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Mifeprex
Mifeprex, the brand name for mifepristone, is a medication used to terminate early pregnancies (up to 10 weeks of gestation). It works by blocking the action of progesterone, a hormone necessary to maintain pregnancy. Mifeprex is usually followed by misoprostol, which helps expel the pregnancy tissue by inducing uterine contractions. Mifeprex is commonly used as part of a two-step medical abortion process.
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Frequently Asked Questions
How long does it take for Mifeprex to work?
Mifeprex begins working within 24-48 hours of taking the misoprostol. Cramping and bleeding typically start within hours of taking misoprostol.
Can Mifeprex be used for pregnancies beyond 10 weeks?
No, Mifeprex is approved for pregnancies up to 10 weeks. For pregnancies beyond 10 weeks, other options such as surgical abortion may be recommended.
What should I do if I miss a dose of misoprostol?
If you forget to take misoprostol after Mifeprex, take it as soon as you remember, following your healthcare provider's instructions.
Is Mifeprex reversible?
Once mifepristone (Mifeprex) is taken, it starts blocking progesterone. It is difficult to reverse its effects, so if you have concerns, speak to your healthcare provider immediately.
What should I do if I experience heavy bleeding?
If you experience heavy bleeding (soaking more than two pads per hour for 2 hours), contact your healthcare provider immediately, as this may require medical attention.
Comprehensive Drug Guide
How Does Mifeprex Work?
Mifeprex (mifepristone) works by blocking progesterone, a hormone that is crucial for maintaining the uterine lining during pregnancy. By preventing progesterone from binding to its receptors, Mifeprex causes the breakdown of the uterine lining, which leads to the detachment of the pregnancy. It is typically followed by misoprostol, which stimulates uterine contractions to expel the pregnancy tissue.
Common Dosages
- 200 mg tablets
Typical Dosing
- The typical dosing regimen for medical abortion is:
- 200 mg Mifeprex (one tablet) taken orally, followed 24 to 48 hours later by 800 mcg misoprostol (either buccally or vaginally) to complete the abortion.
- Follow-up with a healthcare provider is usually recommended 7 to 14 days after taking the medication to ensure the process is complete.
Typical Dosing
FDA Approved Indications
- Termination of early pregnancy (up to 10 weeks gestation) in combination with misoprostol.
Who Shouldn't Take Mifeprex?
- Ectopic pregnancy (pregnancy outside the uterus).
- Chronic adrenal failure.
- Uncontrolled asthma.
- Long-term corticosteroid therapy.
- Known hypersensitivity to mifepristone or any of its components.
Advice From The Pharmacist
- Follow the dosing schedule carefully, taking the 200 mg tablet of Mifeprex first, followed by misoprostol after 24-48 hours as directed by your healthcare provider.
- Cramping and bleeding are expected after taking misoprostol. This is a normal part of the process. However, if you experience heavy bleeding (soaking more than two pads per hour for 2 consecutive hours), contact your healthcare provider.
- Do not use tampons during the termination process to monitor bleeding and prevent infection. Use sanitary pads instead.
- Avoid alcohol during treatment, as it may increase the risk of side effects.
- Attend your follow-up appointment to ensure the abortion is complete and that there are no complications.
Side Effects of Mifeprex
Common Side Effects
- Cramping
- Vaginal bleeding
- Nausea
- Vomiting
- Diarrhea
- Headache
- Fatigue
Uncommon/Severe Side Effects
- Severe allergic reactions: Rash, itching, swelling, or difficulty breathing.
- Heavy bleeding: Seek immediate medical attention if you experience heavy or prolonged bleeding.
- Infection: Symptoms include fever, chills, or foul-smelling vaginal discharge.
Risks and Warnings of Mifeprex
- Incomplete abortion: There is a risk that the pregnancy may not be completely terminated, which may require a surgical procedure to complete the abortion.
- Severe infection: Though rare, serious infections have been reported. Patients should seek medical attention if they experience fever, severe abdominal pain, or persistent nausea after the procedure.
- Heavy bleeding: Heavy or prolonged bleeding may occur. It is important to monitor bleeding and contact a healthcare provider if it becomes excessive.
Interactions with Mifeprex
Common Drug Interactions
- Corticosteroids: Mifeprex may interfere with corticosteroid treatment, making it unsafe for individuals who rely on these medications for chronic conditions.
- Blood thinners (e.g., warfarin): Mifeprex may increase the risk of bleeding when taken with anticoagulants.
- Cytochrome P450 inhibitors: Drugs like ketoconazole or erythromycin may increase mifepristone levels, potentially increasing the risk of side effects.
Alternatives to Mifeprex
- Methotrexate and misoprostol: Another combination used for early pregnancy termination.
- Surgical abortion (aspiration): For individuals who are beyond the 10-week limit or prefer a different method of termination.