Mifegin tablets block the effects of the hormone progesterone at the receptor level. They do not possess gestagenic activity. Antagonism with glucocorticoids may result from competition due to binding to receptors.
How does Mifegin act?
Description of this drug
The drug increases the contractile properties of the myometrium, in choriodecidual cells it stimulates the release of interleukin-8 and increases the sensitivity of the myometrium to prostaglandin. To increase the effectiveness of this medication is used in combination with synthetic analogues of prostaglandin (for example, with misoprostol). Stimulation of uterine contractions contributes to the desquamation of the decidual membrane and the removal of a fertilized egg.
Indications for the use of the medication
According to the instructions to “Mifegin”, the main indication for the use of this medication is medical abortion for the initial period (up to 42 days of absence of menstruation), which was confirmed by testing for pregnancy. The medication is also used in the preparation and induction of labor in cases of full-term pregnancy, for emergency (post-coital) contraception within 72 hours after unsafe sexual intercourse or if the method of contraception used was not considered reliable. An antigestagenic agent is also prescribed for the treatment of uterine leiomyomas (up to 10 weeks of gestation).
Forms of drug release
This medication is available in tablets, which include the main active substance - mifepristone micronized at a dosage of 200 milligrams. As excipients, the drug includes: colloidal silicon dioxide, corn starch, povidone, microcrystalline cellulose, magnesium stearate.
The tablets are packaged in blisters of three pieces, packed in cardboard boxes along with an annotation for use.
Pharmacodynamics
As the instructions indicate, “Mifegin” is a steroidal synthetic antigestagen drug whose action is aimed at blocking progesterone at the receptor level. Does not possess gestagenic properties.
After oral administration of a drug in a single dosage (600 milligrams), the maximum concentration of a substance in the blood is reached in about an hour and a half. Absolute bioavailability is approximately 70%.
In plasma, the active substance is 97% bound to proteins: acidic alpha1-glycoprotein and albumin. After the distribution period, the drug is first eliminated gradually - its concentration decreases by half between 18-74 hours, after which it decreases more quickly. The half-life of the active element is 12 hours.
After taking this medication, breastfeeding should be stopped for two weeks.
Contraindications
What else does the instruction tell us? Mifegin is contraindicated in the following cases:
- With adrenal insufficiency.
- In chronic or acute liver and kidney failure.
- With porphyria.
- During prolonged use of glucocorticoids.
- With anemia.
- With violations of hemostasis (including previous anticoagulant therapy).
- In the presence of severe extragenital pathologies.
- With increased sensitivity to the main substance (history) or its auxiliary components.
In addition, abortion "Mifegin" is contraindicated in the following cases:
- If you suspect an ectopic pregnancy.
- In pregnancy, not confirmed by clinical studies.
- During pregnancy, if menstruation is absent for more than 42 days.
- In pregnancy, which occurred on the background of the use of intrauterine contraceptives or after discontinuation of contraception with hormonal drugs.
- With inflammatory pathologies of the genital organs.
- In smokers in women after 35 years of age without prior medical advice.
"Mifegin" is also contraindicated in certain circumstances, induction of labor or preparation for them:
- With severe gestosis, eclampsia and preeclampsia.
- In preterm or postponed pregnancy.
- In the case of placenta previa.
- With a mismatch in the size of the head of the fetus and pelvis of the woman in childbirth.
- With abnormal position of the fetus.
- With spotting of unknown etiology from the genital tract.
The drug is prescribed with caution in chronic obstructive pulmonary diseases (including bronchial asthma), arrhythmias, arterial hypertension, and chronic heart failure.
Side effects
In accordance with the instructions to "Mifegin", as a side reaction when using this medication, bloody discharge, discomfort and pain in the lower abdomen, exacerbation of the inflammatory process in the uterus and appendages, severe weakness, cephalgia, dyspeptic disorders, diarrhea, hyperthermia can be observed dizziness, urticaria.
Against the background of combination therapy with misoprostol (optional), vaginitis, dyspepsia, sleep disturbances, asthenic syndrome, leg pain, severe anxiety, anemia, a decrease in hemoglobin, leucorrhoea, and fainting can occur.
Method of use and dosage
This medication for abortion should be used only in specialized medical institutions under the strict supervision of a specialist. How to take it?
To terminate the pregnancy, he prescribes 600 mg of mifepristone (three tablets of 200 mg once), the medicine is taken orally in the presence of a specialist. A woman should be monitored for at least two hours after using the medicine.
How long does Mifegin act? In some cases, the drug begins to act in a few hours, in some cases, its effect occurs within a day or more.
48 hours after admission, a woman should appear for an ultrasound scan. After 14 days, the clinical examination and ultrasound are repeated, the levels of beta-chorionic hormone are also determined. This is done in order to confirm the fact that a miscarriage has occurred. If the effect of the medication on day 14 is absent, for example, in cases of incomplete abortion or ongoing pregnancy, vacuum aspiration and subsequent histological examination of the aspirate are performed.
To induce labor or prepare for them, mifepristone is prescribed once at a dosage of 200 mg (1 tablet) per day orally in the presence of a doctor. After a day, the medication should be repeated in the same dose. After two to three days, the birth canal is evaluated and, if necessary, oxytocin or prostaglandins can be prescribed.
Overdose
Taking this medication in dosages of up to 2 g, in most cases, does not cause negative adverse reactions. In case of an overdose of the drug, the patient may have adrenal insufficiency.
What is the interaction of the drug with other drugs? Within 8-14 days after termination of pregnancy, "Mifegin" should avoid taking anti-inflammatory non-steroidal drugs.
special instructions
Patients must necessarily be informed that if there is no effect from the use of this medication on day 14 (with incomplete abortion or a pregnancy that has survived), pregnancy must be terminated in another way, since the fetus may cause congenital malformations.
The use of a medication requires the prevention of rhesus alloimmunization and other measures that accompany abortion.
Women with artificial heart valves, as well as with infectious endocarditis, should use prophylactic antibiotic therapy when using the medicine.
Mifegin is allowed to be used in obstetric and gynecological medical institutions with appropriate licensing, trained personnel and appropriate equipment.
Analogs of "Mifegin"
This drug has a number of analogues, but their use is also determined by the doctor. These medications include:
- "Mifepristone" is an absolute analogue of the drug "Mifegin": it has the same active substance, the same indications for use and the same effectiveness. The cost of funds varies greatly depending on the pharmacy network and the region. This tool is also used to activate the birth process and to terminate pregnancy.
- "Pencrofton" is the active element - mifepristone, therefore, according to the mechanism of action, this medication is similar to the previous ones. Its main difference is that it is not used to induce labor.
- “Ginepriston” - also represents an absolute analogue of “Mifegin” both in terms of mechanism of action and purpose.
In addition to the above medicines, the absolute analogues of Mifegin are:
- "Agesta";
- Ginestril;
- "Zhenale";
- Miropriston;
- "Mytholian";
- Mifeprex;
- Pencrofton.
Reviews about "Mifegin"
There are a lot of reviews about this medication, and most of them are positive. Patients using the Mifegin medication observed that this drug was fairly well tolerated and practically did not cause adverse reactions. Some of them noted only a minor pain syndrome, which is usually associated with an increase in contractile function of the uterus, and is quite normal. In this case, patients experienced pain in the lower abdomen. In extremely rare cases, severe bleeding was observed, however, this was the cause of concomitant pathological processes in the body and is also not a negative characteristic of this medication. In some cases, there was slight nausea that occurred in the next few hours after administration, as well as symptoms of intestinal upset in the form of diarrhea, flatulence, etc. Otherwise, there were no negative signs from taking the drug.
The doctors' reviews about Mifegin are also good, but they strictly warn that it is strictly contraindicated to use such a drug on their own, as this can cause unpredictable reactions of the body up to a fatal outcome. In general, they argue that the medication is quite effective, especially with the right dosages and assessment of a woman’s health status. After its use, the medicine acts already in the first days, which allows you to use it in the early stages of pregnancy to terminate it. In this case, the patient begins artificial bleeding, which is a consequence of hormonal effects and should resemble normal menstruation.
However, according to experts, most often this bleeding is much more intense than usual menstruation, but this should not frighten women, especially if they are at the same time in stationary conditions. However, any emergency should be reported to your doctor to prevent negative consequences.