RU-486 (Mifepristone) Tablets

How It Works

RU-486 falls under the class of drugs known as anti progestational steroids. It works by blocking the effects of the hormone progesterone.  Progesterone is a hormone that supports pregnancy. It helps thicken the lining of the uterus to prepare for a fertilized egg. 

Combined with mifepristone, it causes uterine contractions. Contraction is when the muscles of the uterus tighten and then relax. This happens repeatedly to push the pregnancy tissue out of the body. This results in pregnancy termination.

In Cushing’s syndrome, it reduces blood glucose levels by blocking the activity of cortisol. Cortisol is among the body’s natural substances that control blood glucose level. By blocking cortisol, it decreases the amount of blood glucose. Take this medication as advised by your doctor for safe and effective treatment.

Uses

Abortion 

Used in combination with misoprostol to terminate an early pregnancy (not more than 9 weeks) in women. 

Cushing’s Syndrome 

A condition in which the body makes too much cortisol resulting in increased blood sugar levels.

Benefits

• Ends early pregnancy effectively
• Allows women to have a better control over their reproductive choices 
• Eliminates risks and trauma that are associated with surgery 
• Offers more privacy when you are allowed to use it through a telehealth service 

Dosage

• RU-486 (mifepristone) tablets are used to induce an early abortion in women. This tablet is used in combination with misoprostol in the medical abortion process. 
• Your doctor may prescribe that you take a single pill orally during a visit to the clinic. 
• 4 misoprostol tablets are typically taken after 24 to 48 hours to cause an abortion. Mifepristone comes in the form of a 200 mg tablet. 
• For Cushing’s syndrome, you’ll likely have a starting dose of 300 mg per day. Your doctor may increase the dosage in 2 to 4 weeks of the treatment. 

Missed Dosage: 

If you are taking this medication to end your pregnancy, missing a dose is not possible. 

If you take this medication for Cushing’s syndrome, take the missed dose as soon as possible. If it’s time for your next scheduled dose, skip the missed dose. Do not take an overdose to make up for the missed dose.

Overdose: 

An overdose of the drug can lead to serious side effects. If you suspect an overdose, check with your doctor right away.

Safety Advice

Alcohol : UNSAFE
Do not consume alcohol while using RU-486 (mifepristone) tablets.

Pregnancy : UNSAFE
RU-486 (mifepristone) tablets are used to terminate pregnancy. It is unsafe for pregnant women.

Breastfeeding :  POSSIBLY UNSAFE
Do not use this medication if you are breastfeeding. The abortion pills can have adverse effects on the baby.

Driving : UNSAFE
RU-486 (mifepristone) may make you feel weak. You may need support until the abortion process and recovery is complete. Do not drive a car after taking these pills.

Kidney : SPEAK TO YOUR DOCTOR
If you have an existing kidney problem, talk to your doctor before using a medical abortion kit.

Liver: POSSIBLY SAFE
These drugs are not known to affect the liver. However, if you have a liver disease, do not use abortion pills without medical supervision.

Other Precautions

Before you take RU-486, tell your doctor:

• If it has been more than 10 weeks since your last menstrual period.
• If you have an IUD in place.
• If you have a bleeding disorder such as hemophilia.
• If you have a condition for which you take blood thinners.
• If you have an ectopic pregnancy.
• If you have kidney or liver diseases.
• If you have a history of stroke, heart attack, or congestive heart failure.
• If you suffer from problems such as diabetes, hypertension, angina, etc.
• If you are allergic to prostaglandins.
• If you have endometrial hyperplasia.
• If you have endometrial cancer.
• If you have unusual vaginal bleeding.

Side Effects

Vaginal bleeding and cramps are common symptoms you will experience while ending a pregnancy. 

RU 486 (mifepristone tablets) may lead to side effects such as:

• Headache
• Dizziness
• Diarrhea
• Difficult or painful urination
• Fever, chills, or weakness
• Infection
• Nausea
• Vomiting
• Abdominal pain
• Pain in arms and legs
• Pelvic pain
• Fatigue

If you experience any symptom that worsens or does not improve, call your doctor straight away. 

Drug Interactions

Certain drugs are known to interact with RU-486 (mifepristone) and affect the way it works. If you take any medications. e.g., herbal, OTC, recreational, or any other form of drugs, let your doctor know about them.

• Cyclosporine
• Fentanyl
• Blood thinners such as warfarin
• Dexamethasone
• Antibiotics such as erythromycin
• Oral antifungals such as ketoconazole
• Calcium channel blockers such as amlodipine
• Carbamazepine
• Atorvastatin
• Pimozide
• Ergotamine
• HIV Protease inhibitors such as indinavir and ritonavir
• Phenytoin
• Rifampin
• St. John’s Wort

Interaction with alcohol

Avoid consuming the mifepristone pill with alcohol. Alcohol can damage your health and lead to serious side effects. 

Interaction with grapefruit juice

Grapefruit juice can interact with mifepristone and cause side effects. It can alter the level of this medicine in the blood. Avoid consuming grapefruit juice 24 hours after taking this pill. 

Storage Instructions

• RU-486 tablets should be stored properly and safely in their original packaging.
• Keep the tablets away from direct heat, moisture, and sunlight.
• Keep the tablets out of reach of children.
• Once the pack is opened, store the remaining pills in an airtight container.
• Do not consume the medicine past its expiration date.

Substitutes Available

Cytotec 200 mcg (Misoprostol)

Zydus Cadila

MTP Kit

Cipla Ltd.

References

• 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 from: https://pubmed.ncbi.nlm.nih.gov/25592080/
• Drugs H. Mifepristone (Mifeprex): MedlinePlus Drug Information [Internet]. Medlineplus.gov. 2022 [cited 2022 Sep 23]. Available from: https://medlineplus.gov/druginfo/meds/a600042.html
• [Internet]. Medicinenet.com. 2022 [cited 2022 Sep 23]. Available from: https://www.medicinenet.com/mifepristone-oral/article.htm#what_is_mifepristone_and_how_does_it_work_mechanism_of_action
• Mifeprex, Korlym (mifepristone) dosing, indications, interactions, adverse effects, and more [Internet]. Reference.medscape.com. 2022 [cited 2022 Sep 23]. Available from: https://reference.medscape.com/drug/mifeprex-korlym-mifepristone-343130
• Mifepristone: Uses, Interactions, Mechanism of Action | DrugBank Online [Internet]. Go.drugbank.com. 2022 [cited 2022 Sep 23]. Available from: https://go.drugbank.com/drugs/DB00834
• Can having an abortion affect my fertility? [Internet]. nhs.uk. 2022 [cited 2022 Sep 23]. Available from: https://www.nhs.uk/common-health-questions/womens-health/can-having-an-abortion-affect-my-fertility/
• Mifepristone (Mifepristone Linepharma) followed by misoprostol (GyMiso) for terminating early pregnancy | NPS MEDICINEWISE [Internet]. nps.org.au. 2022 [cited 2022 Sep 23]. Available from: https://www.nps.org.au/news/mifepristone-mifepristone-linepharma-followed-by-misoprostol-gy-miso-for-terminating-early-pregnancy