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As tensions run high in the abortion debate following the leak of Supreme Court draft opinion on overturning Roe v. Wade, the conversation is fueling some misleading and unevidenced narratives.
One argument that has resurfaced in this context concerns the usage of abortion drug misoprostol.
Some social media users have claimed that the drug, which has had US approval on human use for more than two decades, has also been used as an anti-ulcer medicine for horses.
WASHINGTON, DC – MAY 04: Abortion advocates demonstrate in front of the US Supreme Court Building on May 04, 2022 in Washington, DC. Demonstrations across the country continue as abortion and anti-abortion advocates react to the leaked initial draft majority opinion which indicated the US Supreme Court would overturn two abortion related, which would end federal protection of abortion rights.
Anna Moneymaker/Getty Images
Its dual use status has led to parallels being drawn with another drug used on horses: Ivermectin.
Ivermectin, used to treat parasites, was hailed by some as a “miracle” COVID-19 treatment for humans, despite no regulatory approval or definitive evidence to support the claim.
Its lack of regulatory approval has subsequently been criticized by a number of conservative figures, including Rep. Marjorie Taylor-Greene (R-GA), Sen. Rand Paul (R-KY), and Glenn Beck.
Now, in the wake of the Roe v. Wade SCOTUS leak, some commentators are comparing the two drugs and the narratives surrounding them.
In May 2022, several conservative commentators tweeted an article by VICE explaining how to create abortion pills at home.
The article, published earlier that month, discusses how misoprostol is used to treat ulcers in horses, claiming the drug would be “relatively easy to acquire from veterinary sources” in the form of a powder.
On this point, VICE comments on the similarity between acquiring misoprostol from “veterinary sources” and how ivermectin was purchased during the pandemic.
While the article affirms that ivermectin is ineffective as a treatment for COVID-19, right-wing figures on Twitter have drawn a critical comparison between the two medicines.
I’m old enough to remember when medication that’s also used on horses was bad. Apparently horse medication is only bad when used to save a life but it’s totally fine when used to and one!
Anarchist Collective Shares Instructions to Make DIY Abortion Pills https://t.co/sNVZNbdzVM
— Donald Trump Jr. (@DonaldJTrumpJr) May 4, 2022
Posts on other social media, including one on Reddit that gained more than a thousand interactions, doctors claimed were “recommending taking horse medication for self abortions.”
Misoprostol has been used since the 1970s to treat ulcers in humans. When it was first developed, its side effects on the pregnant uterus were already known.
In 2000, the US Food and Drug Administration (FDA) approved its use as part of an abortion medication regime first developed by French researchers during the 1980s.
One of its current FDA entries (which can be found here) shows it is used alongside another drug, mifeprex, to end a pregnancy through 70 days gestation (70 days or less since the first day of a woman’s last menstrual period).
The drug regimen is a prescription-only, non-surgical termination method that the British Pregnancy Advisory Service describes as “very safe” with “considerably” fewer risks than continuing a pregnancy to term.
It can also be used to prevent ulcers caused by certain arthritis or pain medicines. A National Library of Medicine webpage states it should not be used to prevent ulcers in pregnant patients, as it may cause “miscarriages, premature labor, or birth defects.”
While it can indeed be used to treat ulceration in horses, its use is only approved as “off label” (a legally-approved method of using a drug in a way not listed on its label).
So, the drug is used in human abortions and, while it can be used on horses, that usage is not its primary purpose and is not listed on its drug label.
There are other aspects to the two medicines that make such comparisons misleading.
Ivermectin is approved by the FDA to treat people with “intestinal strongyloidiasis and onchocerciasis, two conditions caused by parasitic worms.” It can be used in a topical form (ie applied to the surface of the body) to treat external parasites and skin conditions.
The regulator has also approved some forms of animal ivermectin to prevent heartworm disease and certain parasites, including in horses. But it has not been approved as a COVID treatment.
Suggestions the drug could treat COVID surfaced in March 2020, when Australian scientists discovered it could be used to combat SARS-CoV-2 (the virus that causes COVID-19) in cells in a laboratory setting.
The university said further research was needed to determine a correct human dosage, and it should not be used in humans for COVID until further clinical testing was completed.
More recent evidence however puts the initial findings in question. A study published in The New England Journal of Medicine in March 2022, tracking 1,300 people in Brazil who contracted COVID, found that those treated with ivermectin were no less likely to be hospitalized than those who received a placebo.
Nonetheless, the notion of ivermectin as a “COVID cure” has been weaponized by anti-lockdown and vaccine-skeptic commentators throughout the pandemic.
Podcaster Joe Rogan claimed in September 2021 that it helped cure his own case of COVID.
In November 2021, Rep. Taylor Greene accused doctors who refused to recommend ivermectin to COVID patients as taking part in “politics that is killing people.”
In August the same year, Sen. Paul claimed that “hatred for Trump” was preventing research into the use of ivermectin as a COVID drug.
The FDA has not approved the use of the drug as a safe and effective treatment for COVID. The regulator has been clear in his instructions to discourage the use of ivermectin for such cases.
A spokesman for the FDA Newsweek: “Currently, FDA has not authorized or told approved ivermectin for use in preventing or treating COVID-19 in humans. To date, published clinical trials have shown mixed results.
“Additional clinical trials assessing ivermectin tablets for the prevention or treatment of COVID-19 are ongoing.”
Despite the FDA’s warnings, its past mockery of ivermectin advocates on social media appears to have now been seized on by anti-abortion commentators, keen to suggest the FDA-approved misoprostol represents a double standard or a lack of impartiality in drug regulation.
But these comments lack important context: Misoprostol has been approved for many years primarily as a drug used in medical abortions, but used “off-label” to treat ulceration in horses. By contrast, while ivermectin has been approved in animal (and some human) uses, it is not approved for the treatment of COVID-19 in humans due to a lack of evidence.
Doctors do not prescribe horse medicine for abortions. Misoprostol has been approved as an abortion drug since 2000. Its use in horses is only sanctioned “off label,” meaning it is not officially approved as such. By contrast ivermectin, which some people misleadingly compared it to, is approved as a medicine that can be used on horses, but is not approved as a COVID drug.
FACT CHECK BY NEWSWEEK