mifepristone + misoprostol at a glance
Medicine class
Antiprogestogen combined with a prostaglandin analogue
Licensed use
Termination of a confirmed developing intrauterine pregnancy up to 63 days after the last menstrual period began
Administration
The selected pack contains an oral mifepristone tablet and misoprostol tablets for vaginal use
Follow-up
Bleeding alone does not confirm success; follow-up is needed to check that the pregnancy has ended
What is mifepristone + misoprostol used for?
The selected UK product is licensed for:
Medical termination of a confirmed developing pregnancy within the womb, up to 63 days after the first day of the last menstrual period.
How does mifepristone + misoprostol work?
Mifepristone blocks progesterone, which is needed to maintain pregnancy, and makes the womb more responsive to prostaglandins. Misoprostol acts like prostaglandin E1, softening the cervix and producing womb contractions that help expel the pregnancy.
How to take mifepristone + misoprostol
Use only as instructed by the prescribing abortion service and keep its emergency contact details available.
Swallow the mifepristone tablet with water.
The misoprostol tablets in the selected pack are inserted high into the vagina with clean hands; they should not be divided.
Remain lying down for 30 minutes after inserting the vaginal tablets.
If you vomit shortly after swallowing mifepristone, contact the provider because further action may be needed.
Do not drink grapefruit juice during treatment because it may alter mifepristone levels.
mifepristone + misoprostol side effects
Common or expected effects
- Womb contractions and lower abdominal cramps
- Vaginal bleeding
- Nausea or vomiting
- Diarrhoea
- Chills, dizziness or headache
Get urgent medical advice
- Very heavy or persistent bleeding
- Persistent severe pain
- Fever, flu-like illness or offensive vaginal discharge suggesting infection
- Fainting, marked weakness or a fast heartbeat
- Widespread blistering, peeling or pustular rash
- Continuing pregnancy or incomplete expulsion
mifepristone + misoprostol in pregnancy
This combination is intended to end an existing pregnancy. If the pregnancy continues after exposure, contact the abortion provider promptly: misoprostol exposure has been associated with a small increased risk of specific birth defects, and continuing pregnancy requires specialist counselling and ultrasound monitoring.
mifepristone + misoprostol while breastfeeding
The product information advises avoiding Medabon while breastfeeding because of limited data. UK Specialist Pharmacy Service guidance considers short-term mifepristone and misoprostol compatible with breastfeeding for full-term, healthy infants; individual advice is important if the infant is premature or unwell, or other medicines are being taken.
mifepristone + misoprostol interactions
Tell the prescriber about all medicines, supplements and herbal products. Important examples include:
Long-term corticosteroids, including inhaled corticosteroids
Mifepristone can temporarily reduce corticosteroid effectiveness, so specialist review may be required.
Ketoconazole, itraconazole or erythromycin
These may slow mifepristone metabolism and increase its blood concentration.
Rifampicin, carbamazepine, phenytoin, phenobarbital or St John’s wort
These may increase mifepristone metabolism and reduce its concentration.
Common questions about mifepristone + misoprostol
Answers are fully visible for fast scanning and source review.
How do I know whether mifepristone and misoprostol have worked?
Bleeding and cramps are expected but do not prove that the pregnancy has ended. Complete the follow-up arranged by the abortion provider, which may involve a special pregnancy test, clinical review or ultrasound.
Can mifepristone and misoprostol fail?
Yes. A continuing or incompletely expelled pregnancy can occur and may require further medicine or a surgical procedure, which is why follow-up matters.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.