Mifegyne

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How does it work?

Mifepristone belongs to a group of medicines known as anti-progesterones. Mifepristone acts by blocking progesterone receptors in the uterus and this reduces the effectiveness of the natural hormone progesterone. Progesterone plays an important role in the maintainance of pregnancy such as the successful implantation of the fertilised egg into the wall of the uterus and prevention of uterine contractions during pregnancy. By blocking progesterone receptors in the uterus, mifepristone significantly reduces progesterone levels so that pregnancy cannot be maintained. Abortion may occur solely as a result of the actions of mifepristone, but surgery may also be necessary to remove the foetus. If required, contraception can be started 3 to 9 days after taking mifepristone.

What is it used for?

- Medical alternative to surgical termination of pregnancy of up to 63 days
- Softening and dilation of the cervix (neck of the womb) prior to surgical termination of pregnancy
- Termination of pregnancy between weeks 13 and 20 weeks gestation, used in combination with gemeprost.

Warning!

- Mifepristone may only be used for pregnancy termination in accordance with the Abortion Act 1967 as amended by The Human Fertilisation and Embryology Act 1990.
- Mifepristone must be given under the supervision of a registered medical doctor.
- Both administration of mifepristone and follow-up must take place in an NHS hospital or place approved by the Secretary of State under section 1 (3) of the Abortion Act 1967 and which has received approval by the department of health to undertake medical terminations with mifepristone.
- A follow up visit is recommended at an appropriate interval (usually 8 to 12 days) after taking mifepristone.
- Mifepristone must not be given if there is doubt as to the existence and age of the pregnancy. The prescribing doctor should perform the appropriate tests to determine the age of the foetus e.g. an ultrasound scan.
- If treatment fails or is interrupted, the pregnancy is likely to continue to develop. Exposure to mifepristone may present a high risk of malformation to the foetus. In this event, termination by another method is advised to be undertaken at the follow up visit.

Use with caution in

- Asthma
- Cardiovascular disease or individuals with risk factors
- Chronic obstructive pulmonary disease
- History of infection of the heart valves and sac surrounding the heart (infective endocarditis)
- Individual with artificial heart valves

Not to be used in

- Bleeding disorders
- Ectopic pregnancy
- Insufficient production of natural steroid hormones by the adrenal glands (adrenal insufficiency)
- Kidney failure
- Liver failure
- Long term corticosteriod therapy
- Smokers over the age of 35 when used in combination with gemeprost

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- It is recommended that breastfeeding is avoided for 14 days after this medicine is administered. Seek medical advice from your doctor.

Label warnings

- Follow the printed instructions you have been given with this medication.

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