PFLI note: The following is an email exchange between PFLI president Karen Brauer, RPh, MS and Washington Post reporter Rob Stein. Private information has been removed but otherwise this is a faithful representation of the exchange.
Subject: Ulipristal Re: Washington Post query
Date: Tue, 01 Jun 2010 18:16:18 -0400
To: Rob Stein
The mechanism of action of ellaOne® (generic name: ulipristal), is much more like that of mifepristone (trade name: Mifeprex®; experimental name: RU 486). At this time there are conflicting stories concerning how it would operate as a morning after pill, but the fact that it works for FIVE days after intercourse, and the efficacy does not seem to degrade with increase in time after intercourse, means that it's pretty obvious. This one is more prominently an abortifacient than the morning after pill.
Fewer health care entities will be able to pretend that this one is not working by post fertilization effects. (Many apologists explain away this portion of the mechanism of Plan B by citing its extreme unreliability/ineffectiveness)
Ulipristal is seen as being not much more effective than Plan B One-step. There might be a claim in the future for ulipristal, as has been seen with levonorgestrel in Plan B.
For the time being, the studies show a dose dependent inhibition of ovulation as well as fetocidal effects. In animal studies-- as the dose is increased (well ABOVE the dose planned for administration as a "morning after" pill) ovulation can be inhibited, as well as fetuses killed.
It's all in the CHMP Assessment Report.
For pharmacists, it's more of the same, only with a more easily recognizable and more prominent interceptive/abortifacient effect than the hormonal birth control modalities. With this drug, it will be more possible to accumulate doses and accomplish actual over the counter (OTC) abortions of already implanted human embryos. More pharmacists will think about refusing this drug as it might take longer for the apologists to excuse away the post fertilization mechanisms. Also they might recognize the high potential for off label use for later abortions
There are already telemed abortions occurring in Iowa, and mifepristone is available on the black market all over the world.
Ulipristal is not a major shock wave to those who knew that mifepristone itself was already being used as a morning after pill in other countries. It is more of a shock to those who are just learning about these issues.
In combination with the policies of government controlled health care, it will help to reduce the availability of legitimate health care overall.
With the telemed abortions and the introduction of this drug, the United States abortion industry will have gone full circle, from pretending to prevent unsafe, do-it-yourself abortion, to being the obvious facilitators of the very same thing.
Karen L Brauer MS, RPh
Pharmacists for Life International
PS...Karen responded to further questions by Mr Stein:
KB: This is really just more of the same, but with some additional pharmacists coming on board to the prolife side.
The video evidence as well as attendance at gatherings show a more conservative base coming up from high school and college age kids, and many of them are to the right of me, so I expect more career shifting and dissent based upon the push to make pharmacists dispense unethically.
KB: The unfortunate thing is that their demand for health care professionals to behave as slaves, and not as humans with rights of conscience will degrade the quality of health care for everyone else.
The conscience drives the health care practitioner towards assiduous care of the patients, and excellence in practice.
Having practiced in retail, nursing home, and hospital pharmacy, and having had countless opportunities to correct potentially fatal errors in all those settings, I understand that health care without pharmacists will be severely degraded in quality. To insist that pharmacists fill all prescriptions is denial of the need for their most important job functions to correct malpractice and errors in prescribing.
Natural selection might take care of this denial problem eventually.
Linked below is the January 2010 blurb on ellaOne on my personal (amateur) news blog.
Rob Stein wrote:
I'm working on a story about a drug company that is trying to get a new drug approved for use as an emergency contraceptive. It's called ulipristal. I was wondering what your thoughts might be able what the approval of this drug might mean for pharmacists.
The Washington Post
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