5th Circuit Blocks Mail-Order Mifepristone; Manufacturer Appeals to Supreme Court

U.S. Circuit Court of Appeals issued a unanimous ruling on Friday, May 2, 2026, temporarily blocking the mailing of mifepristone prescriptions nationwide. Danco Laboratories filed an emergency application with the Supreme Court on Saturday, May 3, 2026, to lift the 5th Circuit's ruling prohibiting mail-order distribution of mifepristone.

The 5th Circuit's ruling reinstates a requirement for in-person dispensing of mifepristone, overruling 2023 FDA guidelines that allowed telehealth and mail distribution. The ruling was issued by a three-judge panel in response to a challenge from the state of Louisiana.

The order takes effect immediately and temporarily blocks 2023 FDA guidelines from the Biden administration that eased access to mifepristone.

Danco Laboratories argued in its Supreme Court filing that the 5th Circuit's ruling causes immediate confusion and dramatic upheaval for manufacturers, distributors, providers, pharmacies, and patients. The 5th Circuit ruling agreed with Louisiana that the FDA's looser rule facilitates nearly 1,000 illegal abortions in Louisiana per month.

The FDA is conducting an ongoing safety review of mifepristone at the direction of the Trump administration.

The emergency application to the Supreme Court was filed with Justice Samuel Alito, who is likely to refer it to the full court. Danco Laboratories argued in its filing that Louisiana is not directly impacted by the FDA's approval of mifepristone and should not be able to bring the case.

The Supreme Court unanimously rejected a similar legal challenge to mifepristone two years ago, in 2024, concluding that the doctors and anti-abortion groups lacked standing.

The current legal challenge to mifepristone was brought by the state of Louisiana. Nearly two dozen Republican attorneys general requested an FDA review of mifepristone's safety last year, in 2025. The Trump administration petitioned a judge earlier this year, in 2026, to pause Louisiana’s challenge until the FDA review is complete.

The district court judge granted the Trump administration's request to pause the case and denied Louisiana’s request to reinstate in-person requirements. S. S.

The in-person dispensing requirement for mifepristone was eliminated in 2023 when the Biden administration finalized rules ending it. The Supreme Court upheld access to mifepristone in 2024 in a separate case, ruling unanimously that anti-abortion doctors lacked standing. Missouri, Kansas, and Idaho have taken up the 2024 case to restrict mifepristone.

Texas and Florida are involved in another lawsuit asking for mifepristone to be taken off the market entirely. Mifepristone was approved by the FDA in 2000. S. abortions now use pills, according to surveys.

About 1 in 4 abortions nationally are prescribed via telehealth, according to a survey of abortion providers last year, in 2025. GenBioPro manufactures a generic form of mifepristone and is a defendant in the case. Misoprostol, the second drug in the two-step regimen for medication abortion, is not affected by the ruling.

Danco Laboratories is based in Delaware.