II. Mechanism
- Selective Progesterone receptor modulator acts as Progesterone receptor Antagonist
- Causes Decidual necrosis and uterine contractions
III. Indications
- Early Pregnancy Loss (<84 days)
- Termination of Pregnancy (<77 days)
- Non-pituitary Cushing Syndrome (Hypercortisolism)
IV. Contraindications
- Adrenal Insufficiency
- Chronic Corticosteroid use
V. Precautions
- See Early Pregnancy Loss for combined protocol of Mifepristone with Misoprostol (Cytotec)
- Obstetric Ultrasound is typically used to confirm Early Pregnancy Loss and assess Gestational Age
- Quantitative bhCG is often obtained to monitor serially to confirm completed Miscarriage
- Mifepristone is obtained by licensed medical provider directly from manufacturer
-
RhoGAM has typically been given for Rh Negative patients
- RhoGAM is not needed if undergoing abortion or pregnancy loss <12 weeks (per ACOG, 2024)
VI. Dosing: Early Pregnancy Loss or Termination of Pregnancy
- Mifepristone 200 mg orally given 24-48 hours BEFORE Misoprostol 800 mcg per vagina or buccal