Pharm

Mifepristone

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Mifepristone, Mifeprex

  • Mechanism
  1. Selective Progesterone receptor modulator acts as Progesterone receptor Antagonist
  2. Causes Decidual necrosis and uterine contractions
  • Indications
  1. Early Pregnancy Loss (<84 days)
  2. Termination of Pregnancy (<77 days)
  3. Non-pituitary Cushing Syndrome (Hypercortisolism)
  • Contraindications
  1. Adrenal Insufficiency
  2. Chronic Corticosteroid use
  • Precautions
  1. See Early Pregnancy Loss for combined protocol of Mifepristone with Misoprostol (Cytotec)
  2. Obstetric Ultrasound is typically used to confirm Early Pregnancy Loss and assess Gestational age
  3. Quantitative bhCG is often obtained to monitor serially to confirm completed Miscarriage
  4. RhoGAM is typically given for Rh Negative patients
  5. Mifepristone is obtained by licensed medical provider directly from manufacturer
  1. Mifepristone 200 mg orally given 24-48 hours BEFORE Misoprostol 800 mcg per vagina or buccal
  • Adverse Effects
  1. Nausea
  • References
  1. MacNaughton (2021) Am Fam Physician 103(8) 473-80 [PubMed]