstood. It has been FDA-approved since 2000 and has two distinct medical uses: ending a pregnancy in its early stages, and treating a serious hormonal disorder called Cushing's syndrome. This guide provides a clear, factual overview of what mifepristone is, how it works, how it's taken, and what you should know before using it.

What Is Mifepristone?

Mifepristone is a synthetic steroid that works by blocking specific hormone receptors. It is available under two brand names in the US:

• Mifeprex (200 mg tablet): Used in combination with misoprostol for medical termination of pregnancy through 70 days gestation (10 weeks). Approved by the FDA on September 28, 2000. Also available as a generic (Mifepristone Tablets, 200 mg), approved in 2019. A second generic from Evita Solutions was approved in October 2025.
• Korlym (300 mg tablet): Used for ongoing management of hyperglycemia caused by Cushing's syndrome in adults with type 2 diabetes who cannot have or have failed surgery. Approved by the FDA on February 17, 2012.

Mifepristone is also known by its development code name RU-486. It is on the World Health Organization's List of Essential Medicines and has been used by millions of people worldwide.

What Is Mifepristone Used For?

Mifepristone has two FDA-approved indications:

1. Medical abortion (Mifeprex): Mifepristone 200 mg combined with misoprostol 800 mcg (taken 24-48 hours later) is the FDA-approved regimen for ending a pregnancy of 10 weeks or less. This combination is approximately 97-98% effective and is used in more than two-thirds of abortions performed in the United States.
2. Cushing's syndrome hyperglycemia (Korlym): Korlym is used to control high blood sugar in adults with endogenous Cushing's syndrome who have type 2 diabetes or glucose intolerance and have failed surgery or cannot have surgery. It works by blocking cortisol receptors, reducing the blood sugar-raising effects of excess cortisol.

Off-label uses include management of early pregnancy loss (miscarriage), emergency contraception in low doses, and uterine fibroid management — but these are not FDA-approved uses.

How Is Mifepristone Taken?

The dosage and administration differ significantly between the two uses:

For medical abortion (Mifeprex):

• Day 1: Take one 200 mg mifepristone tablet by mouth as a single oral dose.
• Days 2-3 (24-48 hours after mifepristone): Take four 200 mcg misoprostol tablets (800 mcg total), placed two per cheek pouch and held for 30 minutes, then swallow any remaining pieces.
• Follow up with your provider 7-14 days after mifepristone to confirm the pregnancy is completely terminated.

For Cushing's syndrome (Korlym):

• Starting dose: 300 mg (one tablet) taken by mouth once daily with a meal.
• Dose adjustments: Can be increased every 2-4 weeks based on blood sugar control. Maximum dose is 1,200 mg/day (or 600 mg/day with kidney problems).
• Always take Korlym with food — it is absorbed more reliably with a meal. Do not crush, chew, or split tablets.

Who Should NOT Take Mifepristone?

Mifepristone is contraindicated (should not be used) in certain situations:

• Suspected or confirmed ectopic pregnancy (the pregnancy is outside the uterus)
• IUD currently in place (must be removed before treatment)
• Chronic corticosteroid use (for Korlym, as it blocks cortisol receptors)
• Bleeding disorders or use of anticoagulants (blood thinners)
• Known allergy to mifepristone or misoprostol
• Pregnancy (for Korlym use — the drug will terminate a pregnancy)

Is Mifepristone a Controlled Substance?

Mifepristone is NOT a federally controlled substance under the DEA. However, Louisiana has enacted a state law classifying mifepristone as a state-level controlled substance, creating additional storage and dispensing requirements for providers in that state. It is subject to the FDA's REMS program, which imposes certification requirements on prescribers and pharmacies.

Where to Get Mifepristone

Mifepristone is available only through REMS-certified prescribers and pharmacies. Finding a certified pharmacy near you is not always straightforward. medfinder can call pharmacies in your area to identify which ones can fill your prescription. For a full guide on locating mifepristone, see How to Find Mifepristone In Stock Near You.