Mifegest is a pharmaceutical product used primarily for medical abortion (termination of pregnancy) and the management of certain gynecological conditions. It contains the active ingredient Mifepristone, a synthetic steroid that acts as a progesterone receptor antagonist. Mifegest is widely used in combination with another medication called Misoprostol to ensure the complete termination of an early pregnancy.
Key Details About Mifegest:
1. Active Ingredient:
- Mifepristone (200 mg or 400 mg tablets):
- Mifepristone works by blocking the action of progesterone, a hormone essential for maintaining the lining of the uterus during pregnancy. Without progesterone, the uterine lining breaks down, and the pregnancy cannot continue.
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2. Indications:
- Medical Termination of Pregnancy (MTP):
- Mifegest is used to terminate early pregnancies (up to 10 weeks gestation or 70 days from the first day of the last menstrual period).
- Management of Miscarriage:
- It can be used to manage incomplete or missed miscarriages.
- Cervical Ripening:
- In some cases, Mifegest is used to soften and dilate the cervix before surgical procedures like dilation and curettage (D&C).
- Other Uses:
- Occasionally prescribed for conditions like Cushing’s syndrome or uterine fibroids, though this is less common.
3. Mechanism of Action:
- Mifegest blocks progesterone receptors, leading to:
- Breakdown of the uterine lining.
- Detachment of the embryo.
- Softening and dilation of the cervix.
- When combined with Misoprostol (a prostaglandin analog), it induces uterine contractions, which help expel the pregnancy tissue.
4. Dosage and Administration:
- Step 1: A single dose of Mifegest (200 mg or 400 mg) is taken orally under medical supervision.
- Step 2: After 24-48 hours, Misoprostol (800 mcg) is administered either orally or vaginally to induce uterine contractions and complete the abortion process.
- Follow-Up: A follow-up visit after 7-14 days is essential to confirm the completion of the abortion and rule out complications.
5. Effectiveness:
- When used correctly, Mifegest in combination with Misoprostol has a success rate of over 95% for terminating early pregnancies.
- The effectiveness decreases slightly as the pregnancy progresses closer to 10 weeks.
6. Side Effects:
- Common Side Effects:
- Nausea, vomiting, diarrhea, abdominal pain, dizziness, and fatigue.
- Vaginal bleeding (similar to or heavier than a menstrual period) and cramping are expected as part of the process.
- Less Common Side Effects:
- Headache, fever, or chills.
- Rare but Serious Side Effects:
- Heavy or prolonged bleeding (requiring medical attention).
- Incomplete abortion (requiring surgical intervention).
- Infection or allergic reactions.
7. Contraindications:
- Mifegest should not be used in the following cases:
- Pregnancy beyond 10 weeks gestation.
- Suspected ectopic pregnancy.
- Chronic adrenal failure or long-term corticosteroid use.
- Known allergy to Mifepristone or Misoprostol.
- Hemorrhagic disorders or use of anticoagulants.
- Presence of an intrauterine device (IUD) that has not been removed.
8. Precautions:
- Mifegest should only be used under the supervision of a qualified healthcare provider.
- Patients must have access to emergency medical care in case of complications.
- A follow-up visit is mandatory to ensure the abortion is complete and to monitor for complications.
9. Storage:
- Store at room temperature (15°C to 30°C or 59°F to 86°F).
- Keep the tablets in their original packaging, away from moisture and direct sunlight.
- Medical Termination of Pregnancy (MTP):
