Mifepristone

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Generic Name of Mifepristone - Learn More

Mifepristone

Mifepristone Precaution - What You Need to Know

Before using Mifepristone, it is important for patients to consult their healthcare provider to ensure its safety and suitability for their specific condition. Key precautions include:
- Pregnancy: Mifepristone is indicated for medical abortion and is not recommended for use in ongoing pregnancies or those where the fetus is viable. It should only be used under the supervision of a healthcare provider in appropriate settings, typically during the early stages of pregnancy (up to 10 weeks gestation).
- Ectopic Pregnancy: Mifepristone should not be used in cases of ectopic pregnancy (pregnancy outside the uterus), as it will not be effective and may cause harm. Early diagnosis of ectopic pregnancy is crucial prior to using this drug.
- Adrenal Insufficiency: Patients with adrenal insufficiency or those taking Corticosteroids should use Mifepristone with caution as it may exacerbate their condition. It is necessary to monitor adrenal function and consider alternative treatments.
- Bleeding Disorders: Mifepristone can cause bleeding as part of the abortion process. Patients with bleeding disorders or those on anticoagulant therapy should exercise caution, as they may have an increased risk of excessive bleeding.
- Use of IUD or Implant: Mifepristone is contraindicated in women who have an intrauterine device (IUD) in place, as this increases the risk of infection and uterine perforation. The IUD should be removed before initiating treatment with Mifepristone.
- Chronic Conditions: Women with chronic conditions such as heart disease, renal impairment, or liver disorders should be carefully assessed before starting Mifepristone to ensure there are no contraindications for its use.

Mifepristone Indication - Uses and Benefits

Mifepristone is primarily used for:
- Medical Abortion: Mifepristone is used in combination with another drug, misoprostol, for the medical termination of early pregnancies, typically up to 70 days (10 weeks) of gestation. It works by blocking progesterone, a hormone necessary for maintaining pregnancy, causing the lining of the uterus to break down and leading to miscarriage.
- Cushing's Syndrome: Mifepristone can be used off-label for the management of Cushing’s syndrome, a condition characterized by excessive cortisol production. It is particularly used in cases where surgery is not an option or as a part of the treatment plan when other therapies are ineffective.
- Emergency Contraception: Mifepristone has also been used off-label for emergency contraception when taken within a specific timeframe after unprotected sex, although it is less commonly used for this purpose compared to other emergency contraceptive options.

Mifepristone Contraindications - Important Warnings

Mifepristone is contraindicated in the following situations:
- Confirmed or Suspected Ectopic Pregnancy: It is contraindicated for use in cases where a pregnancy is ectopic (outside the uterus), as it will not terminate the pregnancy and can lead to severe complications such as rupture or hemorrhage.
- Allergic Reactions: Mifepristone should not be used in patients with a known hypersensitivity or allergic reaction to the drug.
- Uncontrolled Chronic Disease: It is contraindicated in patients with uncontrolled adrenal insufficiency, severe asthma, severe liver disease, or other uncontrolled chronic conditions, as it can exacerbate these conditions.
- Placenta Previa or Uterine Abnormalities: Mifepristone should not be used in women with placenta previa, fibroids, or other structural uterine abnormalities that may increase the risk of severe bleeding or injury during the abortion process.
- Hemorrhagic Disorders: Mifepristone is contraindicated in individuals with active bleeding disorders such as hemophilia, or those using anticoagulant medications, due to the increased risk of excessive bleeding.
- IUD in Place: Mifepristone should not be used in women with an intrauterine device (IUD) because the device must be removed before starting treatment.

Mifepristone Side Effects - What to Expect

Common and severe side effects associated with Mifepristone include:
- Bleeding: Mifepristone can cause heavy bleeding, especially during the abortion process, which can last for several days or even weeks. In some cases, this bleeding may require medical intervention if it becomes excessive or prolonged.
- Abdominal Pain or Cramping: Many patients experience abdominal pain or cramping as the uterus contracts to expel the pregnancy. These symptoms can be managed with over-the-counter pain relievers but should be monitored for severity.
- Nausea and Vomiting: Mifepristone can cause nausea, vomiting, and diarrhea, particularly when combined with misoprostol for medical abortion.
- Fatigue and Dizziness: These are common effects due to the hormonal changes and the physical process of abortion. Patients may experience tiredness and dizziness, which typically resolve after the procedure is completed.
- Infection: As with any procedure involving the uterus, there is a risk of infection if there is retained tissue or failure to complete the abortion. Fever, chills, or unusual discharge should be reported immediately.
- Severe Bleeding: Excessive bleeding (more than 2 pads per hour for several consecutive hours) may indicate a complication that requires urgent medical attention.

Mifepristone Pregnancy Category ID - Safety Information

5

Mifepristone Mode of Action - How It Works

Mifepristone is a progesterone antagonist and its mechanism of action involves:
- Progesterone Receptor Blockade: Mifepristone works by blocking the action of progesterone, a hormone necessary for maintaining pregnancy. By binding to the progesterone receptors in the uterus, it prevents the lining from supporting the pregnancy.
- Uterine Contractions: The inhibition of progesterone also promotes uterine contractions, which are necessary to expel the pregnancy from the uterus.
- Cervical Softening: Mifepristone can cause the cervix to soften and dilate, making it easier for the pregnancy tissue to be expelled when combined with misoprostol.

Mifepristone Drug Interactions - What to Avoid

Mifepristone has several potential drug interactions that should be considered:
- CYP3A4 Inhibitors: Mifepristone is metabolized by the CYP3A4 enzyme, and medications that inhibit this enzyme (e.g., ketoconazole, itraconazole, clarithromycin) may increase Mifepristone levels, increasing the risk of side effects. Lower doses may be required when using these drugs in combination.
- CYP3A4 Inducers: Drugs that induce CYP3A4 (e.g., rifampin, phenytoin, carbamazepine) can reduce the effectiveness of Mifepristone, potentially necessitating higher doses or alternative treatments.
- Warfarin: There is a risk that Mifepristone could alter the metabolism of warfarin, potentially increasing the risk of bleeding. Monitoring of the International Normalized Ratio (INR) is advised during concurrent use.
- Anticoagulants: The use of Mifepristone with anticoagulants (e.g., heparin, warfarin) may increase the risk of bleeding. Close monitoring for signs of excessive bleeding is necessary.
- Other Progestins: Mifepristone should not be used in combination with other progestins or hormonal treatments that may interfere with its action in terminating pregnancy.

Mifepristone Adult Dose - Recommended Dosage

The recommended dose for adults (for medical abortion) is as follows:
- Medical Abortion: The typical dose of Mifepristone is 200 mg taken orally once, followed by misoprostol (usually 800 mcg) 24–48 hours later. A follow-up visit is typically scheduled within 7–14 days to confirm the abortion's success.
- Cushing's Syndrome: For Cushing’s syndrome, the usual starting dose is 300 mg daily; the dose can be increased up to 1200 mg per day depending on the patient's response.

Mifepristone Child Dose - Dosage for Children

Mifepristone is not recommended for use in children, as it is indicated primarily for adult women in specific medical contexts (e.g., medical abortion). There is insufficient safety and efficacy data for pediatric populations. If there is any need for use in younger patients, it should be done under strict medical guidance and supervision.

Before using Mifepristone, patients should always consult a healthcare provider to assess its appropriateness for their individual condition, particularly in pregnancy-related situations.

Mifepristone Renal Dose - Dosage for Kidney Conditions

Mifepristone does not require any specific dose adjustments for patients with renal impairment. However, caution should be exercised, and the drug should be used under medical supervision, as renal function may affect the metabolism and elimination of the drug.