Mifepristone is available through three main channels in the United States: certified retail pharmacies like CVS, reproductive health clinics like Planned Parenthood, and telehealth services that can mail it to your door. Where you can actually access it depends almost entirely on which state you live in, since 13 states enforce total abortion bans and others have varying restrictions on how the medication can be dispensed.
Retail Pharmacies
Since January 2023, the FDA has allowed retail pharmacies to dispense mifepristone, ending a longstanding rule that restricted it to clinics and specialty providers. CVS Pharmacy has begun filling mifepristone prescriptions in select states where it’s legally permitted. Walgreens has similarly moved to dispense the medication in certain states. Not every location within those chains carries it, so calling ahead is necessary.
The catch is that pharmacies must go through a federal certification process before they can stock and dispense mifepristone. This is part of the FDA’s Risk Evaluation and Mitigation Strategy (REMS), a safety program that requires pharmacies to complete an agreement form, verify that prescriptions come from certified prescribers, and ship or dispense the medication with tracking. Any pharmacy that meets these requirements is eligible, but many independent and smaller chain pharmacies haven’t pursued certification. In practice, your options at the pharmacy counter are limited to larger chains in states without bans.
Telehealth and Virtual Clinics
Telehealth has become the most affordable route for many people. Virtual clinics that specialize in medication abortion offer the entire process remotely: a video or phone consultation with a certified prescriber, followed by the medication shipped directly to you. The median price through these virtual-only clinics dropped to about $150 by 2023, compared to $600 for an in-person visit at a brick-and-mortar facility.
Planned Parenthood offers telehealth appointments for the abortion pill in select states, with the option to either receive the medication by mail or pick it up at a health center or pharmacy. Other established telehealth providers operate similarly, though availability varies by state. During the consultation, a provider confirms your gestational age (typically through your last menstrual period) and reviews the treatment process. An ultrasound isn’t always required. Professional guidelines call for one only when there’s a risk of ectopic pregnancy or when gestational age can’t be confirmed through other clinical information.
Reproductive Health Clinics
Abortion clinics and reproductive health centers remain the traditional source for mifepristone. At an in-person visit, a provider evaluates you, explains the two-medication process, and dispenses the pills on-site or sends a prescription to a certified pharmacy. The median cost for in-person medication abortion was $600 in 2023. Some clinics offer sliding-scale fees or can connect you with abortion funds that help cover costs.
In-person clinics are the primary option in states that require physical visits or have restrictions on telehealth prescribing for abortion medications.
How the Prescription Process Works
Mifepristone isn’t something you can buy over the counter. The FDA requires a prescription from a health care provider who is certified under the federal REMS program. That provider must complete a specific agreement form, explain the risks of the treatment, and have you sign a patient agreement before writing the prescription. The medication can then be dispensed only by a certified prescriber directly, or by a certified pharmacy that receives the prescription.
The FDA approves mifepristone for ending a pregnancy through ten weeks of gestation. The standard protocol involves taking mifepristone first, then a second medication (misoprostol) 24 to 48 hours later. Both medications are typically provided together or prescribed at the same visit. The process is completed at home.
The safety record is well documented. In a study of over 11,000 patients, only 0.31% experienced a major complication such as hospitalization, transfusion, or surgery. Across roughly 5.9 million medication abortions tracked through the end of 2022, the mortality rate was 0.54 deaths per 100,000 uses.
States Where Access Is Blocked
As of late 2024, 13 states enforce total bans on abortion, which means mifepristone cannot be prescribed or dispensed for pregnancy termination within those states regardless of the source. CVS, Walgreens, clinics, and telehealth providers all face the same restrictions. Louisiana has gone a step further, classifying both mifepristone and misoprostol as Schedule IV controlled substances, which also complicates their use for miscarriage management and emergency obstetric care.
If you live in a state with a total ban, your options are limited to traveling to a state where abortion is legal or, in some cases, using telehealth based in a state with a shield law. Seven states have enacted shield laws designed to protect providers who offer reproductive care to patients from restrictive states. These laws vary in scope. Some protect providers’ medical licenses from discipline initiated by other states, shield their malpractice insurance, and limit the enforcement of out-of-state legal actions. Massachusetts has a provision that applies its protections “regardless of the patient’s location,” though how this works across state lines in practice remains legally untested.
The legal landscape shifts frequently. Providers like CVS have stated they continually monitor changes in state law and will dispense mifepristone wherever it becomes legally permissible.
Mifepristone for Non-Abortion Uses
Mifepristone is also FDA-approved under the brand name Korlym for treating high blood sugar caused by excess cortisol in adults with Cushing’s syndrome. In this context, it works as a cortisol blocker rather than ending a pregnancy, and it’s prescribed at different doses on an ongoing basis. Korlym is available through standard prescription channels and is not subject to the same state-level abortion restrictions, though it does require a prescription and provider counseling.