Comprehensive medication guide to Mifeprex including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$50 copay with insurance coverage in states where abortion is legal; covered by most major commercial health plans in those states; federally funded Medicaid only covers abortion in cases of rape, incest, or life endangerment under the Hyde Amendment.
Estimated Cash Pricing
$300–$800 at in-person clinics for the full medication abortion regimen; as low as $150 at telehealth providers in eligible states; the Mifeprex 200 mg tablet alone starts from approximately $41 at certified pharmacies.
Medfinder Findability Score
35/100
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Mifeprex is the brand name for mifepristone, a 200 mg oral tablet approved by the FDA on September 28, 2000. It is used in combination with misoprostol to end an intrauterine pregnancy through 70 days (10 weeks) of gestation — a regimen known as medication abortion. The combination is approximately 97% effective in the first 63 days of pregnancy.
Mifeprex is manufactured by Danco Laboratories and is also available as a generic from GenBioPro (approved 2019) and Evita Solutions (approved October 2025). Medication abortion accounts for nearly two out of every three abortions in the United States. A different brand of mifepristone, Korlym, is used at higher doses to treat Cushing's syndrome — this page focuses on the Mifeprex indication.
Mifeprex is classified as a progesterone receptor modulator and antiprogestational steroid. It is not a federally scheduled controlled substance, though Louisiana has classified it as a controlled substance under state law.
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Mifeprex works by blocking progesterone receptors in the uterus. Progesterone is a hormone essential for maintaining early pregnancy — it prepares the uterine lining, prevents contractions, and keeps the cervix closed. Mifepristone is a competitive antagonist: it binds to the progesterone receptor without activating it, preventing progesterone from doing its job.
When mifepristone blocks progesterone: the uterine lining breaks down and detaches the embryo from its blood supply; the cervix begins to soften and dilate; and the uterus becomes more sensitive to prostaglandins (substances that cause contractions). Misoprostol, taken 24–48 hours later, provides the prostaglandin activity that triggers strong uterine contractions to expel the pregnancy tissue. Together, the two-drug regimen is approximately 97% effective.
At the higher doses used in Korlym for Cushing's syndrome (300–1200 mg/day), mifepristone also blocks glucocorticoid receptors, reducing the effects of excess cortisol. At the 200 mg dose used in Mifeprex, this anti-cortisol effect is minimal, but contraindications related to corticosteroid use still apply.
200 mg — tablet
Single oral dose on Day 1 for medication abortion; followed 24–48 hours later by misoprostol 800 mcg buccally
Mifeprex has a findability score of 35 out of 100, indicating significant access challenges. Unlike most medications, Mifeprex's availability limitations are not due to a manufacturing or supply chain shortage — the FDA has not issued an official drug shortage designation. The drug is produced by three manufacturers as of 2026. Instead, the barriers are regulatory and legal.
Key barriers to access include: the FDA's Mifepristone REMS Program (requiring certified prescribers and pharmacies); state abortion bans in 12 states and 6-week gestational limits in 4 more states; active federal litigation in 2026 (Fifth Circuit ruling temporarily stayed by SCOTUS); and an ongoing FDA safety review of the REMS. Not all pharmacy locations of major chains are REMS-certified, requiring patients to search specifically for certified locations.
In states where abortion is legal, patients can find Mifeprex at REMS-certified pharmacies, Planned Parenthood health centers, reproductive health clinics, and via telehealth with mail delivery. medfinder calls pharmacies near you on your behalf to find which certified locations can fill your Mifeprex prescription — saving you hours of searching.
Mifeprex is not a controlled substance, but it is subject to the FDA's Mifepristone REMS Program. Every prescriber must complete REMS certification before they can legally prescribe it. This requires signing a Prescriber Agreement Form attesting to clinical qualifications including the ability to assess gestational age, rule out ectopic pregnancy, and manage or arrange care for complications.
The following healthcare professionals can become REMS-certified prescribers (depending on their state's scope-of-practice laws):
Physicians (MD or DO) — including OB/GYNs, family medicine, and internal medicine physicians
Nurse practitioners (NP) — where permitted by state law
Certified nurse-midwives (CNM)
Physician assistants (PA) — where permitted by state law
Telehealth prescribing is currently available in states where abortion is legal, under U.S. Supreme Court emergency stays as of mid-2026 protecting the 2023 REMS provisions. REMS-certified providers can consult by video or secure messaging and coordinate with certified pharmacies for mail delivery. To initiate or verify REMS certification, visit mifeinfo.com or call 855-643-3463.
Mifeprex (mifepristone) is not a federally scheduled controlled substance under the DEA's Controlled Substances Act. It does not require a DEA-registered prescriber, DEA form, or controlled substance prescription pad. However, it is subject to its own special program: the FDA's Mifepristone REMS Program, which imposes prescriber certification, pharmacy certification, and patient agreement requirements that function similarly to controlled substance restrictions.
Louisiana is the only state as of 2026 that has classified mifepristone as a controlled substance under state law, creating additional legal requirements for prescribers and pharmacies within that state. Patients and providers in Louisiana should be aware of these state-specific requirements, which exceed the federal REMS requirements.
In all other states, mifepristone is not classified as a controlled substance at the state level. Despite not being a controlled substance, the REMS program means it cannot simply be prescribed and filled like a standard non-controlled medication — prescribers and pharmacies must both complete REMS certification.
Most side effects of Mifeprex occur after taking misoprostol (the second medication, taken 24–48 hours later) and are expected signs that the regimen is working:
Cramping and abdominal pain (often stronger than normal menstrual cramps)
Vaginal bleeding and spotting (average 9–16 days, up to 30 days)
Nausea and vomiting
Diarrhea
Low-grade fever or chills (common in first 24 hours after misoprostol)
Fatigue and weakness
Headache and dizziness
Serious bacterial infection/sepsis: Rare but potentially fatal. May present atypically without fever. Seek emergency care for persistent malaise, weakness, or illness lasting more than 24 hours.
Excessive bleeding: Soaking through 2 thick pads per hour for 2 consecutive hours requires emergency evaluation.
Incomplete abortion: Occurs in 2–7% of patients. Requires surgical completion.
Ectopic pregnancy rupture: If ectopic pregnancy was not ruled out before treatment. Life-threatening.
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Misoprostol (alone)
Off-label use for medication abortion when mifepristone is unavailable; approximately 80% effective vs. 97% with the combination; fewer access restrictions but less effective
Surgical abortion (MVA)
Manual vacuum aspiration; more than 99% effective through about 14 weeks; requires in-person clinic visit; not affected by REMS restrictions
Korlym (mifepristone 300 mg)
Same active ingredient as Mifeprex but at higher doses for Cushing's syndrome management; separate REMS program; not indicated for pregnancy termination
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Warfarin / Heparin (anticoagulants)
majorContraindicated — mifepristone causes significant bleeding and combining with anticoagulants can cause life-threatening hemorrhage
Long-term corticosteroids (prednisone, dexamethasone)
majorContraindicated — mifepristone's anti-glucocorticoid effect can precipitate adrenal insufficiency in patients on chronic steroids
CYP3A4 inducers (rifampin, St. John's Wort, phenytoin, phenobarbital, carbamazepine)
moderateMay reduce mifepristone blood levels and potentially reduce efficacy; discuss with prescriber before use
CYP3A4 inhibitors (ketoconazole, itraconazole, erythromycin)
moderateMay increase mifepristone blood levels, potentially intensifying side effects
Grapefruit juice
moderateInhibits CYP3A4 metabolism of mifepristone, potentially increasing blood levels; avoid during treatment
Aspirin / NSAIDs
moderateAntiplatelet effects may increase bleeding risk; discuss use with prescriber
Mifeprex (mifepristone) has been FDA-approved for over 25 years and, when used correctly within the approved regimen, has a well-established safety and efficacy record. The challenges patients face accessing it in 2026 are regulatory and legal, not related to the medication's safety profile. The legal landscape is changing rapidly — SCOTUS stays, active litigation, an FDA safety review, and new state laws are all evolving simultaneously.
For patients in states where abortion is legal, Mifeprex remains accessible through REMS-certified prescribers and pharmacies, including via telehealth and mail. The most practical step a patient can take is to act promptly given the 70-day gestation limit, seek out a REMS-certified provider, and use available resources to find a certified pharmacy.
If you have a Mifeprex prescription and need help finding a certified pharmacy near you, medfinder calls pharmacies on your behalf and texts you which ones can fill your prescription — saving you hours of searching at a critical time.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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