mifepristone (Mifeprex)

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Pronunciation: MIF e PRIS tone

Brand: Mifeprex

What is the most important information I should know about Mifeprex?

This medication guide provides information about the Mifeprex brand of mifepristone. Korlym is another brand of mifepristone that is not covered in this medication guide.

Mifeprex is used together with misoprostol to end an early pregnancy. MIFEPREX MUST NOT BE USED IN AN ATTEMPT TO END PREGNANCY BEYOND 10 WEEKS.

Do not use Mifeprex or misoprostol if you do not intend to end your pregnancy.

Call your doctor right away if you have heavy vaginal bleeding or a general ill feeling after taking this medicine.

Seek emergency medical help if you still have any of the following symptoms more than 24 hours after taking Mifeprex or misoprostol: fever, severe stomach pain, heavy or prolonged vaginal bleeding, nausea, vomiting, diarrhea, or feeling like you might pass out.

What is mifepristone (Mifeprex)?

Mifeprex blocks the actions of a hormone needed to maintain a pregnancy.

Mifeprex is used to end an early pregnancy that is not further along than 70 days (10 weeks) after the first day of your last menstrual period. Mifeprex is used together with another medicine called misoprostol (Cytotec).

Mifeprex is available only from a certified healthcare provider under a special program. You must be registered in the program and understand the risks of taking this medicine.

MIFEPREX MUST NOT BE USED IN AN ATTEMPT TO END PREGNANCY BEYOND 10 WEEKS.

This medication guide provides information about the Mifeprex brand of mifepristone. Korlym is another brand of mifepristone that is not covered in this medication guide.

Mifeprex may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking Mifeprex?

Do not use Mifeprex or misoprostol if you do not intend to end your pregnancy. Mifeprex may cause birth defects in an unborn baby if the treatment procedure does not fully terminate the pregnancy. You may need surgery to end the pregnancy completely.

Treatment with Mifeprex and misoprostol requires at least 2 visits to your doctor. Do not use this medicine if you cannot attend all required follow-up visits.

You should not take Mifeprex or misoprostol if you are allergic to either medicine, or if:

  • it has been more than 70 days (10 weeks) since your last menstrual period began;
  • you cannot easily get emergency medical help if needed in the 2 weeks after you take these medicines;
  • you have an intrauterine device, or IUD (it must be removed before you take Mifeprex);
  • you have a pregnancy outside the uterus (ectopic pregnancy);
  • you have problems with your adrenal glands (chronic adrenal failure);
  • you have a bleeding or blood-clotting disorder, such as hemophilia;
  • you have porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system);
  • you have a condition for which you use a blood thinner such as warfarin (Coumadin, Jantoven);
  • you have a condition for which you have been taking steroid medicine for a long period of time; or
  • you are allergic to prostaglandins.

To make sure Mifeprex is safe for you, tell your doctor if you have:

  • a history of uterine rupture or uterine scar; or
  • kidney disease.

Mifeprex can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is Mifeprex given?

Before receiving this medicine, you must read a Mifeprex Medication Guide. Then, you must sign a Patient Agreement form stating that you understand the risks and benefits of using this medicine.

Complete treatment to end the pregnancy will require at least 2 visits to your doctor.

  • At the first visit (Day 1) you will be given a Mifeprex tablet. You will also be given or prescribed 4 misoprostol tablets. If you receive only a prescription for misoprostol, be sure to get the prescription filled right away so you will be ready to take the medicine on schedule.
  • In 24 to 48 hours, you will take 4 misoprostol tablets at one time. For treatment to be effective, you must take misoprostol 24 to 48 hours after you took Mifeprex.
  • Misoprostol can cause cramps, nausea, diarrhea, and other side effects. Your doctor may give you medicine to treat or prevent these side effects.
  • Your uterus should begin to pass the pregnancy within 2 to 24 hours after taking misoprostol. Be sure you are in a place where you will be ready for this to happen. You will likely have fairly heavy vaginal bleeding while your uterus is passing the pregnancy.
  • At the second visit (Day 7 to 14 after you took Mifeprex), your doctor will check your uterus to make sure the pregnancy has completely ended.
  • If your body has not completely passed the pregnancy, you may be given another dose of misoprostol. If you take a second dose of misoprostol, you should have a follow-up visit 7 days later.

Cramping and bleeding are signs that this medicine is working properly. But sometimes you can have cramping and bleeding and still be pregnant. Only your doctor can confirm whether your pregnancy has completely ended. Using a home pregnancy test kit is not effective in confirming that your uterus has been completely cleared of the pregnancy. Do not miss any of your follow-up visits.

You may need surgery to end the pregnancy completely. Carrying a pregnancy to term after taking Mifeprex or misoprostol may cause birth defects or death of the baby. Talk with your doctor about your treatment options.

Bleeding and spotting are normal side effects of Mifeprex and misoprostol. It is possible to continue bleeding for up to 30 days. Bleeding may be heavier than a normal heavy period, and you may also pass blood clots and tissue.

Call your doctor if you bleed enough to soak through 2 full-size sanitary pads per hour for 2 hours in a row. In rare cases, serious and sometimes fatal bleeding or infection may occur after termination of a pregnancy. Call your doctor if you have heavy vaginal bleeding or a general ill feeling. You may also have a fever, stomach pain, or fast heartbeats.

Go to an emergency room if you still have any of the following symptoms more than 24 hours after taking misoprostol: fever, severe stomach pain, heavy or prolonged vaginal bleeding, nausea, vomiting, diarrhea, or feeling like you might pass out. Be sure to tell your caregivers when you last took misoprostol.

It is possible to get pregnant again right after terminating a pregnancy. You may begin using birth control after your doctor has confirmed that treatment with Mifeprex has effectively ended your pregnancy.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

What happens if I miss a dose?

Since Mifeprex is used as a single dose, it does not have a daily dosing schedule.

Call your doctor for instructions if you miss any follow-up appointment.

What happens if I overdose?

Since Mifeprex is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after taking Mifeprex?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Grapefruit and grapefruit juice can make it harder for your body to metabolize Mifeprex. Avoid the use of grapefruit products shortly before or after taking Mifeprex.

What are the possible side effects of Mifeprex?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • a fever higher than 100.4 degrees F (38 degrees C) lasting longer than 4 hours;
  • a general ill feeling or fast heartbeats;
  • severe pelvic pain or tenderness;
  • severe or ongoing nausea, vomiting, diarrhea, weakness; or
  • no vaginal bleeding at all after taking Mifeprex.

Common side effects may include:

  • heavy vaginal bleeding for 2 days;
  • light vaginal bleeding or spotting for up to 16 days;
  • fever, chills, weakness;
  • dizziness; or
  • nausea, vomiting, diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Mifeprex?

Tell your doctor about all your current medicines, especially:

  • St. John's wort;
  • medication to treat hepatitis or HIV;
  • an antibiotic or antifungal medication;
  • heart or blood pressure medication;
  • seizure medication; or
  • tuberculosis medication.

This list is not complete. Other drugs may interact with Mifeprex, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your doctor or pharmacist can provide more information about Mifeprex.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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