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Mifeprex is used to terminate a pregnancy that is less than 70 days old. Mifeprex is approved by the FDA and also comes in generic form as Mifepristone. The drug works in combination with Misoprostol (Cytotec).
Mifeprex causes the cervix to widen and stops the production of the hormone progesterone. When progesterone production ceases, the supply of food and oxygen to the developing fetus stops. The fetus detaches from the wall of the endometrium and is ready to leave the womb through the widened cervix.
Mifeprex drug contains inactive substances, including microcrystalline cellulose, magnesium stearate, corn starch, colloidal silica anhydrous, and it is yellow.
Mifeprex should be used with Misoprostol for effective results. First, take Mifeprex, and then wait for 2 to 3 days before taking four pills of Misoprostol (each 200 mg). Do not swallow chew, crush, or break Misoprostol pills. Instead, place them under your tongue and let them melt away.
Misoprostol causes the uterine walls to contract, thus pushing out the fetus. Since the fetus is already detached from the wall, it gets out quickly. During the process, heavy bleeding and cramping occur. It may last for hours and, rarely, days.
A medical professional should administer this medication. But self-administration is sometimes allowed.
Mifeprex can terminate a pregnancy. The standard dosage is a single pill – 200mg with a glass of water, preferably on an empty stomach. This pill should be taken within 9 weeks of pregnancy – as per the first day of amenorrhea in a 28-day cycle where ovulation occurs at mid-cycle.
Before administering this drug, the doctors should be sure that you are pregnant, as well as know the age of the pregnancy. Ultra-sonogram (USG) scan is used to determine the duration of pregnancy. Again, ectopic pregnancy must be ruled out.
Three days after consuming, Mifeprex should follow the consumption of Misoprostol 800mcg. If the abortion does not occur, the second dose of Misoprostol 400mcg should be orally administered.
The patient is advised to go for a checkup after 7 to 14 days. This is to confirm if the fetus was fully expelled. If the fetus was not expelled, there are high chances of fetal malformation. So a medical practitioner may take a USG scan or perform a clinical examination to rule out the presence of the fetus. If the fetus is present, it should be removed by surgical means.
All patients using Mifeprex must be cautious. They only should get this drug under the instructions of a doctor, which requires 3 visits:
The typical sign that Mifeprex is working is vaginal bleeding. If there is little bleeding, consult your doctor. In case any tissues remain within the uterus after taking Mifeprex, doctors may remove them through the cervix.
Tell your doctor in case you have an intrauterine device; it must be removed before taking the drug.
Contraindications exist in patients who have the following conditions:
These are not all possible contraindications. Stay in contact with your doctor just in case of any problem.
A patient taking Mifeprex might need medical emergency treatment in cases of an incomplete abortion, blood transfusions, and emergency resuscitation. This is reason enough to be in contact with a medical practitioner.
Patients with hepatic failure, renal failure, and malnutrition are advised against taking Mifeprex. Again, any consumption of this drug must be under the supervision of a certified gynecologist.
The effectiveness and safety of Mifeprex in women with chronic diseases such as hypertension, heart disease, liver dysfunction, insulin-dependent diabetes, respiratory or kidney disease, severe anemia, and heavy smoking is not known because no data exists. Similarly, women above 35 years of age who smoke need treatment with great caution.
If abortion is not successful, the fetus is at risk of developmental abnormalities according to studies carried out on animals, and evidence from human cases. As such, Patients should be cautious of the effects of Mifeprex. They should know the reason for using these drugs and the importance of gynecologists in this matter.
Always use contraceptives; there is a high chance that pregnancy might occur soon after terminating a pregnancy.
Some women might experience decreased red blood cell count, hematocrit, and hemoglobin concentration. This is an effect of vaginal bleeding.
Gastrointestinal symptoms and cramps may occur immediately after taking Misoprostol. Find drugs that can alleviate such symptoms.
Chances to terminate a pregnancy may be lower in some cases, especially when Mifeprex is administered within a day or after two days.
Misoprostol initiates abortion between 2 and 24 hours. So the patient must be in a secure place, probably under the care of someone.
Before the administration of Mifeprex and Misoprostol, the doctor considers conception date as the last menstrual period.
Few studies have been conducted to show drug interaction, so nothing is definite yet. However, possibilities exist that certain medications and substances such as ketoconazole, itraconazole, erythromycin, and grapefruit could inhibit the metabolism of Mifeprex. Similarly, dexamethasone, rifampicin, and certain anticonvulsants may induce Mifeprex metabolism.
By contrast, Misoprostol does not interfere with the effects of aspirin; i.e., it does not affect the absorption and antiplatelet effects of aspirin. Also, studies show that Misoprostol does not have any implications on several NSAIDs (ibuprofen, diclofenac, piroxicam, aspirin, naproxen, or indomethacin).
Patients on Mifeprex should not take Antacids containing magnesium, as it may worsen diarrhea caused by Misoprostol.
Before taking this medication, discuss with your doctor about all other medications you've been taking. There are some worse interaction that may be detrimental to your health. There may be some changes in Mifeprex usage if you are using any of the following medicines. Your doctor should authorize such changes.
The list of drugs below is not advised to be used together with Mifeprex though it might be required in some cases. In such cases, your doctor will suggest the best way to take the medication.
Mifeprex |
| Alfentanil | Desipramine | Hydrocodone | Norfloxacin | Sevoflurane |
| Amiodarone | Deslorelin | Hydroxychloroquine | Nortriptyline | Simeprevir |
| Anagrelide | Deutetrabenazine | Hydroxyzine | Octreotide | Siponimod |
| Aripiprazole | Digoxin | Ibutilide | Ofloxacin | Sodium Phosphate |
| Aripiprazole Lauroxil | Dihydrocodeine | Idelalisib | Olaparib | Sodium Phosphate, Dibasic |
| Arsenic Trioxide | Disopyramide | Ifosfamide | Ondansetron | Sodium Phosphate, Monobasic |
| Asenapine | Dofetilide | Iloperidone | Paliperidone | Solifenacin |
| Astemizole | Dolasetron | Imipramine | Panobinostat | Sorafenib |
| Azithromycin | Domperidone | Indinavir | Pasireotide | Sotalol |
| Benzhydrocodone | Donepezil | Inotuzumab Ozogamicin | Pazopanib | St John’s Wort |
| Boceprevir | Doxorubicin | Itraconazole | Pentazocine | Sufentanil |
| Buprenorphine | Doxorubicin Hydrochloride Liposome | Ivabradine | Phenobarbital | Sulpiride |
| Buserelin | Droperidol | Ivosidenib | Phenytoin | Sunitinib |
| Carbamazepine | Efavirenz | Lapatinib | Pimavanserin | Telaprevir |
| Ceritinib | Encorafenib | Leuprolide | Pitolisant | Telavancin |
| Chloroquine | Erythromycin | Levofloxacin | Procainamide | Telithromycin |
| Chlorpromazine | Escitalopram | Lofexidine | Prochlorperazine | Tetrabenazine |
| Cilostazol | Fingolimod | Lopinavir | Promethazine | Toremifene |
| Ciprofloxacin | Flecainide | Lumefantrine | Propafenone | Tramadol |
| Citalopram | Fluoxetine | Macimorelin | Protriptyline | Trazodone |
| Clarithromycin | Foscarnet | Mefloquine | Quetiapine | Triclabendazole |
| Clofazimine | Fosphenytoin | Meperidine | Quinine | Trifluoperazine |
| Clomipramine | Gemifloxacin | Methadone | Ranolazine | Trimipramine |
| Clozapine | Glasdegib | Metronidazole | Ribociclib | Triptorelin |
| Cobicistat | Gonadorelin | Moxifloxacin | Rifabutin | Vandetanib |
| Codeine | Goserelin | Nafarelin | Rifampin | Vardenafil |
| Colchicine | Granisetron | Naloxegol | Rifapentine | Vemurafenib |
| Conivaptan | Halofantrine | Nefazodone | Ritonavir | Vinflunine |
| Crizotinib | Haloperidol | Nelfinavir | Salmeterol | Voriconazole |
| Dabrafenib | Histrelin | Nilotinib | Sertraline | Ziprasidone |
| Zuclopenthixol |
Side effects of Misoprostol are abdominal or stomach pain, diarrhea, back pain, dizziness, headache, and nausea. Rare side effects include heavy vaginal bleeding and unusual tiredness. A woman taking Mifeprex and Misoprostol may have one or multiple side effects at a go.
Less common side effects include:
Other side effects that might occur are:
No severe side effects have been reported even with the administration of Mifeprex in a single dose higher than threefold of that advised for abortion. However, massive ingestion leads to symptoms of adrenal failure.
In cases of acute intoxication, one may require special treatment, including dexamethasone administration. Misoprostol toxic dose is not yet determined in humans. The only reported effect is gastrointestinal problems arising from a daily dosage of 1600 mcg.
Notable signs of overdosing include tremor, sedation, convulsions, breathlessness, abdominal pain, diarrhea, fever, hypotension, and bradycardia. Seek medical attention right away.
Feeling nauseated is common in some women, which may lead to vomiting. You might need an antiemetic drug to stop vomiting. But check with your doctor first.
Misoprostol pills are safe. However, they might cause gastrointestinal effects which are not serious
Store in a cool, dry place and at room temperature. The drug container should remain tightly closed when not in use. The drug container keeps the pills away from children and pets.
The chances of Mifeprex affecting a woman’s fertility are minimal. According to studies, women resume their normal menstrual flow within four weeks. This means that the woman will ovulate thus can get pregnant.
Experts advise that it should take at least a week before participating in sex.
Mostly, No. Using Mifeprex doesn’t lead to depression and anxiety at any level.
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