New York, California stockpile misoprostol

New York and California are stockpiling massive quantities of an alternative abortion medication in case a federal judge’s order suspending the Food and Drug Administration’s approval of the main drug mifepristone goes into effect later this week.

New York Gov. Kathy Hochul on Tuesday ordered the state health department to immediately start purchasing 150,000 doses of misoprostol, a five-year supply of the pill. Hochul’s announcement comes a day after Gov. Gavin Newsom said California has secured 2 million pills of misoprostol.

Medication abortions are the most common way to terminate a pregnancy the U.S. Patients typically use a two drug-regimen in which mifepristone is taken first, followed by misoprostol. The second pill is used as a standalone abortion medication in parts of the world.

Misoprostol is FDA approved to treat gastric ulcers, so it will remain on the market if U.S. District Judge Matthew Kacsmaryk’s order suspending mifepristone takes effect at 12 a.m. central time on Saturday.

“One judge in Amarillo, Texas thinks he knows better than thousands of doctors and scientists and experts. And not to mention the countless women who’ve used this medication safely for decades,” Hochul said during a press conference with Planned Parenthood’s New York chapter Tuesday.

“This isn’t just an attack on abortion, it’s an attack on democracy. Courts have never before revoked a science backed decision made by the FDA,” the governor said.

Hochul said she is working with New York’s legislature to require private insurers to cover misoprostol when it is prescribed off-label for abortions.

The Justice Department and Danco Laboratories, the distributor of mifepristone, have asked the U.S. 5th Circuit Court of Appeals to block Kacsmaryk’s ruling by noon Thursday.

The World Health Organization and the American College of Obstetricians and Gynecologists recommend misoprostol as a standalone abortion medication when the two-drug regimen is not available. But misoprostol is not as effective when it is used on its own, according to obstetricians and gynecologists.

The FDA has approved the two-drug abortion regimen through the 10th week of pregnancy. Mifepristone stops the pregnancy from developing further by blocking a hormone called progesterone. Misoprostol induces contractions that empty the uterus.

Patients take 200 milligrams of mifepristone by mouth on day one, and then take 800 micrograms of misoprostol in the cheek pouch 24 to 48 hours later, according to the FDA’s label.