Drug Action
Mifepristone, an antiprogestogenic steroid, sensitises the myometrium to prostaglandin-induced contractions and ripens the cervix. Genito-urinary system
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Drug reference
Mifepristone, an antiprogestogenic steroid, sensitises the myometrium to prostaglandin-induced contractions and ripens the cervix. Genito-urinary system
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Cervical ripening before mechanical cervical dilatation for termination of pregnancy of up to 84 days gestation (under close medical supervision) ▶BY MOUTH ▶Adult: 200 mg for 1 dose, to be taken 36-48 hours before procedure Labour induction in fetal death in utero where prostaglandin or oxytocin inappropriate (under close medical supervision) ▶BY MOUTH ▶Adult: 600 mg once daily for 2 days, if labour not started within 72 hours of first dose, another method should be used Medical termination of intra-uterine pregnancy of up to 49 days gestation (under close medical supervision) ▶BY MOUTH ▶Adult: 600 mg for 1 dose, dose followed 36–48 hours later (unless abortion already complete) by gemeprost 1 mg by vagina or misoprostol 400 micrograms by mouth, alternatively 200 mg for 1 dose, dose followed 36–48 hours later (unless abortion already complete) by gemeprost 1 mg by vagina; observe for at least 3 hours (or until bleeding or pain at acceptable level); follow-up visit within 2 weeks to verify complete expulsion and to assess vaginal bleeding Medical termination of intra-uterine pregnancy of 50–63 days gestation (under close medical supervision) ▶BY MOUTH ▶Adult: 600 mg for 1 dose, alternatively 200 mg for 1 dose, dose followed 36–48 hours later (unless abortion already complete) by gemeprost 1 mg by vagina; observe for at least 3 hours (or until bleeding or pain at acceptable level); follow-up visit within 2 weeks to verify complete expulsion and to assess vaginal bleeding Termination of pregnancy of 13–24 weeks gestation (in combination with a prostaglandin) (under close medical supervision) ▶BY MOUTH ▶Adult: 600 mg for 1 dose, alternatively 200 mg for 1 dose, dose followed 36–48 hours later by gemeprost 1 mg by vagina every 3 hours up to max. 5 mg or misoprostol; if abortion does not occur, 24 hours after start of treatment repeat course of gemeprost 1 mg by vagina up to max. 5 mg; follow-up visit after appropriate interval to assess vaginal bleeding recommended
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Acute porphyrias p. 1120. chronic adrenal failure. suspected ectopic pregnancy (use other specific means of termination). uncontrolled severe asthma
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Adrenal suppression (may require corticosteroid). anticoagulant therapy. asthma (avoid if severe and uncontrolled). existing cardiovascular disease. haemorrhagic disorders. history of endocarditis. prosthetic heart valve. risk factors for cardiovascular disease
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Supplied to NHS hospitals and premises approved under Abortion Act 1967.
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→Appendix 1: mifepristone
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▶Common or very common Abdominal cramps. diarrhoea. infection. nausea. pelvic inflammatory disease. uterine disorders. vaginal haemorrhage (sometimes severe). vomiting ▶Uncommon Hypotension ▶Rare or very rare Angioedema. chills. dizziness. erythema nodosum. fever. headache. hot flush. malaise. skin reactions. toxic epidermal necrolysis. toxic shock syndrome. uterine rupture
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Manufacturer advises avoid in Genito-urinary system hepatic failure (no information available).
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Manufacturer advises avoid.
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Careful monitoring of blood pressure and pulse essential for 3 hours after administration of gemeprost pessary (risk of profound hypotension).
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 10 ▶Mifepristone (Non-proprietary) Mifepristone 200 mg Mifepristone 200mg tablets | 1 tablet P £9.48 ▶Mifegyne (Nordic Pharma Ltd) Mifepristone 200 mg Mifegyne 200mg tablets | 3 tablet P £52.66 (Hospital only) PROSTAGLANDINS AND ANALOGUES
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Patient information leaflet to be provided.
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200 mg for 1 dose, to be taken 36-48 hours
First-line fragment. Read the complete Indications and Dose section above.
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600 mg once daily for 2 days, if labour not
First-line fragment. Read the complete Indications and Dose section above.
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600 mg for 1 dose, dose followed 36–48 hours
First-line fragment. Read the complete Indications and Dose section above.
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600 mg for 1 dose, alternatively 200 mg for
First-line fragment. Read the complete Indications and Dose section above.
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600 mg for 1 dose, alternatively 200 mg for
First-line fragment. Read the complete Indications and Dose section above.
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