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Mifepristone
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Mifepristone is a synthetic steroid compound used as a pharmaceutical. It is used as an abortifacient in the first two months of pregnancy, and in smaller doses as an emergency contraceptive. It can ... be used as a treatment for obstetric bleeding.[1] During early trials, it was known as RU-486, its designation at the Roussel Uclaf company, which designed the drug. The drug was initially made available in France, and other countries then followed—often amid controversy. In France and countries other than the United States it is marketed and distributed by Exelgyn Laboratories under the tradename Mifegyne. In the United States it is sold by Danco Laboratories under the tradename Mifeprex.
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Mifepristone, a norethindrone derivative, is a synthetic antiprogestin. Misoprostol is a methyl ester of prostaglandin E1 that stimulates uterine contractions through EP2/EP3 receptors. Given 48 hours after mifepristone, it results in complete abortion in up to 95-99% of cases. Initially mifepristone was advocated in the dose of 600 mg for this purpose [ 2 , 3 ]. Studies regarding the pharmacokinetics of mifepristone suggest that after ingestion of doses higher than 100mg, there is no significant difference in plasma concentrations of the drug within the first 48 hrs[ 4 ] (peak serum concentration remains between 2.0-2.5µg/ml). Further trials have confirmed equal efficacy (93-97%) of low dose mifepristone as well[ 5 , 6 , 7 ] .
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As with most medications, Mifepristone may have some expected side effects. Just like a miscarriage, Mifepristone can cause cramping and bleeding. The bleeding may be similar to a heavy period, but could be greater. Also like a miscarriage, Mifepristone may cause diarrhea, nausea, and other symptoms. Your provider will work with you to help manage any side effects, including giving you appropriate medicine.
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Clinical Applications of Mifepristone (RU 486) and other Antiprogestins: Assessing the Science and Recommending a Research Agenda bleeding and increased uterine contractility. About 50 percent of the patients have started to bleed at the time of prostaglandin treatment, and almost all within four hours thereafter. The mean duration of bleeding in the French study was eight days. In 89.7 percent of the women, bleeding lasted for 12 days or less. In 9 percent of the women the bleeding was described as severe or excessive in the 24 to 48 hours after mifepristone and 4 hours after prostaglandin therapy (U.K. Multicentre Trial, 1990).
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Mifepristone comes as a tablet to take by mouth. It should be taken only in a clinic, medical office, or hospital under the supervision of a qualified doctor. You will take three tablets of mifepristone at one time on the first day. Two days later you must go back to your doctor. If your doctor is not certain that your pregnancy has ended, you will take two tablets of another medication called misoprostol. You may have vaginal bleeding for 9 to 30 days or longer.
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Mifepristone was developed in France and was first approved for use there in 1988. Twelve years later, in September 2000, the FDA approved mifepristone for sale in the US under the brand name Mifeprex™. Mifepristone is now available in most of the European Union, China, Taiwan, Tunisia, Ukraine, Israel, New Zealand, South Africa, and Russia as a method of early abortion. Medical abortion with mifepristone offers women more privacy than surgical abortion and allows women greater control in ending a pregnancy. In addition, mifepristone has the potential to expand access to safe, legal abortion in the US since many doctors who do not currently perform surgical abortions say they would administer mifepristone. Currently, 86% of US counties do not have an abortion provider, leaving too many women with no safe or legal options for terminating an unintended pregnancy.
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Mifepristone