Miropristone instructions for use

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Miropristone is a synthetic antigestagenic drug. Belongs to the group of sex hormones and modulators of the reproductive system - progesterone receptor modulators (G03XB01). Active ingredient: Mifepristone.

You need to know that the simultaneous use of Miropriston and NSAIDs should be avoided. The drug is available with a doctor's prescription!

Analogues of the drug according to ATC codes:

GYNEPRISTONE GINESTRIL GINESTRIL ZHENALE MIFEGIN MIFEPRISONE PENCRFTONE All

Before using MIROPRISTONE you should consult your doctor. These instructions for use are for informational purposes only. For more complete information, please refer to the manufacturer's instructions.

Preparatory procedures

To obtain a pharmacological abortion, a woman must first go to a licensed clinic with highly qualified specialists. The gynecologist necessarily conducts a visual examination, prescribes an ultrasound, and confirms the period that has already passed since conception.

It must be taken into account that preparation for the implementation of a medical abortion involves the appointment of preliminary tests:

• for hCG;
• general blood analysis.

These laboratory tests are usually organized expressly, allowing the doctor to receive information on the same day of treatment.

The list and number of tests may vary in each clinic.

In public medical institutions, mandatory tests usually include:

• cervical smear for infections of the genitourinary system;
• blood testing for syphilis, HIV.

In addition, a woman with chronic pathologies must undergo additional diagnostics as directed by a gynecologist.

pharmachologic effect

The drug is a synthetic steroid antigestagen. Blocks the action of progesterone at the receptor level. It does not have gestagenic activity; antagonism with GCS is noted (due to competition at the level of communication with receptors).

Increases myometrial contractility by stimulating the release of interleukin-8 in choriodecidual cells and increasing the sensitivity of the myometrium to prostaglandins. As a result of the action of the drug, desquamation of the decidua occurs and the fertilized egg is expelled.

Pros and cons

Discussions about the admissibility and even ethics of using Mifepristone to induce labor have not subsided in recent years. There are doctors who trust this drug and often use it, there are categorical opponents of the drug who prefer other methods and methods of induction of labor.

To a greater extent, the controversy is associated with a fairly large number of deaths while taking this antigestagen. In Western countries, it has been calculated that since the beginning of active mass use, drugs based on mifepristone have led to the death of 15 women. The first case occurred in France, but then they did not take it seriously, because the woman who terminated an unwanted pregnancy with the help of the drug smoked a lot and for a long time and had several other contraindications.

Further, there were deaths in Canada, the USA, and the UK. In almost all cases, death occurred as a result of a medical abortion and almost always, with rare exceptions, women and girls had certain contraindications that were simply ignored by them and their treating doctors. However, the drug has already gained fame as dangerous and very controversial.

In other words, there is no convincing evidence base that would help doctors allow themselves to claim that the drug is harmless for the woman in labor and her baby who is about to be born. However, there is no reason yet to claim that Mifepristone poses a danger to them.

The woman in labor must decide whether to agree to use the product or not. She has every right to information regarding the method, method and medications for induction of labor. If a woman considers that such a drug is unacceptable for her, she should inform her attending physician, who will select a different method or method of inducing labor or give preference to a cesarean section. No one has the right to force a pregnant woman to sign a consent to use Mifepristone.

Pharmacokinetics

Suction

After a single oral dose of 600 mg, Cmax is reached after 1.3 hours and is 1.98 mg/l. Absolute bioavailability is 69%.

Distribution

Plasma protein binding is 98% (with albumin and acid α1-glycoprotein).

Removal

T1/2 - 18 hours. Elimination is carried out in two phases: first, slow elimination of the drug over 12-72 hours (the concentration of mifepristone in the blood plasma decreases by 2 times), then a phase of rapid elimination of the drug.

Adverse reactions

"Miropriston" can provoke the following negative actions:

1. Migraine.
2. Hyperthermia is the accumulation of excess heat in the body with an increase in temperature, which is provoked by factors causing poor heat transfer.
3. Nausea.
4. Vomiting.
5. Nettle rash.

Termination of pregnancy may be accompanied by pain in the lower abdomen and bleeding from the vagina. In addition, exacerbation of inflammation of the uterus and appendages is likely. Reviews of Miropriston tablets for inducing labor are usually positive.

"Miropriston" is used not only to prevent unwanted pregnancy, but also to stimulate labor. Not always with a positive course, labor also begins and goes according to plan - sometimes you have to resort to drugs.

How long does it take for Miropriston to work to induce labor? The medicine must be used strictly as prescribed by the doctor and only in medical institutions that specialize in female reproductive medicine.

Labor is observed in the next 2-3 days after using the drug. On average, labor begins 60 hours after taking the second tablet.

According to reviews of “Miropriston” for inducing labor, a pregnant woman after taking the drug should be under medical supervision and report any changes in her condition. Already in the first hours after taking the first tablet, pain in the lower back is noted, and the release of the mucus plug can be noted.

All these unpleasant sensations, as a rule, gradually increase, clearly intensifying after the second tablet. If 2 days after taking the second tablet there is not even a hint of stimulation, another, stronger medication is prescribed.

MIROPRISTONE: DOSAGE

The drug should be used only in medical institutions that have appropriately trained medical personnel and the necessary equipment.

For medical termination of pregnancy in the early stages, the drug is prescribed in a dose of 600 mg (3 tablets) once. In the presence of a doctor, the drug is taken orally 1-1.5 hours after a meal (light breakfast), washed down with 100 ml of boiled water. 36-48 hours after taking Miropriston, the patient should report to a medical facility to take misoprostol at a dose of 400 mcg. After taking misoprostol, dynamic observation by a doctor is necessary for 2 hours. After 10-14 days, a clinical examination and ultrasound control are repeated, and if necessary, the level of human chorionic gonadotropin is determined to confirm the abortion.

If there is no effect from the use of the drug on day 14 (incomplete abortion or ongoing pregnancy), vacuum aspiration is performed, followed by histological examination of the aspirate.

To prepare and induce labor, the drug is prescribed at a dose of 200 mg (1 tablet) in the presence of a doctor. After 24 hours, the drug should be re-prescribed at a dose of 200 mg. After 48-72 hours, the condition of the birth canal is assessed and, if necessary, prostaglandins or oxytocin are prescribed.

Where to buy Miropriston for medical abortion in St. Petersburg, price

Miropriston is not sold through the pharmacy chain in St. Petersburg. The drug is supplied exclusively to medical institutions of the appropriate profile for its use directly in the process of artificial induction of labor or medical termination of pregnancy. For example, have a medical abortion at the Diana Clinic, at 10 Zanevsky Prospekt. The cost of a set of services, including abortion pills, an appointment with a gynecologist and a comprehensive ultrasound of the female organs is 3,500 rubles.

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Contraindications

• adrenal insufficiency;
• long-term use of GCS;
• acute or chronic renal failure;
• acute or chronic liver failure;
• porphyria;
• uterine fibroids (for this dosage form);
• anemia (hemoglobin level less than 100 g/l);
• hemostasis disorders (incl.
• previous anticoagulant therapy);
• acute inflammatory diseases of the female genital organs;
• the presence of severe extragenital pathology;
• smoking women over 35 years of age (without prior consultation with a therapist);
• a history of hypersensitivity to mifepristone.

For medical abortion

• suspected ectopic pregnancy;
• pregnancy,
• not confirmed by clinical studies;
• pregnancy for more than 42 days of amenorrhea;
• pregnancy,
• occurring during the use of intrauterine contraception or after discontinuation of hormonal contraception.

For preparation and induction of labor

• severe gestosis;
• preeclampsia;
• eclampsia;
• premature or post-term pregnancy;
• discrepancy between the sizes of the mother's pelvis and the fetal head;
• abnormal position of the fetus;
• bleeding during pregnancy from the genital tract of unspecified etiology;
• premature rupture of amniotic fluid;
• severe forms of hemolytic disease of the fetus.

The drug should be prescribed with caution for chronic obstructive pulmonary diseases, bronchial asthma, arterial hypertension, cardiac arrhythmias, and heart failure.

special instructions

The drug can only be supplied to specialized obstetric and gynecological institutions belonging to the state health care system, as well as to private and municipal institutions that have the appropriate license to conduct this type of activity.

The use of Miropriston requires the prevention of Rh alloimmunization and other measures accompanying abortion.

Every woman who is prescribed Miropriston to terminate a pregnancy should be warned that if a miscarriage does not occur after 10–14 days, the pregnancy must be terminated in another way, since after using mifepristone the risk of congenital malformations in the fetus is extremely high.

Possible consequences

These include:

• ectopic pregnancy;
• inflammation in the gastrointestinal tract, pelvic organs;
• intolerance to the composition.

Complications may also occur in 1% of women. To prevent their development, it is forbidden to carry out the procedure yourself.

The drug Mifepristone promotes the release of the fertilized egg from the uterus; it cannot be found on the open market. The drug is not dispensed without a prescription - this is a violation of the law. Only a doctor can choose the correct dosage, taking into account the duration of pregnancy and the health of the patient.

Attempting a pharmaceutical abortion on your own at home will lead to disastrous consequences:

• acute bleeding;
• allergies to Mifepristone;
• hormonal imbalances and weight gain;
• dysfunction of the endocrine system;
• incomplete removal of the fertilized egg;
• introduction of infection;
• inflammatory processes;
• maintaining pregnancy with pathologies.

So, the implementation of medical abortion is always associated with certain risks. Mifepristone only when prescribed by a doctor helps to achieve the expected results with minimal harm to the body.

About indications for induction of labor

This is the name for accelerating the activation of labor with the help of synthetic drugs or procedures.

Stimulation is used when the expectant mother cannot give birth on her own for the following reasons:

1. Excess fetal weight and polyhydramnios.
2. The pregnant woman has a history of serious illnesses, such as diabetes.
3. Early discharge of amniotic fluid.
4. Placental abruption with a risk of bleeding and threat to the life of the fetus.
5. Postterm pregnancy, that is, more than 40 weeks.
6. Rare contractions of an irregular nature, their complete cessation.
7. Exhaustion of a woman after contractions.

If there are such indications, the woman is stimulated with the help of prostaglandins, oxytocin, amniotomy, and tablet drugs.