In preparation for a federal judge’s ruling suspending the Food and Drug Administration’s approval of the primary medicine mifepristone going into effect later this week, New York and California are hoarding enormous amounts of an alternate abortion pill.

On Tuesday, Kathy Hochul, the governor of New York, gave the state health department the go-ahead to start buying 150,000 doses of misoprostol, or a five-year supply. A day after Gov. Gavin Newsom declared that California has 2 million misoprostol pills on hand, Hochul made his declaration.

In the United States, drug abortions are the most popular method of ending a pregnancy. Usually, patients will take mifepristone first, then misoprostol, in a two-drug regimen. In some parts of the world, the second tablet is used as an abortion drug on its own.

In the event that U.S. District Judge Matthew Kacsmaryk’s ruling halting mifepristone goes into effect at 12 a.m. central time on Saturday, misoprostol, which is FDA-approved to treat gastric ulcers, will still be available.

“One judge in Amarillo, Texas believes he is smarter than tens of thousands of specialists and medical professionals. At a press conference with Planned Parenthood’s New York branch on Tuesday, Hochul added, “And not to mention the numerous women who have used this drug safely for decades.

“This is an attack on democracy as well as on abortion. Courts have never yet overturned an FDA judgement that was supported by science, according to the governor.

Hochul said that she is collaborating with the New York Assembly to make it law that private insurers must pay for misoprostol when it is prescribed for abortions off-label.

At midday on Thursday, the U.S. 5th Circuit Court of Appeals had been contacted by the Justice Department and Danco Laboratories, the company that sells mifepristone, to request that Kacsmaryk’s decision be overturned.

When the two-drug combination is not available, misoprostol is advised by the World Health Organization and the American College of Obstetricians and Gynecologists as a stand-alone abortion medicine. Obstetricians and gynaecologists claim that misoprostol is less efficient when used alone.

The two-drug abortion regimen is permitted by the FDA up until the tenth week of pregnancy. By preventing the progesterone hormone from acting, mifepristone prevents the pregnancy from progressing further. Misoprostol causes uterus-emptying contractions.

According to the FDA’s label, patients take 800 micrograms of misoprostol in the cheek pouch 24 to 48 hours after taking 200 milligrammes of mifepristone orally on day one.

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