With a name that means ‘all’, the new drug ellaOne is being marketed as just that, an all in one ‘contraceptive’.
Ella works as a contraceptive by blocking progesterone’s activity, which delays the ovaries from producing an egg. RU-486, too, blocks the action of progesterone, which is also needed to prepare the womb to accept a fertilized egg and to nurture a developing embryo. That’s how RU-486 can prevent a fertilized egg from implanting and dislodge growing embryos. Ella’s chemical similarity raises the possibility that it might do the same thing, perhaps if taken at elevated doses. But no one knows for sure because the drug has never been tested that way.
As the National Health Service in the UK recently advised young women to “stockpile” morning after pills, we are setting a dangerous precedent for the new all-in-one pharmaceuticals. What ella does chemically is perhaps not as severe as what it does socially, which is to erase an already blurry line between contraceptive use and routine chemical abortions.
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“Plan B, which works for up to 72 hours after sex,”
Er… yeah. With a whole lot of luck. It may work, but don’t count on it.
Plan B is not reliable even if taken early. That’s why it’s Plan B. You use it when Plan A fails, because it’s better than nothing.
Reading the article, it appeats that Ella could function as an abortificant, but only if not used as approved. That’s true of a great many drugs.
I find it curious that this drug is refered to by either it’s brand name (Ella) or generic name (ulipristal), and yet RU-486 is rarely refered to by it’s generic name (mifepristone), but instead by it’s pre-approval testing designation. I think this is because the numerical code was often used in it’s earlier days, and the name stuck so hard that even after approval it remains the most recogniseable token.
There are several issues here, but the first is that if ellaOne is marketed as a ‘morning after pill’, it will be accessible as such (over the counter in many places, with doctors note in others, available to kids etc.). The issue is that with the RU-486 ingredient, taking a multiple dose (or possibly any dose) of ella will potentially ‘dislodge’ already growing embryos like RU-486 does, an abortion. The possibility of misusing the drug goes up as it becomes more accessible to youth, especially in places where abortion pills are not. Thus, the lack of intense testing is a big concern for opponents.
Calling ella ‘ella’ makes it so much more approachable, less medicinal and institutional, “Oh, I’ll just take an ‘ella’. No big deal.” Ella is a much more appealing word than mifepristone, it’s a feminine name, it’s almost your friend. It’s marketing for the target audience. In 1988, perhaps pharmaceutical companies were less savvy. After all, we didn’t have ads for prescription drugs then as we do now. Some sweet sounding pill with a long list of side effects that we have to ‘ask our doctor about’ because the commercial didn’t tell us what the heck it’s for. Anytime people are making money off the vulnerable, there’s an element of the sinister.
“The issue is that with the RU-486 ingredient”
Just a minor correction… ulipristal/ella does not contain RU-486/mifepristone. It isn’t the same drug. It does have a very similar molecular structure, and operates through roughly the same mechanism.
“Calling ella ‘ella’ makes it so much more approachable”
Welcome to marketing. That’s one of two reasons that drugs are sold under brand names – the generic names arn’t so marketable. The other is that having a respected, trademarked brand is useful once the patent expires.
The generic name for ella is ulipristal. Ella is just a brand name.
Mifepristone is sold as mifegyne and mifeprex – but those unmarketable names are because mifepristone doesn’t get marketed direct to the patient. There’s no point trying to appeal to someone who doesn’t make the usage decision. It’s perscribed by doctors, not patients.
Drug names are very confusing. The more cynical people say this is deliberate, as drugs manufacturers try to discourage people from switching to another brand by trying to prevent customers realising that, say, most brands of painkiller you can buy over the counter is basically just ibuprofen – it doesn’t matter which you get, because it’s probably the same active ingredient.
“Ella works as a contraceptive by blocking progesterone’s activity, which delays the ovaries from producing an egg.”
How is that, exactly? The purpose of progesterone is to maintain and nourish the uterine lining, in preparation for the implantation of an embryo. It’s produced by the corpus luteum, which doesn’t exist before ovulation. In other words, progesterone is only at basal levels before ovulation, and therefore blocking progesterone’s activity BEFORE ovulation would have little or no effect on whether an egg was released.
http://www.fertilityfriend.com/HelpCenter/FFBook/ff_menstrual_cycle.html
However, if you were to block progesterone’s activity during the luteal phase (the latter half) of the menstrual cycle, the uterine lining would be made unreceptive to the embryo, and implantation would not take place. In fact, progesterone is necessary to maintain a pregnancy, so this ulipristal could most definitely have abortive effects, even after implantation.
Honestly, I wouldn’t be so upset about this if they were marketing this drug as an anti-implantation method of birth control. We already have several on the market already (think IUDs) so there is really no reason to ban it on ethical grounds. But to market it as a contraceptive (ie: prevents conception) is just plain lying. Women can make their own decisions about whether or not they will use a form of birth control that allows for conception, but then flushes a developing embryo out of her body. But to lie and say that a drug will prevent conception, when in fact it does not is just plain unethical.
One last thing: RU-486 is not available in Canada. It failed its testing by the Drug Administration. (A woman died during clinical trials.) If, in fact, this ulipristal is a similar drug to RU-486, then I would expect to see extensive trials to prove that it is safe for widespread use. And I certainly would not like to see it available over the counter. The possibility for abuse is just too great.