Mifegyne is an anti-hormone that acts by blocking the effects of progesterone, a hormone which is needed for pregnancy to continue. Mifegyne can therefore cause termination of pregnancy. It can also be used to soften and open the entrance (the cervix) to the womb (uterus).
Mifegyne is recommended for the following indications:
- For the medical termination of a pregnancy: – no later than 63 days after the first day of your last period, – in combination with another treatment called prostaglandin (a substance that increases contraction of the womb) which you take 36 to 48 hours after taking Mifegyne.
- For softening and opening the cervix before surgical termination of pregnancy during the first trimester.
- As pre-treatment before giving prostaglandins for termination of pregnancy for medical reasons beyond 3 months gestation.
- To induce labour in cases where the foetus has died in the womb and where it is not possible to use other medical treatments (prostaglandin or oxytocin).
Mifegyne is taken as a single dose of 3 tablets each containing 200mg mifepristone. The tablets should be swallowed with some water in the presence of a doctor or a member of his/her medical staff. The prostaglandin (misoprostol 400 micrograms) is either given as tablets which should be swallowed with water or as a vaginal pessary (gemeprost 1 mg). The prostaglandin is taken as a single dose 36 – 48 hours after taking the Mifegyne.
This method involves your active participation and you should therefore be aware that: – You need to take the second medicament (which contains prostaglandin) to ensure the treatment is effective. You need to attend a check-up consultation (3rd consultation) within 14 – 21 days of taking Mifegyne in order to check that your pregnancy has been completely expelled and you are well. – The method of medical pregnancy termination using the combination of Mifegyne and prostaglandin is not 100 % effective. The average success rate is 95% and you may therefore require a surgical procedure to complete the treatment. For pregnancies that have occurred with a contraceptive coil in place, the coil will be removed prior to administering Mifegyne. The schedule below will be followed. After the Mifegyne has been administered, you return home. Uterine bleeding usually starts 1 to 2 days after taking Mifegyne.
Like all medicines, Mifegyne can cause side effects, although not everybody gets them.
Very common (occur among more than 1 in 10 patients): uterine contractions or cramping in the hours following prostaglandin intake, effects related to prostaglandin use such as nausea, vomiting or diarrhoea.
Common (occur among more than 1 in 100 patients but less than 1 in 10 patients): heavy bleeding, infection following abortion, gastro intestinal cramping light or moderate.
Uncommon (occur among more than 1 in 1000 patients but less than 1 in 100 patients): skin rashes and blood pressure fall have been observed.
Rare (occur among more than 1 in 10 000 patients but less than 1 in 1000 patients): headaches, malaise, vagal epidermal necrolysis and erythema nodosum) have also been reported.
Very rare (occur among less than 1 in 10000 patients): – Localised swelling of face and/or larynx which can be with urticaria; – Cases of fatal or serious toxic shock caused by infection by pathogens like Clostridium sordellii endometritis, Escherichia coli, presenting with or without fever or other obvious symptoms of infection.
In a very small number of women, especially those who have had an operation on the womb or have had a baby by caesarean delivery, there is a risk that the womb may split or rupture.