MTP Kit (Combipack of Mifepristone and Misoprostol)

Active Ingredient	Mifepristone and Misoprostol
Type	Abortion
Manufacturer	Zydus Lifesciences Limited

How It Works

MTP Kit consists of two medicines: Mifepristone and Misoprostol. Mifepristone blocks progesterone’s effects, causing the placenta to separate from the endometrium. Misoprostol softens the cervix and increases uterine contractions so the contents can pass easily. The uterine contents are usually blood clots that are passed through the vagina when the bleeding starts.

The combination of these two medicines is highly effective in terminating early pregnancies. This is especially true for people who have regular periods, are pretty sure of the first day of their last period, and are less than 10 weeks from the first day of their last period. After taking the abortion pill, bleeding, and cramping, similar to a heavy menstrual period, are common. In most cases, the process resembles a miscarriage.

MTP Kit is only used to terminate a pregnancy, which should not be more than nine weeks, counting from the first day of the last menstrual period.

Dosage

MTP Kit consists of one tablet of Mifepristone and four tablets of Misoprostol. Mifepristone is intended to be taken orally with water. The four tablets of Misoprostol are recommended to be taken 24 to 48 hours after taking the Mifepristone tablet.

Misoprostol can either be taken buccally or vaginally. The four tablets need to be placed in the cheek pouch for buccal administration. The two pills of Misoprostol should be placed on one side of the mouth and the remaining pills on the other side of the mouth (behind the teeth, in your cheek pouch). After 25-30 minutes, the remaining contents should be swallowed with water. Bleeding usually starts within the first 4 hours. A few sanitary pads should be handy as the bleeding will be heavier than usual.

For vaginal administration, the four tablets should be inserted one by one inside the vagina. If the pills fall out before the bleeding starts, they need to be inserted again.

A follow-up visit to the doctor’s clinic is recommended two weeks after abortion.

Missed Dosage: The abortion pill is taken as prescribed by the doctor. Therefore, the chances of missing a dose are not possible.

Overdose: The MTP Kit or the Abortion pill is usually taken in the presence of a doctor. However, if the doctor advises you to take the tablets at home and an overdose is suspected, contact your doctor immediately.

Important Advisory

Before you take the MTP Kit, tell your doctor:

1. If you are allergic to Mifepristone or Misoprostol.
2. If you have a bleeding disorder.
3. If you have a kidney disease or liver disease.
4. If you suffer from diabetes, hypertension, etc.
5. If you have uncontrolled blood pressure.
6. If you have a history of heart attack, stroke, etc.
7. If you have severe anemia.
8. If you have any inherited skin disease.

Side Effects

Common side effects of the MTP Kit include:

1. Nausea
2. Stomach cramp
3. Uterine contractions
4. Vomiting
5. Diarrhea
6. Chills or hot flushes
7. Fatigue
8. Shivering
9. Pelvic pain
10. Dyspepsia
11. Heavy menstrual bleeding

If you soak two sanitary pads or more within two hours or experience any side effects for a long, contact your doctor immediately and get to urgent care if needed.

Drug Interactions

Certain drugs are known to interact with MTP Kit and affect the way it works. If you take any herbal, OTC, recreational, or other medicines, let your healthcare provider know about them.

1. Antibiotics such as erythromycin
2. Antifungals such as ketoconazole
3. Corticosteroids such as dexamethasone
4. Alprazolam
5. Amlodipine
6. Carbamazepine
7. Chlorpheniramine
8. Atorvastatin
9. Cyclosporine
10. HIV Protease inhibitors such as indinavir and ritonavir
11. Phenytoin
12. Rifampin

Interaction with alcohol

Alcohol can increase the risk of experiencing side effects. Avoid consuming alcohol with the MTP Kit.

Storage Instructions

MTP Kit should be stored appropriately and safely in its original packaging.

1. Keep the medicine away from direct heat, moisture, and sunlight.
2. Keep the medicine out of reach of children.
3. Once the pack is opened, store the remaining pills in an airtight container.
4. Only consume the medicine before its expiration date.

Substitutes Available

Frequently Asked Questions (FAQs)

Is MTP Kit safe to use?

Research shows that self-managing an abortion with abortion pills (Mifepristone and/or misoprostol) can be safe and effective. MTP Kit is a safe and effective medicated abortion that is used for the termination of pregnancy in women. It is clinically proven to terminate intrauterine pregnancy of up to 63 days gestation period.

How effective is the MTP Kit? 

Abortion pills work really well. MTP Kit is considered an effective method of abortion with an efficacy rate of up to 98.8% when taken within the first 6 weeks (or 42 days) and 95.5% when taken between 7 and 9 weeks of pregnancy. Users who are in their first trimester can make use of this kit to terminate their pregnancy.

How long does it take for MTP Kit to work?

In most cases, the pregnancy tissue usually gets expelled within the first 4 to 6 hours. Cramping and bleeding slow down after the expulsion of the pregnancy tissue. A follow-up visit to your healthcare provider may be recommended after two weeks.

When should these pills not be taken?

While the MTP Kit (the abortion pill) is a safe option for the termination of pregnancy in the first 9 weeks, it usually isn’t the right option for everyone. Therefore, an MTP Kit may not be the right choice if you have any of the following:

1. An ectopic pregnancy – a pregnancy implanted outside the uterus that can only be treated by a medical professional.
2. Chronic adrenal or liver failure.
3. Suffer from HIV – if you have HIV, the abortion process can put you at a higher risk of infection. Therefore, you should use antibiotics at the same time and contact your doctor before you make use of the abortion pill.
4. An STI – if you have a sexually transmitted infection such as gonorrhea, you should see a doctor for treatment.
5. An IUD in place – you should have an Intrauterine device removed before taking the abortion pill.
6. Suffer from porphyria – an inherited disease such as porphyria affects the blood’s ability to carry oxygen to organs and tissues.

How to confirm abortion?

You will experience specific symptoms after taking abortion pills. The symptoms after taking abortion pills are the same as a miscarriage. A follow-up appointment is recommended to make sure that the home abortion is complete. Your healthcare provider may ask you to visit the clinic, wherein a medical professional will perform a quick examination, blood test, or ultrasound.

What are the essential precautions you must follow after the abortion procedure?

If possible, plan to take rest for a day or two after the abortion. Certain precautions should be taken after the abortion:

1. Strenuous exercise should be avoided for the first week.
2. Avoid inserting anything into the vagina for 2-3 weeks (including tampons, sex toys, etc).
3. Avoid stimulating the nipples to reduce breast discharge.

Most symptoms usually go away after 24 hours.

Are there any possible complications that I need to look out for?

Signs of possible complications include:

1. Fever above 101 ° F lasting more than 24 hours.
2. Heavy bleeding that doesn’t stop – soaking two or more pads in an hour for 2 hours in a row.
3. Nausea, vomiting, or diarrhea that lasts for more than 24 hours.
4. Foul-smelling vaginal discharge.
5. Severe pain or cramping that won’t go away even with the medication.
6. Continued symptoms of pregnancy after 2 to 4 weeks.

If you experience these things, contact your healthcare provider immediately. These signs may indicate that additional treatment is required.

Is there any difference between Medical Abortion and the Abortion Pill?

The Abortion Pill is sold under different names. However, medical abortion, medication abortion, and medicated abortion are the same thing as the abortion pill.

Are abortion pills legal in all US states?

It is best to check a fact sheet that has information about legal issues concerning abortion pills and pregnancy. Before purchasing abortion pills, check if your states provide abortion pills.

References

• JANI, Parul S.. Use of MTP kit (Mifepristone and Misoprostol combination pack) for 1st trimester MTP (up to 63 days) at GMERS Dharpur, Patan, Gujarat, India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, [S.l.], v. 7, n. 9, p. 3615-3618, aug. 2018. ISSN 2320-1789. Available at: <https://www.ijrcog.org/index.php/ijrcog/article/view/5150>.
• Gatter M, Cleland K, Nucatola DL. Efficacy and safety of medical abortion using mifepristone and buccal misoprostol through 63 days. Contraception. 2015 Apr;91(4):269-73. doi: 10.1016/j.contraception.2015.01.005. Epub 2015 Jan 13. PMID: 25592080; PMCID: PMC4373977. Available at: <https://pubmed.ncbi.nlm.nih.gov/25592080/>
• Abubeker, F.A., Lavelanet, A., Rodriguez, M.I. et al. Medical termination for pregnancy in early first trimester (≤ 63 days) using combination of mifepristone and misoprostol or misoprostol alone: a systematic review. BMC Women’s Health 20, 142 (2020). https://doi.org/10.1186/s12905-020-01003-8

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