Mifepristone and misoprostol can be obtained through a certified prescriber, a certified retail pharmacy, or a telehealth visit that ships the medications to your home by mail. The FDA allows both in-person and mail-order dispensing, and as of January 2023, retail pharmacies can become certified to stock and dispense mifepristone directly. The specific path available to you depends largely on where you live and your state’s current laws.
The Two Main Routes: Telehealth or In-Person
There are two practical ways to get these medications. The first is through a virtual clinic or telehealth provider. You complete an online consultation, often including a video or phone visit with a certified prescriber, and the medications are shipped to your address with tracking. The second is visiting a clinic like Planned Parenthood or another reproductive health provider in person, where the prescriber may hand you the medications directly or send a prescription to a certified pharmacy.
The cost difference between these two routes is significant. The median price for medication abortion through a virtual clinic dropped to about $150 in 2023, while in-person care at a brick-and-mortar clinic had a median price of $600. That gap has been widening: virtual clinic prices fell from $239 in 2021, while in-person prices rose from $580 over the same period. Some brick-and-mortar clinics also offer telehealth visits at a lower price than their in-person care, with a typical median around $500.
How the FDA System Works
Mifepristone is regulated under a special FDA program called REMS, which means it can only be prescribed by a certified prescriber and dispensed by either that prescriber (or someone they supervise) or a certified pharmacy. You cannot walk into any pharmacy and request it. The pharmacy must have completed a specific agreement form with the FDA and must be able to ship the medication with tracking.
The FDA approves the combined regimen for pregnancies up to 10 weeks (70 days) of gestation. The standard protocol is 200 mg of mifepristone taken by mouth, followed by 800 mcg of misoprostol 24 to 48 hours later. The misoprostol is typically placed vaginally or between the cheek and gum (buccally) rather than swallowed, as these routes are substantially more effective. Research shows that simultaneous dosing of both medications is also effective, though the spaced interval remains the standard approach.
The FDA explicitly recommends against purchasing mifepristone outside of this system, such as buying it from unregulated online sources or importing it from another country.
Finding a Verified Provider
Three resources are widely used to locate legitimate providers. AbortionFinder.org maintains a directory of verified clinics and telehealth services searchable by location. Plan C provides information comparing clinical care with self-managed options and lists online providers by state. And Planned Parenthood’s website can connect you to your nearest health center offering medication abortion.
If you live in a state with abortion restrictions, the situation is more complicated. Several states, including Connecticut, California, Delaware, Illinois, Massachusetts, New Jersey, and New York, have passed “shield laws” that protect providers in those states from legal action taken by states with abortion bans. Some of these laws may allow providers to prescribe via telehealth to patients in restrictive states, though the legal landscape varies and continues to shift. Massachusetts’ shield law, for example, applies regardless of where the patient is located.
What the Medications Do and What to Expect
Mifepristone blocks the hormone progesterone, which is needed to sustain a pregnancy. Misoprostol, taken a day or two later, causes the uterus to contract and empty. The combined regimen is highly effective. Over 99% of medication abortions provided at Planned Parenthood clinics in a large study completed without any clinically significant complications. The most common issue requiring further care was an ongoing pregnancy, which occurred in about 0.5% of cases. Serious adverse events (hospitalization, transfusion, emergency treatment, or IV antibiotics) occurred in 0.16% of cases.
After taking misoprostol, expect heavy cramping and bleeding, typically heavier than a normal period. This usually begins within a few hours of the misoprostol dose. Bleeding may continue at lighter levels for one to two weeks afterward. Nausea, chills, and diarrhea are common side effects of the misoprostol and usually resolve within hours.
Misoprostol Alone as an Alternative
When mifepristone is unavailable, misoprostol can be used on its own, though it is less effective. A large systematic review covering nearly 13,000 women found that misoprostol alone, using the most effective protocols, resulted in complete abortion without surgery about 87% of the time. That compares to over 99% success with the combined regimen.
The most effective misoprostol-only approach uses an initial dose of 800 mcg placed vaginally (moistened before insertion), buccally, or sublingually, repeated for at least three doses over 48 hours or more. The route matters enormously: when 800 mcg was taken orally instead of vaginally, the rate of needing a surgical procedure jumped from 19% to 52%. Three doses produced meaningfully better results than a single dose, with complete abortion rates rising from 69% to 79%.
Who Should Not Use These Medications
Medication abortion is not safe or appropriate for everyone. It should not be used if you have a confirmed or suspected ectopic pregnancy (where the embryo implants outside the uterus), because the medications will not end that type of pregnancy and delaying treatment can be dangerous. Other contraindications include chronic adrenal failure, long-term corticosteroid use, bleeding disorders or blood thinner medications, inherited porphyrias, a known allergy to either medication, and having an IUD in place. If you have an IUD, it needs to be removed first before proceeding.
An ultrasound or clinical evaluation before starting the medications helps rule out ectopic pregnancy and confirm gestational age, both of which affect safety and the likelihood of success. Most telehealth providers will walk through your medical history and risk factors during the consultation to screen for these issues.