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Claims that Mifepristone is “Safer than Viagra, Penicillin, or Tylenol” Don’t Withstand Scrutiny

Jan 17, 2024 | Abortion

Randall K. O’Bannon, Ph.D. , NRL Director of Education and Research

Every time abortion pills are back in the news, you can count on some hot shot reporter taking the bait offered by the abortion industry and repeating carefully crafted but factually suspect claims that “mifepristone is safer than,” well, whatever popular, common drug that millions of Americans use every year without any significant concern for safety.

A while ago, it was Tylenol. We will review that claim momentarily, but we and others have answered that here.  Now they are using penicillin and Viagra for comparisons.

Of course, any discussion of this sort ignores the most obvious and serious safety issue with mifepristone – that someone dies every time the abortion drug is used successfully – the innocent unborn child who is the target of this “medication.” 

Count these deaths and you’ve easily got the deadliest drug on record.   Compared to healing, helping drugs like Tylenol, penicillin, and Viagra, the numbers aren’t even close.

The legacy media and mifepristone’s defenders don’t want you thinking about that though. They’d rather focus on the unintended (but rare) collateral damage that occurs when women (or men) take these or other common drugs familiar to patients, thinking that mifepristone will look better by comparison.

Looked at carefully, objectively, it won’t. Even without factoring in the hundreds of thousands of unborn lives lost each year when these abortion pills are taken, the evidence shows that mifepristone is clearly a more dangerous and deadly drug.

Reviewing the numbers with Tylenol

Basically, with Tylenol, they were trying to argue that there were more deaths associated with that widely used pain reliever every year than had been reported with mifepristone, but they ignored the fact that Tylenol was being sold and used tens of thousands of more times a year than mifepristone. 

The risk of death with both Tylenol and mifepristone (at least for the mother) was small, but considered in terms of deaths per dose, mifepristone was considerably more dangerous, about 833 times more lethal.

Again, find more details, data, and calculations here.

Though once repeated ad nauseam by the abortion industry’s media allies, with the exposure of their dubious mathematics, advocates have shifted course and attempted comparisons with other drugs, the most recent being Viagra and penicillin.

Safer than familiar prescriptions?

In a piece called  “How safe is the abortion pill compared with other common drugs?”, CNN reporters Annette Choi and Will Mullery claim that 

Comparatively, the risk of death by penicillin — a common antibiotic used to treat bacterial infections like pneumonia — is four times greater than it is for mifepristone, according to a study on life-threatening allergic reactions. The risk of death by taking Viagra — used to treat erectile dysfunction — is nearly 10 times greater, according to a study cited in the amicus brief filed by the FDA.  (CNN, 12/13/23)

The sources for the chart accompanying this article stem from figures posted in reports in medical journals from 2000 and 2001 that offer some statements about deaths connected to penicillin or Viagra, claiming that for every million uses, there are 5 deaths with mifepristone, 20 deaths with penicillin, and 49 with sildenafil (Viagra).

The data CNN cites for mifepristone comes from the FDA and is a couple of years old, missing some recent reports of deaths the FDA has connected to the drug, so we already know that the official risk assessment based on FDA figures is a bit higher (closer to 5.5 per million) than what CNN reports.  There is still reason to believe that these figures may be vastly underestimated but let us deal with that later.

There is also reason, though, to question how accurate or current the figures CNN offers for penicillin and Viagra. 

Penicillin is a proven lifesaver

CLINCALC.com says that there were 22,009,031 total prescriptions for Amoxicillin or Augmentin, the most popular penicillin formulations among 17,334,790 patients in 2020. Other varieties of penicillin include Ampicillin, Piperacillin, and Ticarcillin.  

As many as 10% claim to be allergic to penicillin, but only about 1% to 5% of those taking the drugs report mild to moderate reactions like temporary rashes or asthma like responses to the drugs. More serious reactions to the drugs, like anaphylaxis, which can include swelling, low blood pressure, abdominal pain, and difficulty breathing are considerably rarer, affecting only about .0005% of those taking penicillin (UpToDate.com, “Patient Education: Allergy to penicillin and related antibiotics,” accessed 12/18/23).

While anaphylaxis is serious and can be fatal, it need not be.  Emergency treatment with epinephrine can be given to address the immediate crisis, as well as corticosteroids to address swelling and antihistamines to address other allergic reactions so that the patient can not only survive but return to normal functioning.

If the risk figures above are accurate, estimates of 500-1000 anaphylactic deaths per year due to penicillin allergy seem unlikely. With .0005% of perhaps 20 million patients a year suffering severe anaphylactic reactions, even if all these proved fatal, this would only represent five deaths per million – the same figure given above for mifepristone.

Whatever the case, whether the penicillin mortality rate is 20 per million, 5 per million, or something less, the truth is that the risk/benefit ration is still radically different for penicillin than for mifepristone. A handful of deaths due to penicillin, tragic though they may be, are more than balanced by the millions upon millions of lives saved by those antibiotics.

That is something you can’t say about mifepristone, responsible not just for what may be a similar number of maternal deaths, but also millions of deaths of innocent unborn children.

Reassessing Viagra

Early on, when the medical establishment was still assessing the new drug sildenafil, or Viagra, the full range of risks and benefits were largely unknown.  That’s less the case now.

Doctors now know that certain men should not be given Viagra. That’s why there is a  caution at the end of the advertisements that men should “ask your doctor if you’re healthy enough for sexual activity.” 

The calculation of the mortality rate with Viagra mentioned in CNN’s article was from 2000, just two years after the FDA approved that drug for the U.S. market. With better understanding of the risks and other alternatives on the market, it may well be that the risk of death today is considerably lower or at least that more vulnerable men know to avoid Viagra or use alternatives.

Under contemporary use and with our current understanding, the conclusive claim that the death rate for Viagra is ten times greater than that for mifepristone is no longer tenable. A systematic review of sildenafil (Viagra) mortality published in December of 2022 in Cureus concluded that “the literature available on this topic is deemed insufficient to provide enough data to establish a direct link of causality between sildenafil and mortality.”

If recent studies tell us anything, it is actually that men taking drugs like Viagra may be 25% less likely to die early (Journal of Sexual Medicine, January 2023). That doesn’t settle the issue and more research is needed, but it does show that studies from more than twenty years ago should not necessarily be the last word on Viagra safety and should not be used to try and score dubious propaganda points in a contentious political or even medical controversy.

The point is, before taking the word of pro-abortion groups or any of their many allies in the media and concluding either that mifepristone is safer or these other drugs are more deadly, serious journalists should find out a bit more about the drugs involved and perhaps consider the reasons the industry is anxious to spin the data this way.

Different drugs, much different purposes

Even if, just for the sake of argument, we were to assume that the death rate for mifepristone was lower than whatever the real death rate for penicillin and Viagra might be, it isn’t clear that this would give mifepristone a more favorable cost/benefit ratio than either of those other drugs. 

It is one thing for a very sick person at death’s door to take a drug that should cure her or him but has a remote chance of making a condition worse, and another entirely for an entirely healthy person to take electively a drug that will expose him or her to a small but serious risk.

Penicillin’s benefits outweigh the risks

A woman taking penicillin or another antibiotic is already struggling with an infection that, if not treated, may well threaten her life. In most cases, especially if she has been carefully screened by her prescribing physician, that antibiotic will work, fully justifying whatever risk the prescription might have entailed. 

This is even with the understanding that there will be times that, should the bacteria she is fighting prove particularly virulent, the antibiotic may not be powerful enough to save her life so that she succumbs to the infection. 

This is still the case should she be one of those who, on extremely rare occasions, have an unexpected allergic reaction to the drug that inadvertently launches her towards death’s door. Even given that possibility, the seriousness of her original condition and the promise the drug offers the vast majority of people, warrants the risk of giving her the most powerful medicine in the doctor’s arsenal.

Whatever the actual level of risk associated with penicillin, it is more than balanced by the millions upon millions of lives that it has saved. The same cannot be said for mifepristone, whose very purpose is the destruction of human life.

Pregnancy is not a disease to be “cured” by mifepristone

The situations with penicillin and mifepristone could not be more different, and the risk evaluations must consider the radically different contexts.

We must start with acknowledging that there is nothing wrong with a woman who is pregnant. Pregnancy is not a disease or an illness but a natural, normal healthy part of many women’s lives for which their body is particularly suited and structured. 

If anything, it is the interruption of that process that poses one of the greatest dangers to her health, something that would be more apparent if there were better records of abortion’s physical and psychological aftereffects.

Mifepristone, the drug she takes, along with the prostaglandin misoprostol that is part of the chemical abortion package, blocks the activity of progesterone, one of the body’s key pregnancy hormones, and stimulates powerful, painful contractions and heavy bleeding to kill and force out the child who should be safe and thriving in her womb.

The drug she takes will cause that healthy woman to double over with pain, gush blood, and end the life of her healthy, growing child.  This is hardly the profile of a “safe” drug – making a woman worse off in many ways than before she took the drug.

Restoring or interfering with a natural function

It is a different case with Viagra, but here again is a comparison where the circumstances and the risk assessments are significantly different.  

It is one thing, after consulting with a doctor, for a person with a treatable health condition that negatively interferes with their quality of life to take a drug that could remedy that condition with minimal risks, and another for a healthy person whose body is functioning perfectly to take a drug which throws their entire body into bloody, painful disequilibrium and can send her, as well as thousands of others like her, to the emergency room.

While it may be argued whether treating erectile dysfunction with a relatively benign drug qualifies as elective in the strictest sense, it is clearly the case that pregnancy is not a disorder requiring treatment and that abortion is rarely a medical necessity. If a pregnant woman is facing a medical emergency, mifepristone is not typically considered the ideal choice, owing to the length of time it takes to work and its broad range of effects and side effects. It does not work in circumstances of ectopic pregnancy. 

Again, rather than treating a serious medical condition or pressing disorder, mifepristone and misoprostol can actually induce some sort of medical crisis (copious bleeding, painful cramping, etc.) in a healthy woman as part the drugs’ very mode of operation. 

As long as it is not too great, most people consider it appropriate to take on a certain level of risk when facing a significant medical crisis or even when dealing with some condition that interferes with normal healthy human functioning. But giving a perfectly healthy pregnant mother pills that will intentionally induce significant pain and bleeding that can easily turn into something much worse is a different level and category of risk entirely.

It doesn’t really compare. 

 

Greatly underestimating mifepristone’s risk

The claim that mifepristone is four times safer than penicillin or ten times safer than Viagra depends not only on what may be an exaggerated risk for antibiotics or erectile dysfunction drugs, but also an overly rosy assessment of the abortion pill.

We have already noted that the CNN report relied on an older FDA report of adverse events associated with mifepristone. The risk climbs a bit when more recent deaths are added in. But this, of course, depends on deaths and other adverse events generally being reported to the FDA, and there is reason to believe the FDA misses a lot of incidents.

Missing a lot of data

The FDA admits up front it doesn’t catch a lot of complications, saying in its bBrief in the Alliance for Hippocratic Medicine v. FDA (2023) that “FAERS [the FDA’s Adverse Events Reporting System] data cannot be used to calculate the incidence of an adverse event or medication error in the U.S. population.” 

One doctor compared adverse events data from Planned Parenthood from one year (2010) with adverse event data for the same year reported by the FDA and found that the FDA missed at least 866 adverse events from that provider alone (Planned Parenthood is believed to be responsible for perhaps 40% of the abortions performed in the U.S.).

Deaths connected to mifepristone would only be recorded by the FDA if they were recognized and reported as such. Yet some abortion pill providers anticipate that some patients may end up at the emergency room and openly caution them not to reveal that they have taken these drugs. Instead, women are told to say that they are experiencing a miscarriage. 

Women may not even tell their families or partners that they have taken mifepristone and abortion providers tell women that doctors in the emergency room would not be able to tell from an examination that they have taken the drugs. This would presumably include coroners as well, making mortality figures reported by the FDA incomplete at best and gross underestimations at worst.

Selective reading of the data

CNN cites a 2015 study from University of Southern California, San Francisco abortion researcher Ushma Upadhyay as proof that serious complications from mifepristone/misoprostol are rare, amounting to about a third of one percent, and says this data show that these chemical abortions are even safer than “procedural” or surgical abortions.

Ignoring the danger of letting an abortion advocate spin her own data, CNN seems to have failed to read Upadhyay’s study more carefully. The study actually shows 5.19% of chemical abortion patients showing up at the emergency room reporting a complication of some sort, nearly seventeen times the complication rate Upadhyay chose to emphasize with the reporters.

This is done by narrowly defining what counts as a “major complication” to include “unexpected adverse events requiring hospital admission, surgery or blood transfusion,” but relegating complications like hemorrhage, infection, uterine perforation, and incomplete or failed abortions to the “minor” category. Before dismissing these as minor complaints or statistical noise, one should consider that all of these “minor” events were sufficiently concerning to prompt more than a thousand women in this study to make a trip to the ER and seek emergency help.  

Considering the broader range of complications, chemical abortion is decidedly riskier than either surgical abortion or even birth, contradicting CNN’s assertions to the contrary.

Other field data shows higher risk

The complication rate of 5.19% as found by Upadhyay is bad enough, but there is evidence that even that estimate is low. Researchers from Canada looking at nearly 40,000 abortion patients in Ontario between 2017 and 2020 using a similar pharmacy distribution system to the one recently being proposed here in the U.S. found nearly 10.3% of chemical abortion patients visited the emergency room with some concern or complaint (Annals of Internal Medicine, January 3, 2023).

Whether the Canadian figures reflect increased risk due to the looser protocol in use or simply reflect better reporting from a nationalized health system, we may never know, but it is clearly at odds with the rosier assessment abortion pill advocates and their media allies are reporting for the U.S.

We simply may start to see a lot more women suddenly showing up at their local emergency rooms gushing blood, fighting infections, or dealing with ruptured ectopic pregnancies. There could be a sudden unexplained rash of women dying from “miscarriages” or rare bacterial infections.

It will all make sense to those who are actually familiar with the drug and how it works. But those who have relied upon and reprinted the spin of the abortion industry will have some explaining to do.

Not nearly as safe as advertised

The same people who say that unborn babies do not feel pain, that they do not have brain waves, or a beating heart are now saying that abortion pills which could send at least one in ten women to the hospital emergency department are completely safe, even safer than common drugs like penicillin and Viagra.

The evidence does not support this contention.  Those drugs save lives, relieve pain, and generally make life better. Mifepristone interrupts a healthy pregnancy, takes lives, causes incredible pain and copious bleeding, and puts a mother’s life and health at risk.

Women who have a more complete knowledge of chemical abortion or the related safety data know better than to trust the abortion pill advocates and their media allies on this.  

The risk is just too great.

January 2024

Categories: Abortion