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5th Circuit Reinstates In-Person Dispensing Requirement for Mifepristone
The 5th U.S. Circuit Court of Appeals issued a unanimous ruling temporarily blocking the mailing of mifepristone prescriptions nationwide. Danco Laboratories filed an emergency application with the Supreme Court to lift the restriction. The decision reinstates in-person dispensing requirements, overriding 2023 FDA guidelines.
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A three-judge panel of the U.S. Court of Appeals for the 5th Circuit issued a unanimous ruling on Friday, May 2, 2026, that temporarily blocks nationwide distribution of mifepristone by mail and reinstates the requirement that the drug be dispensed in person. The order responds to a challenge brought by the state of Louisiana.
Danco Laboratories, which manufactures the brand-name version of mifepristone, filed an emergency application with the Supreme Court on Saturday, May 3, 2026, asking the justices to lift the 5th Circuit’s order. The application was directed to Justice Samuel Alito.
The 5th Circuit’s ruling reinstates the in-person dispensing requirement that the FDA had eliminated in 2023 under the Biden administration. That change had permitted telehealth consultations and mail-order distribution. According to the court’s order, the panel agreed with Louisiana’s position that the 2023 FDA guidelines facilitate nearly 1,000 illegal abortions per month in the state.
The FDA is conducting an ongoing safety review of mifepristone at the direction of the Trump administration. Nearly two dozen Republican attorneys general requested that review in 2025. Earlier in 2026 the Trump administration asked a district court judge to pause Louisiana’s challenge pending completion of the FDA review.
The district court granted that request and denied Louisiana’s motion to immediately reinstate the in-person requirement.
In its Supreme Court filing, Danco Laboratories stated that the 5th Circuit’s ruling “causes immediate confusion and dramatic upheaval for manufacturers, distributors, providers, pharmacies, and patients.” The company also argued that Louisiana is not directly impacted by the FDA’s approval of mifepristone and therefore lacks standing to bring the case.
Mifepristone was approved by the FDA in 2000. The second drug in the two-drug medication abortion regimen, misoprostol, is not affected by the 5th Circuit’s order. GenBioPro, which manufactures a generic version of mifepristone, is also a defendant in the litigation.
