Mifepristone

Description

Mifepristone is a synthetic steroid used for the termination of an early pregnancy. It is also used for the management of high blood sugar levels in people with people with high level of cortisol for a prolonged duration (Cushing's syndrome).

Side effects

Major & minor side effects for Mifepristone

  • Heavy vaginal bleeding
  • Infections
  • Unusual tiredness and weakness
  • Abdominal pain and cramps
  • Uterine cramping
  • Nausea and Vomiting
  • Headache
  • Dizziness
  • Diarrhea
  • Pain in the arms and legs
  • Decreased appetite
  • Sleeplessness
  • Difficult or painful urination
  • Loss of strength
  • Difficult and painful breathing

Uses of Mifepristone

What is it prescribed for?

  • Termination of pregnancy
  • Cushing's syndrome
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Concerns

Commonly asked questions

  • Onset of action
    This medicine is rapidly absorbed into the bloodstream upon oral administration and reaches the peak levels within 1-2 hours.
  • Duration of effect
    The effect of this medicine lasts for an average duration of 7-10 days.
  • Safe with alcohol?
    Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
  • Is it habit forming?
    No habit forming tendencies were reported.
  • Usage in pregnancy?
    The use of this medicine is acceptable for medical termination of intrauterine pregnancy which is 63-70 days old. However, use of this medicine for control of elevated blood sugar levels along with elevated cortisol level is not recommended for pregnant women. It should be noted that a failed attempt to terminate pregnancy might result in severe complications.
  • Usage while breast-feeding?
    The use of this medicine should be avoided by women who are breastfeeding. However, if it becomes necessary to use this medicine then breastfeeding should be discontinued. Consult your doctor regarding the potential benefits and risks involved before taking this medicine.

Allergy

This medicine is not recommended for use if you have a known history of allergy to it or any other medicine that are classified under the category of prostaglandin analogue.

Ectopic pregnancy

This medicine is not recommended for termination of pregnancy in women who are suspected to have the fertilized egg to be present outside the uterus (Ectopic pregnancy).

Current use of intra-uterine device

This medicine is not recommended for use in women who have an intra-uterine device in place.

Chronic adrenal failure

This medicine is not recommended for use if you have a long term adrenal gland malfunction.

Corticosteroids

This medicine is not recommended for use in patients who are using Corticosteroids for serious conditions like immune system disorder.

Unexplained vaginal bleeding

This medicine is not recommended for use in women who have an active or historic case of severe and unexplained vaginal bleeding. The bleeding may be intermittent and after the menopause indicative of uterine cancer.

Other bleeding disorders

This medicine is not recommended for use in patients who have a bleeding disorder and are receiving anticoagulants for the same.

Porphyria

This medicine is not recommended for use in patients having this inherited disorder of the disease of the blood affecting the nervous system and skin (Porphyria).
Warnings for special population

Pregnancy

The use of this medicine is acceptable for medical termination of intrauterine pregnancy which is 63-70 days old. However, use of this medicine for control of elevated blood sugar levels along with elevated cortisol level is not recommended for pregnant women. It should be noted that a failed attempt to terminate pregnancy might result in severe complications.

Breast-feeding

The use of this medicine should be avoided by women who are breastfeeding. However, if it becomes necessary to use this medicine then breastfeeding should be discontinued. Consult your doctor regarding the potential benefits and risks involved before taking this medicine.
General warnings

Confirmation of pregnancy

It is recommended to undergo a clinical examination to confirm a pregnancy before this medicine is used. If the egg is situated outside the uterus (ectopic pregnancy), then the medicine may be ineffective and could cause adverse effects. The likelihood of an ectopic pregnancy is very high in women who have an intrauterine device inserted into the uterine cavity.

Use in women aged 35 or above

This medicine should be used with caution in women aged 35 or above as the risk of complications are significantly higher.

Severe vaginal bleeding

This medicine should be used with caution as it may cause severe vaginal bleeding which could be potentially fatal.

Risk of infections

This medicine should be used with caution as incidences of severe or fatal infections have been reported in some cases.

Confirmation of termination

It is recommended to visit the doctor and obtain confirmation on the termination of pregnancy after 14 days of use of Mifepristone. A clinical examination or ultrasonographic scan is recommended for the same.

Hyperglycemia not associated with Cushing's syndrome

This medicine should not be used to treat elevated blood sugar levels that are not associated with increased cortisol levels (Cushing's syndrome)

Adrenal gland insufficiency

This medicine can cause impairment of adrenal gland and hence the patient should be aptly monitored. The use of mifepristone should be discontinued if an impairment of adrenal function is detected.

Hypokalemia

This medicine should be used only after confirming the serum potassium levels of the patient. If the potassium levels are lower than normal, then it should be corrected before starting the treatment with mifepristone.

Use of glucocorticoid medicine

This medicine is not recommended for use in patients receiving life-saving glucocorticoid medication for conditions where the immune system is compromised, viz. immune deficient disorders, organ transplant etc.

Other medicine

This medicine is known to interact with a large number of other medicine that you might be using. Report the use of all medicine including supplements and herbs to the doctor to ensure safety and efficacy of use.

Missed Dose

Take the missed dose as soon as you remember if the intended use is to control elevated blood sugar levels. If it is almost time for the next scheduled dose then the missed dose should be skipped. For medical termination of pregnancy, it is a single dose therapy and hence missing a dose is not possible.

Overdose

Contact your doctor and seek immediate help if an overdose with mifepristone is suspected.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.

Instructions

Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
Interaction with Medicine

Dexamethasone

Erythromycin

Hydrocortisone

Ketoconazole

Simvastatin

Pimozide

Warfarin

Ergotamine

Disease interactions

Disease

Information not available.
Food interactions
Avoid the consumption of large quantities of grapefruit juice while taking mifepristone as it can alter the levels of this medicine in the blood.
Lab interactions
Information not available.
Take Mifepristone as prescribed by the doctor. The dosing schedule, duration, and strengths may vary depending upon the intended use of the medication. It is recommended to strictly adhere to all the instructions mentioned on the label while using this medicine to ensure safe and effective use.
Miscelleneous

Can be taken with or without food, as advised by your doctor

To be taken as instructed by doctor

May cause sleepiness

How it works
This medicine acts by blocking the effect of progesterone and helping in termination of pregnancy. It also blocks the cortisol receptors and helps in controlling high blood sugar levels in people with Cushing's syndrome.
Legal Status

Approved

Approved

Approved

Approved

Classification

Category

Progesterone receptor modulators, Uterotonic agents

Schedule

Schedule H

[Internet]. 2017 [cited 11 April 2017]. Available from:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/020687s010-lbl.pdf

[Internet]. 2017 [cited 11 April 2017]. Available from:

https://www.medicines.org.uk/emc/medicine/617

DailyMed - mifepristone tablet [Internet]. Dailymed.nlm.nih.gov. 2017 [cited 11 April 2017]. Available from:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=542f3fae-8bc8-4f00-9228-e4b66c9ad6a9

Mifepristone (Mifeprex): MedlinePlus Drug Information [Internet]. Medlineplus.gov. 2017 [cited 11 April 2017]. Available from:

https://medlineplus.gov/druginfo/meds/a600042.html

Mifepristone | C29H35NO2 - PubChem [Internet]. Pubchem.ncbi.nlm.nih.gov. 2017 [cited 11 April 2017]. Available from:

https://pubchem.ncbi.nlm.nih.gov/compound/55245#section=Top

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Information on this page was last updated on 16 Nov 2017

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