Dear Ms van Rooyen,
Your request for information about the actual use and problems of
drugs used for inducing abortion has been passed on to me for reply. I
understand from your message that you have consulted Medline and are
up-to-date, therefore, with the scientific literature. As you will be
aware neither methotrexate nor misoprostol is approved in any country
of the world for inducing abortion and there are no "official" data,
therefore, on their use.
No doubt you know that misoprostol has been used clandestinely by
women to self-induced abortion in Brazil and probably also in other
countries. The extent to which the compound was/is being (mis)used in
this way is impossible to assess, of course. As for methotrexate, the
experience to date has been mostly, if not exclusively, in the context
of clinical studies and I doubt that there is any significant degree
of clandestine use of this drug at the present time. Incidentally,
the Toxicology Panel of our Programme has recently issued a statement
which recommends against the use of methotrexate for inducing
abortion. If you are interested in obtaining a copy, please send me
your mailing address.
Finally, as far as mifepristone is concerned, the compound is
currently used in four countries, namely the UK, Sweden, France and
the People's Republic of China. Data about the extent of use can
probably be best obtained from the company since it will have accurate
sales figures. Similarly, the company may be willing to share data
about adverse drug reaction reporting. If it is not possible to
obtain the latter information from the company, it may be worth trying
to get it from national regulatory authorities in the countries
concerned. Obviously, one could also contact some key people in each
of the four countries to obtain their personal experience in providing
a medical abortion service, but the information thus obtained
inevitably will be fragmentary and may be biased. If you nevertheless
wish to pursue that approach, please let me know and I'll provide some
names.
with kindest regards,
Paul F.A. Van Look
WHO Special Programme of Research, Development and Research Training in
Human Reproduction
1211 Geneva 27
Switzerland
Email: vanlookp@who.ch
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