Medication abortion, often referred to as the “abortion pill,” is a common method for ending an early pregnancy using a two-drug regimen. This process involves taking Mifepristone and Misoprostol, which work together to safely terminate the pregnancy. Questions often arise regarding how long these pills remain effective and what risks are associated with their use. This article addresses the stability of the medication, the consequences of using expired doses, and the general health risks involved in the procedure.
The Medications Used in Abortion
The medication abortion process relies on the distinct actions of two pharmaceutical agents. The first drug taken is Mifepristone, which works by blocking the hormone progesterone. Disrupting progesterone’s function causes the pregnancy to stop developing and detach from the uterine wall.
The second medication, Misoprostol, is typically taken 24 to 48 hours later. Misoprostol causes the cervix to soften and the uterus to contract. These contractions lead to cramping and bleeding, which causes the expulsion of the contents of the uterus, similar to a miscarriage. Using the two medications in combination is significantly more effective than using Misoprostol alone, with success rates between 93% and 99%.
Shelf Life and Proper Storage
The shelf life for the medications differs based on their chemical composition and stability. Mifepristone generally has a longer manufacturer-approved shelf life, often cited as five years, when stored correctly. Misoprostol is more chemically sensitive and typically carries a shorter expiration date of around two years.
Proper storage is necessary to ensure the drugs retain their full potency up to their labeled expiration date. Both medications should be kept in their original, sealed blister packaging to protect them from environmental factors. Exposure to moisture, light, and extreme temperatures can accelerate chemical degradation, making the medication less effective.
Misoprostol is particularly vulnerable to degradation when exposed to air and moisture. Studies indicate that Misoprostol can lose approximately five percent of its active ingredient within 48 hours if removed from its protective packaging. To preserve stability, both pills must be stored in a cool, dry place, away from direct sunlight. Using drugs past the manufacturer’s date is a risk to the procedure’s success due to the time-sensitive nature of medication abortion.
Risks of Using Expired Medication
The primary risk associated with using expired medication is a reduction in the drug’s effectiveness. Over time, the active ingredients in Mifepristone and Misoprostol chemically degrade, decreasing the total dosage available to the body. This loss of potency means the medication may be unable to successfully complete the abortion process.
If the medication is not strong enough, it can result in an incomplete abortion or the continuation of the pregnancy. An incomplete abortion occurs when pregnancy tissue remains in the uterus, requiring further medical intervention. In such cases, a surgical procedure, such as dilation and curettage (D&C), may be necessary to fully empty the uterus and prevent complications like infection or excessive bleeding.
While there is a theoretical risk of consuming unknown degradation products, the tangible risk is that the time-sensitive window for a medical abortion will be wasted on a failed attempt. The need for a follow-up procedure adds physical and emotional stress, making the use of medication past its expiration date a significant factor in procedural failure.
Known Health Risks of Medication Abortion
Even when the procedure is successful, there are expected side effects and rare, serious health risks. Common side effects include heavy bleeding and intense cramping, which can be more severe than a typical menstrual period. Other frequent, temporary side effects include nausea, vomiting, diarrhea, headache, and a temporary fever or chills.
Serious complications are uncommon, but individuals should be aware of specific warning signs that require immediate medical attention. One rare risk is hemorrhage, defined as extremely heavy bleeding that soaks through two or more maxi pads in an hour for two consecutive hours. Passing blood clots larger than a lemon is also a sign to seek urgent care.
Another rare complication is infection, which may present as a fever of 100.4°F or higher lasting more than 24 hours after taking Misoprostol. Other signs of infection include severe abdominal or back pain, or foul-smelling vaginal discharge. Medication abortion is also not effective in cases of ectopic pregnancy, where the pregnancy is located outside the uterus, and this condition requires immediate medical intervention.