Ketoconazole, itraconazole, erythromycin and grape friut juice, inhibit milepristone metabolism.
Rifampicin,dextromethasone, St John's wort and certain anticonvulsants (phenytoin,
phenobarbital, carbamzepine) induce mifepristone metabolism

Lab interactions:
Both plasma ACTH and plasma cortisol levels may be elevated by mifepristone

 

Excessive vaginal bleeding, unusual tiredness,or weakness, uterine carmping, back pain,

diarrhea, dizziness, headache, nausea, vomiting, dyspepsia, anxiety, belching, cough,

dizziness, fever, flu-lke symptoms, headache, heartburn, increased clear or white vaginal

discharge, itching of vagina, or genital area, fatigue, pain during sexual intercourse, pain or

tenderness around eyes and cheek bones, pale skin , shortness of breath, insomnia, tightness

of chest or wheezing , unusual bleeding or bruising, sinusitis, uterine hemorrhage, vaginitis.

 

Confirmed or ectopic pregnancy
Chronic adrenal failure
Concurrent long term corticosteroid therapy
History of allergy to mifepristone, misoprostol or other prostaglandin
Hemorrhage disorders or concurrent anticoagulant therapy
Inherited porphyrias

Special precautions:
Bleeding: vaginal bleeding in almost all women during the procedure. in some cases excessive
bleeding may require treatment

Confirmation of temination of pregnancy: Patients should be followed up after 14 days for the
confirmation of termination of prergnancy

Women with other disease conditions like cardiovascular , hepatic , renal , hypertensive
should be treated with caution, also women above 35 yrs and who smoke should be treated
with caution.

 

Indications:

Pharmacology:
Mifepristone is synthetic 19-nonsteroidal related to norethisterone. It binds to intracellular progesterone receptor  where it competitively inhibits progesterone attachment and thus antagonises the effects of endogenous propgesterone
Mifepristone by antagonising the progesterone activity induces ,labor in pregnancies.

Pharmacokinetics:
Mifepristine is rapidly absorbed after oral ingestion, the time taken to reach peak plasma concentration is approximately 1 to 2 hrs. The bioavailabilitry of mifepristone is 40% because of its presystemic metabolism. Elimination half life has been reported to be 24 and 48hrs.