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Back To Vidyya Some Hospitals Shun Drug Used With RU-486

Obstetricians Say Move Is Harmful To Women

Some hospitals have stopped offering a drug that is used in conjunction with the abortion pill RU486. Obstetricians say the result is that women at these hospitals are getting inferior care.

The drug, called misoprostol, causes the uterus to contract and is often used to induce labor in full-term deliveries. It is also used to expel a fetus that has died. But some hospitals have stopped using misoprostol for obstetric purposes since its manufacturer, Searle, sent out a letter warning doctors not to give the drug to pregnant women. The letter was sent in August, several weeks before the Food and Drug Administration (FDA) approved RU486. Since then, misoprostol has been pulled from about half of the nation's teaching hospitals, according to an informal poll by the New York University School of Medicine.

As reported in a story today on Morning Edition with Bob Edwards from NPR News, Searle's letter is preventing many women from having access to an important drug. Among the hospitals no longer using misoprostol is the prestigious Brigham and Women's in Boston, which is affiliated with Harvard University.

The American College of Obstetricians and Gynecologists is protesting Searle's efforts to halt use of misoprostol. The group says randomized clinical trials have found that the drug is safe and effective when prescribed correctly. Alternatives are less effective and have troublesome side effects, the group says.

Misoprostol was developed as an anti-ulcer drug. But it has become better known as the second drug in a regimen that causes an abortion. Patients take RU486, which prevents the uterus from supporting a pregnancy. Then they take misoprostol, which expels the contents of the uterus. Abortion opponents protested approval of the regimen, often called a medical abortion. They also threatened to lead protests against any American company that agreed to make RU486.

Misoprostol is not approved by the FDA for obstetric uses. However doctors often prescribe drugs for purposes not sanctioned by the FDA -- and drug makers rarely oppose the practice.

Both Searle and its parent company Pharmacia Corporation turned down Morning Edition's repeated requests for an interview.

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Editor: Susan K. Boyer, RN
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