mifepristone, Mifeprex

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

DOSING: Treatment with mifepristone and misoprostol requires three separate office visits.

  • Day 1: Three 200 mg tablets (600 mg) of mifepristone are taken as a single dose.
  • Day 3: 400 mcg of misoprostol is given orally unless abortion has been confirmed.
  • Day 14: No medication administered. Patient returns for a post-treatment examination to confirm that a complete termination of pregnancy has occurred.

The dose for treating Cushing syndrome is 300 mg daily initially. The dose may be increased to 1200 mg daily.

DRUG INTERACTIONS: Ketoconazole, itraconazole (Sporanox), erythromycin, and grapefruit juice may increase blood levels of mifepristone by inhibiting the enzyme responsible for metabolizing (breaking down) mifepristone. Rifampin, dexamethasone, St. John's Wort, phenytoin, phenobarbital, and carbamazepine may decrease blood levels of mifepristone by increasing the activity of the enzyme responsible for metabolizing mifepristone and decrease the effectiveness of mifepristone. Mifepristone may inhibit liver enzymes which are responsible for the metabolism of various drugs, resulting in increased blood levels of these drugs.

PREGNANCY: Mifepristone is used for the termination of pregnancy through the 49th day of pregnancy. Otherwise, it should not be used during pregnancy because it will terminate the pregnancy.

NURSING MOTHERS: Mifepristone is secreted into breast milk. Due to the risk of adverse effects, breastfeeding mothers should decide whether to discontinue breast-feeding or mifepristone.

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