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Mifepristone is also known as RU 486. It is used to cause an abortion during the early part of pregnancy. Mifepristone is used up to week ten of pregnancy that is up to 70 days after the first day of the last menstrual period. It blocks the action of progesterone which is needed for the pregnancy to continue.
Mifepristone is an effective medication which is used to soften the cervix and make contraceptives work better. It is a combination that ensures that pregnancy is terminated. This medication is utilized to terminate a pregnancy if it is undesirable or medically unjustified. A doctor can prescribe or use this medication if the baby has died in the womb. Mifepristone can also be used to make a curettage i.e. the removal of an embryo with a vacuum pump. (1) This medication makes abortion less painful than the usual experience. This combination is more than 95 percent effective during the first 49 days of pregnancy. A woman can verify the effect of Mifepristone two weeks after its use. It is also known as 'Korlym'. Mifepristone blocks the actions of a hormone which is called Cortisol. This medicine can reduce certain side effects caused by excess cortisol in the body. It is helpful in treating high blood sugar i.e. hyperglycemia in adults. This medication also helps in treating Cushing Syndrome. (2) This medicine is on the World Health Organization's List of Essential Medicines i.e. the most effective and safe medicines needed in a health system. (3)
In this article you will get to know about:
- Why is Mifepristone prescribed?
- What are the symptoms of Mifepristone?
- How should Mifepristone medicine be used?
- What are the precautions to be followed before Mifepristone use?
- What are the precautions to be followed after Mifepristone use?
- What are the side effects of Mifepristone?
- What is the dosage of Mifepristone?
- What is the composition of Mifepristone?
- What are the Interactions of Mifepristone with Other Medicines
Mifepristone is used in combination with another popular medicine misoprostol to abort an early pregnancy.Early pregnancy means it has been 70 days or less since the last menstrual period began in the concerned woman. Mifepristone is considered in a class of medications i.e. called anti progestational steroids. It works by blocking the activity of progesterone which is one of the crucial hormones that prepares the human body to help it continue the pregnancy. This medication is also available as another product i.e. Korlym. Korlym is helpful in controlling hyperglycemia in individuals with a specific type of Cushing's syndrome. In this syndrome, the body builds a high amount of the hormone cortisol. This combination helps an unwanted pregnancy is growing. Mifepristone is also prescribed by medical experts to avoid unwanted pregnancies in most of the cases.
The Food and Drug Administration has placed various restrictions on the use of Mifepristone in the case of women in different stages of life. Women can only use the drug for abortions within the first seven weeks after their last menstrual period. The doctors who recommend abortion pills must be able to accurately determine the duration of pregnancy and to diagnose a tubal pregnancy, which cannot be terminated with the drugs.
Mifepristone is available only from a certified healthcare provider under a special program. It is used together with misoprostol to end an early pregnancy. Treatment with Mifepristone and misoprostol requires at least 2 visits to the patient's doctor. Taking this medicine without any consultation of a doctor can cause multiple side effects on the individual consuming it. Women should take the proper dosage of this medicine to have an effective and positive impact on their body. It is advisable to take care of below-mentioned symptoms before and after taking medicine.
- After taking Mifepristone medicine, most of the women do not have any visible symptoms. If someone experience bleeding after taking Mifepristone, it is still very necessary to use Misoprostol in order for the medication to work at the desired rate.
- It is observed that after using misoprostol, cramping, and bleeding is experienced by a woman. Some woman has experienced blood clots as well. It is not specifically proved when bleeding and pain will start. It could start soon after the use of Misoprostol or else after a few hours of taking medicine.
A woman experiences the bleeding same as she has at the time of her menstrual periods. The abortion takes about two weeks to take place in a woman. This means that a woman can continue to bleed on and off for some days or even weeks after using abortion pills. Each woman has a different experience at the time of the abortion. The symptoms vary from woman to woman according to their physique and complexity of their medical case. Therefore, women should not compare their experience with the medication with some other patient.
Mifepristone is a tablet which is prescribed by a doctor when a patient is undergoing an abortion. A patient is required to take this medication once on the first day of the dose as per the prescription. After taking the medicine within 24 to 48 hours a patient will require to have four tablets of misoprostol. Two tablets of this medication are needed to be placed between the gum and the cheek. Every patient is required to keep the medicine for 30 minutes in this particular location. After completion of 30 minutes, a patient can swallow the remaining part of the medicine with or another liquid. A patient must take this medicine at home or a stable location because Mifepristone causes vaginal bleeding, cramps, nausea, and diarrhea. The effect of Mifepristone usually begins within 2 to 24 hours after consuming it. The effects can also begin within 2 hours after taking Mifepristone. Vaginal bleeding or spotting generally remains for 9 to 16 days but it can last for 30 days or longer. One person should go back to her doctor after 7 to 14 days of taking Mifepristone for an ultrasound. This examination is important to confirm that the pregnancy has ended.
Mifepristone is also utilized to end pregnancies when more than 70 days have passed since the last menstrual period. It can be used as an emergency contraceptive after having unprotected sexual intercourse. Mifepristone is also prescribed to the patients having endometriosis, fibroids or even at the time of. (4)Every patient must know that it is possible to conceive after taking Mifepristone. A patient should always return to her doctor for follow up appointment so that next pregnancies turn out to be healthy ones. It will also ensure that the pregnancy has ended after taking Mifepristone. If in case a woman is still pregnant after taking Mifepristone then there is a chance that the baby may be born with some birth defects. If the pregnancy is not ended successfully then the doctor will discuss other options to be considered in her medical case. A doctor can also recommend a woman to take another dose of Misoprostol or else to have surgery to end the pregnancy. If a patient takes a repeat dose of misoprostol then she must go for a follow-up visit with your doctor in 7 days after that dose to be sure that your pregnancy has ended.
Mifepristone is not recommended in case of certain medical conditions or other problems. Before using this medicine, a woman should consult her doctor if she has any of the following conditions:
- Undiagnosed abdominal growth
- Adrenal gland problem that is a chronic adrenal failure
- Heavy bleeding
- Blood disorder (inherited porphyries)
- Intrauterine Device (IUD) in place
- Pregnancy longer than 10 weeks
- Having an ectopic pregnancy
- A woman should avoid taking Mifepristone if she cannot visit her doctor in the next 7 to14 days. This is because it is necessary to visit a doctor after taking Mifepristone.
- A woman should avoid taking Mifepristone if she is unable to get emergency help in the two weeks after taking Mifepristone.
- If an Intrauterine Device (IUD) is inserted in the past, it should be removed before Mifepristone treatment begins. This will help in resulting in the successful treatment with Mifepristone.
A patient should tell every detail related to her health to her doctor before she is prescribed for Mifepristone. Consulting to your doctor regarding your allergies to medicine or about any other medicine plays an important role in a result-oriented treatment. It is important to discuss some of the vital details with your doctor before having Mifepristone because it might contain inactive ingredients, which can cause allergic reactions to your body. Various precautions to be taken by the patients are:
- Talk to your doctor about your allergies i.e. hives, rash, itching, swelling or difficulty in breathing to Mifepristone or any ingredient present in Mifepristone tablet. Ask your pharmacist or check the medication guide for the list of the ingredients used in Mifepristone. This will help you and your doctor to decide whether to consume the medication or not.
- Consult your doctor if you are taking corticosteroids like Budesonide, Hydrocortisone, Prednisolone, and Triamcinolone. This is because it can be dangerous for a woman to take Mifepristone if she is consuming corticosteroids at the same point in time. Your doctor may probably recommend you not to take Mifepristone in such cases.
- Inform your doctor if you are taking other prescribed or non prescribed medications, vitamins, and nutritional supplements. A patient should surely mention the name of the medications she is taking. If in case, a woman is taking Benzodiazepines, Calcium channel blockers, Diazepam, Carbamazepine, and cholesterol-lowering medications. A doctor may need to change the doses of your medications or monitor the patient carefully for any of the possible side effects.
- A patient must inform the doctor regarding current consumption of herbal products. It is necessary for a patient to inform her doctor if she is on breastfeeding.
- Every patient should discuss her previous pregnancies. She must consult if she ever had an ectopic pregnancy. This will help the doctor to advise her with the best possible treatment.
- She must tell her doctor if she ever had an Intrauterine Device (IUD) inserted into herself in the past. It is necessary to be removed before taking Mifepristone. This will ensure that medicine works efficiently.
There are multiple precautions which need to be taken after Mifepristone:
- Usually, it is prescribed that a person who has taken Mifepristone must not drive. Driving can because of some side effects on his body. A woman should talk about all the positive as well as the negative impact of medicine before consuming it.
- If in case a woman becomes pregnant after ending a pregnancy with Mifepristone even before the periods return then a woman should start using birth control pills before she starts having intercourse again.
Nearly all women who are using or are prescribed Mifepristone medicine experience multiple side effects. These side effects include abdominal pain, uterine cramping, and vaginal bleeding or spotting for an average of 9 to 16 days. However, up to 8 percent of women experience some types of bleeding for almost 30 days or more. Every patient should remember that their doctor has prescribed this medication because he or she has judged that the medicine is beneficial to you. The doctor is sure that the benefit is greater than the risk of side effects in your medical care. However, many patients using this medication do not face any serious side effects.
- A patient may feel nausea, vomiting, weakness, diarrhea, or dizziness. If in case any of these side effects of Mifepristone persist longer than the first 24 hours then the patient must seek immediate medical attention.
- It is expected to have some bleeding and cramping during this treatment. Generally, these symptoms prove that drugs are working efficiently. However, in some cases, a patient can conceive even if she is experiencing bleeding or cramping. Therefore, every patient must return for follow-up by visiting her doctor.
- Nausea and cramping may get worse after taking second drug i.e. Misoprostol. In this case, the doctor may direct you to take other medication to help with these types of symptoms. A patient should discuss all the negative and positive impact of this medicine before use. So that they may not get any side effects from it.
- Bleeding and spotting may last up to 30 days as stated above. It may be much heavier when compared to the usual menstrual period. In very few cases, the bleeding will need to be stopped by surgery. The patient must visit her doctor immediately if she experiences heavy bleeding. (5)
- A patient may have a high fever of 100.4 degrees F (38 degrees C) or higher as a side effect of Mifepristone. A woman can also experience fainting, fast heartbeat, stomach, and abdominal pain. (6)
- The patient whosoever consume Mifepristone can have some very serious allergic reaction. This type of allergic reaction is although very rare. However, the patient can seek medical attention if she notices any of the symptoms of a serious allergic reaction. (7)
The dosage of Mifepristone depends on the age of the patient. The intake of Mifepristone and Misoprostol is for the termination of pregnancy that requires three office visits by a pregnant woman. Mifepristone should be prescribed only by specialists. It may be administered only in a clinic, medical office, or hospital, by or under the supervision of a physician. (8)
- Day One: Mifepristone Administration
A physician recommends that three tablets of Mifepristone 200 mg tablets (600 mg) are taken in a single oral dose.
- Day Three: Dosage of Misoprostol
The patient is required to return to the healthcare provider after two days of consuming Mifepristone. If the abortion has occurred and it is confirmed by ultrasonographic scan then the patient needs to take two 200 µg tablets (400 µg) of Misoprostol orally. The doctor also discusses the measures to be taken if any significant discomfort, excessive bleeding, or other adverse reactions occur after the intake of the medication.
- Day 14: Post-Treatment Examination
Patients are required to return for a follow-up visit approximately after 14 days of the dosage of Mifepristone tablet. This visit is very important to confirm that the complete termination of pregnancy has occurred or not.
Mifepristone tablets contain 200 mg of Mifepristone which is a synthetic steroid along with anti progestational effects. These tablets are light yellow in color, cylindrical in shape, and biconvex. Mifepristone is considered for oral administration only. Mifepristone tablet includes certain inactive ingredients colloidal silica anhydrous, corn starch, povidone, magnesium stearate, and microcrystalline cellulose.
Mifepristone is basically a replacement of 19-nor steroid compound that is chemically designated as 11ß-[p-(Dimethylamino)phenyl]-17ß-hydroxy-17-(1-propynyl)estra-4,9-dien-3-one. The molecular weight of Mifepristone is 429.6 and it has a melting point of 191-196°C. This medication is completely soluble in methanol, chloroform, and acetone and feebly soluble in water, isopropyl ether and hexane. (9)
There is no specific information provided by the researchers about the interaction of certain drugs or food with Mifepristone. However, it is possible that ketoconazole, erythromycin, grapefruit juice, and itraconazole may inhibit its metabolism which results in increased serum levels of Mifepristone. It is possible on the basis of this medicine's metabolism by CYP 3A4. Furthermore, dexamethasone, rifampin, and certain anticonvulsants like phenytoin, Phenobarbital, carbamazepine may induce Mifepristone metabolism which will lower serum levels of Mifepristone.
Based on research, the co-administration of Mifepristone leads to an increase in serum levels of these drugs. Because of the slow elimination of Mifepristone from the body, these interactions can be observed for a prolonged period after the administration of this medicine. Therefore, a woman should be cautious when Mifepristone is administered with drugs i.e. CYP 3A4 substrates. It has a narrow therapeutic range, together with some agents used during general anesthesia effectively in the respective patient's case.
Interaction with Alcohol:
Interaction of Mifepristone with alcohol is unknown. The top medical experts ask patients to consult a medical specialist before the consumption of this medication. Consuming Mifepristone with alcohol can have adverse effects on your body. It is better to avoid caffeine or alcohol during the consumption of Mifepristone. Alcohol can impact the function of the medication in an unnecessary manner.
Avoid the consumption of large quantities of grapefruit juice while taking Mifepristone. This is due to the reason that the consumption of grapefruit juice can alter the levels of this medicine in the blood. (10)
Thus, Mifepristone is an effective medication to deal with an unwanted pregnancy. But its uses can also lead to many side effects as well. So, it would be great to use it with caution and under the complete guidance of a pharmacist or physician. For having this medication, it would be advisable to read the article and then proceed with the best-prescribed dose of medication. Keep reading more such articles on OVO Fertility blog related to infertility issues, and information about required medications. Patients can take the assistance of OVO fertility experts to find the best infertility treatment for their respective case. Most of the patients need to understand that infertility procedures take a certain time period for the execution of the same. You can also consult OVO Fertility for any discussion or query related to any infertility issue or contact us at +918268260808 for the best solution of your case.
SOURCES AND REFERENCES:
- ^ Mifepriston | Apotheek Apotheek.nl, 10 June 2019
- ^ What Is Mifepristone | drugs Drugs.com, 10 June 2019
- ^ Know More about Mifepristone | Wikipedia En.wikipedia.org, 10 June 2019
- ^ Why Is Mifepristone Prescribed | Medline Plus Medlineplus.gov, 10 June 2019
- ^ Mifepristone Tablet | WebMD Webmd.com, 10 June 2019
- ^ Mifegyne | EMC Medicines.org.uk, 10 June 2019
- ^ What Is the Abortion Pill? Carafem.org, 10 June 2019
- ^ MIFEPREX RU486 | RxList Rxlist.com, 10 June 2019
- ^ Mifepristone | Pub C hem Pubchem.ncbi.nlm.nih.gov, 10 June 2019
- ^ KORLYM - Mifepristone Tablet Dailymed.nlm.nih.gov, 10 June 2019
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