Unlikely to cause abortion Mugwort ● Non tox per pdex ● Contains thujone, a GABA antagonist- potential stimulant effects in large amts ● Used traditionally for abortion/birth, however effect not studied cotton root bark Gossypium hirsutum ● Seeds contain gossypol- polyphenolic bisesquiterpene ● Non tox per pdex ● Used traditionally as contraceptive and abortifacent ○ May have antiprogesteron effects-> reduction of corpus luteum ○ https://www.sciencedirect.com/topics/medicine-and-dentistry/gossypol Queen Anne’s lace/wild carrot ● may be confused with poison hemlock ● TOXICITY: Specifically unknown, possibly psoralens. The leaves of wild carrots cause contact dermatitis in hypersensitive individuals, especially when the leaves are wet. ● Potentially: n/v, flushing, bradycardia, hypotension ● Used traditionally as contraceptive and abortiface May cause abortion Black cohosh ● Minimum lethal and maximum tolerated human exposures have not be delineated. ● s/s Bradycardia, dizziness, tremor, possible hypotension ● The exact effect in pregnancy is unknown, but an overdose may cause premature birth. Herbal preparations containing Cimicifuga racemosa have been used as abortifacients. ○ Theory based low level evidence and expert opinion ○ https://pubmed.ncbi.nlm.nih.gov/17085773/ Penny royal ● As little as a tablespoonful (10 to 15 mL) may cause death ● (2 mL) has caused serious neurological toxicity in adults. ● s/s gastrointestinal distress and nonspecific symptoms (lightheadedness, generalized weakness ● Significant pennyroyal oil ingestions can lead to fulminant hepatic failure, acute renal failure, disseminated intravascular coagulation, metabolic acidosis, gastrointestinal bleeding, pulmonary congestion, altered mental status, seizures, and death. ● Abortion may occur with marked maternal toxicity or death. Pennyroyal oil has been used as an abortifacient. blue cohosh root ● The dose of the crude drug recommended by the United States Dispensatory was from 0.5 to 1 gram. Lethal dose not established. ● aponins can produce nausea, vomiting, cramping, diarrhea and possible dehydration. N-methylcytisine effects can include gastrointestinal effects followed by hypertension, large pupils, sweating, and possibly seizures. ● the crude drug derived from this plant has an oxytocic effect and until more studies are done, should not be taken during pregnancy. The oxytocic properties are produced by the caulosaponin portion of the plant Pharmaceutical Products mifepristone -Korlym, Mifeprex - ** Rx ** ● KORLYM MDD 20mg/kg ● MIFEPREX : Day 1, mifepristone 200 mg orally in a single dose. Days 2 or 3, misoprostol 800 mcg buccally taken a minimum of 24 hours after mifepristone dose; misoprostol must be taken within 24 to 48 hours after mifepristone. Incomplete expulsion with pregnancy not ongoing, a repeat dose of misoprostol 800 mcg buccally may be taken ● Progesterone blocker ● Commonly called abortion pill, often used in conjunction with misoprostol. ● Prescription for medical induced abortion ● COMMON: Uterine bleeding (may be severe), abdominal pain and cramping, nausea, vomiting, diarrhea, headache, dizziness, fatigue, back pain. OTHER EFFECTS: Hypotension, tachycardia, dyspnea, rash, dizziness, elevated liver enzymes, fever. ● There are no studies regarding the long-term use of mifepristone during pregnancy. However, mifepristone is contraindicated for use during pregnancy, as it can inhibit both endogenous and exogenous progesterone at the progesterone receptor, resulting in pregnancy loss or fetal harm Misoprostol- cytotec- ** Rx ** ● Early pregnancy termination dosing is 400 mcg orally once in conjunction with mifepristone ● MDD 2400mcg ● Prescription for medical induced abortion ● Commonly called abortion pill, often used in conjunction with mifepristone ● Abdominal cramping, diarrhea, headache, dizziness, and uterine contraction and bleeding may occur. ● In rare cases, hypertension, tachycardia, fever, tremor, rhabdomyolysis, renal insufficiency, and elevated liver enzymes have occurred. Hyperthermia, increased pulse, and increased respiratory rate may result from an acute overdose. In pregnant patients, uterine contractions, hemorrhage, and fetal death have occurred. Levonorgestrel- Plan B, My Way, EContraEX- ** OTC ** ● Dose 1.5mg ● Commonly called morning after pill, not used to induce abortion ● Can be bought OTC ● Chronic use has resulted in the following adverse effects: Nausea, vomiting, abdominal pain, headache, drowsiness, dizziness, edema, skin sensitivity reactions (ie, edema, generalized rash, pruritus, and urticaria), alopecia, acne, hirsutism, injection site reaction, decreased glucose tolerance, weight gain, oligomenorrhea, amenorrhea, decreased libido, breast tenderness, dysmenorrhea, thromboembolism, cholestatic jaundice, hepatitis, porphyria, acute allergic reactions, anaphylaxis, osteoporosis, backache, asthenia, nervousness, depression, tachycardia, pulmonary embolism, and increases in blood pressure. ● Use of levonorgestrel is contraindicated in pregnancy or with a suspected pregnancy. If pregnancy occurs with a levonorgestrel intrauterine in place, there is an increased risk of ectopic pregnancy, including loss of fertility, miscarriage, septic abortion (including septicemia, shock and death), and premature labor and delivery.