RU-486 (Mifepristone) Tablets

Description

RU 486 Mifepristone abortion pill is an oral medication that is used in combination with Misoprostol to terminate a pregnancy of not more than 9 weeks. It belongs to the class of drugs known as antiprogestational steroids. It blocks the effects of progesterone (pregnancy hormone) and stops the pregnancy from growing any further. It is also a cortisol receptor blocker that may be used to control hyperglycemia in adults with Cushing’s syndrome. It comes in the form of a single tablet that needs to be taken orally with water.

How does RU 486 Tablet work?

RU-486 or Mifepristone is in a class of medications called antiprogestational steroids. It works by blocking the action of progesterone and causes the placenta to separate from the endometrium. Thus, it stops the pregnancy from growing.

Uses

Medical Abortion – It is a procedure that uses medicine to terminate an early pregnancy (of not more than 9 weeks).
Cushing’s Syndrome – It occurs when the body makes too much of the hormone cortisol.

Recommended dosage

RU 486 pill is intended to be taken orally with water. A single tablet is given by the doctor, usually at the clinic to take orally with water. After roughly 24 to 48 hours, the four pills of Misoprostol are recommended to be taken to complete the abortion process.
If you are taking it for the treatment of Cushing’s syndrome, a dose of 300 mg may be prescribed initially.

Missed dose

In case you have missed a dose, take it as soon as you remember. If it’s time for your next scheduled dose, take the next dose.

Overdose

An overdose can lead to serious side effects. In case an overdose is suspected, contact your doctor immediately.

RU-486 Mifepristone Side Effects

Common side effects of RU-486 are:

• Vaginal bleeding or spotting
• Cramps
• Pelvic pain
• Vaginal burning, itching, or discharge
• Headache
• Nausea
• Diarrhea
• Fever, chills, or weakness

If any of the above-mentioned side effects persist for long, contact your doctor immediately.

Safety advice

Keep in mind the following before you take RU-486:

• If you are allergic to Mifepristone, let your doctor know about it..
• Discuss your complete medical history with the doctor.
• If you have had an ectopic pregnancy, adrenal failure, porphyria, or an IUD inserted, check with your doctor.
• If you have an IUD place, let your doctor know about it.
• If you are allergic to prostaglandins, let your doctor know about it.
• If you have a history of unexplained vaginal bleeding, endometrial cancer, or endometrial hyperplasia, let your doctor know about it.
• Mifepristone is contraindicated in women with the mentioned conditions.

Drug interactions

RU-486 can interact with certain medications that can affect the way it works. These include:

• Benzodiazepines such as alprazolam (Xanax),
• Diazepam (Diastat, Valium),
• Midazolam, or triazolam (Halcion); buspirone;
• Calcium channel blockers such as amlodipine (Norvasc),
• Diltiazem (Cardizem, Cartia, Diltzac, others),
• Felodipine, nifedipine (Adalat, Afeditab CR, Procardia),
• Nisoldipine (Sular), or verapamil (Calan, Verelan, in Tarka);
• Carbamazepine (Equetro, Tegretol, Teril, others);
• Chlorpheniramine (antihistamine in cough and cold products);
• Cholesterol-lowering medications (statins) such as atorvastatin (Lipitor, in Caduet),
• Lovastatin (Altoprev, in Advicor), or simvastatin (Simcor, Zocor, in Vytorin);
• Clarithromycin (Biaxin, in Prevpac);
• Cyclosporine (Gengraf, Neoral, Sandimmune);
• Erythromycin (E.E.S., Erythrocin, others);
• St. John’s wort

Storage

• Keep this medication in the container it came in, and tightly closed.
• Keep it out of reach of children.
• Store it at room temperature and away from excess heat and moisture.

References

• Chu JJ, Devall AJ, Beeson LE, Hardy P, Cheed V, Sun Y, Roberts TE, Ogwulu CO, Williams E, Jones LL, La Fontaine Papadopoulos JH, Bender-Atik R, Brewin J, Hinshaw K, Choudhary M, Ahmed A, Naftalin J, Nunes N, Oliver A, Izzat F, Bhatia K, Hassan I, Jeve Y, Hamilton J, Deb S, Bottomley C, Ross J, Watkins L, Underwood M, Cheong Y, Kumar CS, Gupta P, Small R, Pringle S, Hodge F, Shahid A, Gallos ID, Horne AW, Quenby S, Coomarasamy A. Mifepristone and misoprostol versus misoprostol alone for the management of missed miscarriage (MifeMiso): a randomised, double-blind, placebo-controlled trial. Lancet. 2020 Sep 12;396(10253):770-778. doi: 10.1016/S0140-6736(20)31788-8. Epub 2020 Aug 24. PMID: 32853559; PMCID: PMC7493715. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31788-8/fulltext
• Wingo E, Raifman S, Landau C, Sella S, Grossman D. Mifepristone-misoprostol versus misoprostol-alone regimen for medication abortion at ≥24 weeks’ gestation. Contraception. 2020 Aug;102(2):99-103. doi: 10.1016/j.contraception.2020.05.001. Epub 2020 May 12. PMID: 32407810.
• Sonalkar S, Koelper N, Creinin MD, Atrio JM, Sammel MD, McAllister A, Schreiber CA. Management of early pregnancy loss with mifepristone and misoprostol: clinical predictors of treatment success from a randomized trial. Am J Obstet Gynecol. 2020 Oct;223(4):551.e1-551.e7. doi: 10.1016/j.ajog.2020.04.006. Epub 2020 Apr 17. PMID: 32305259; PMCID: PMC7529708.
  https://www.ajog.org/article/S0002-9378(20)30431-2/fulltext
• Chen MJ, Creinin MD. Mifepristone With Buccal Misoprostol for Medical Abortion: A Systematic Review. Obstet Gynecol. 2015 Jul;126(1):12-21. doi: 10.1097/AOG.0000000000000897. PMID: 26241251.
  https://journals.lww.com/greenjournal/Abstract/2015/07000/Mifepristone_With_Buccal_Misoprostol_for_Medical.4.aspx
• Schreiber CA, Creinin MD, Atrio J, Sonalkar S, Ratcliffe SJ, Barnhart KT. Mifepristone Pretreatment for the Medical Management of Early Pregnancy Loss. N Engl J Med. 2018 Jun 7;378(23):2161-2170. doi: 10.1056/NEJMoa1715726. PMID: 29874535; PMCID: PMC6437668.
  https://www.nejm.org/doi/10.1056/NEJMoa1715726
• MIFEPREX (mifepristone) Tablets Label [Internet]. Accessdata.fda.gov. 2022 [cited 2022 Sep 14]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2000/20687lbl.htm
• Autry BM, Wadhwa R. Mifepristone. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557612/