II. Mechanism

  1. Selective Progesterone receptor modulator acts as Progesterone receptor antagonist
  2. Causes Decidual necrosis and uterine contractions

III. Indications

  1. Early Pregnancy Loss (<84 days)
  2. Termination of Pregnancy (<77 days)
  3. Non-pituitary Cushing Syndrome (Hypercortisolism)

IV. Contraindications

V. 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

VI. Dosing: Early Pregnancy Loss or Termination of Pregnancy

  1. Mifepristone 200 mg orally given 24-48 hours BEFORE Misoprostol 800 mcg per vagina or buccal

VII. Adverse Effects

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Ontology: Mifepristone (C0026088)

Definition (NCI) A derivative of the synthetic progestin norethindrone with antiprogesterone activity. Mifepristone competitively binds to the progesterone receptor, resulting in inhibition of the effects of endogenous or exogenous progesterone. This agent also exhibits antiglucocorticoid and weak antiandrogenic activities.
Definition (NCI_NCI-GLOSS) A drug used to end early pregnancies. It is also being studied in the treatment of some types of cancer and other conditions. Mifepristone blocks the action of progesterone, a hormone that helps some cancers grow. It is a type of antiprogesterone.
Definition (MSH) A progestational and glucocorticoid hormone antagonist. Its inhibition of progesterone induces bleeding during the luteal phase and in early pregnancy by releasing endogenous prostaglandins from the endometrium or decidua. As a glucocorticoid receptor antagonist, the drug has been used to treat hypercortisolism in patients with nonpituitary CUSHING SYNDROME.
Definition (CSP) 11-((4-dimethylamino) phenyl)-17-hydroxy-17-(1-propynyl) estra-4,9- dien-3-one; progesterone and glucocorticoid antagonist with potential applications in terminating pregnancy, controlling menstruation, and treating hypercortisolism.
Definition (PDQ) A synthetic compound with antiprogesterone properties. Mifepristone competitively binds to the progesterone receptor, leading to changes in the endometrial blood supply. This agent also exhibits antiglucocorticoid and weak antiandrogenic activity. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40888&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40888&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C655" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH D015735
SnomedCT 129483007, 326145000, 395796009
English Mifepristone, mifepristone, Estra-4,9-dien-3-one, 11-(4-(dimethylamino)phenyl)-17-hydroxy-17-(1-propynyl)-, (11beta,17beta)-, (aa Beta, 17 beta)-11-[4-(dimethylamino)-phenyl]-17-hydroxy-17-(1-propynyl)estra-4,9-dien-3-one, 11 Beta-[4-(N,N-dimethylamino)phenyl]-17alpha-(propyl-1-ynyl)-delta-4,9-estradiene-17 beta-ol-3-one, 11-((4-dimethylamino) phenyl)-17-Hydroxy-17-(1-propynyl) Estra-4,9- dien-3-one, Mifepristone product, progesterone inhibitors mifepristone (RU 486), mifepristone (medication), mifepristone (RU 486), Mifepristone [Chemical/Ingredient], MIFEPRISTONE, Mifepristone product (substance), Mifepristone (product), Mifepristone (substance)
Swedish Mifepriston
Czech mifepriston, RU-486
Finnish Mifepristoni
Japanese ミフェプリストン, ミフェギン
Polish Mifepryston
Spanish mifepristona (producto), mifepristona (sustancia), mifepristona, Mifepristona
French Mifépristone, Ru 486
German Mifepriston
Italian Mifepristone
Portuguese Mifepristona