WARNING

Mifepristone, commonly known by the brand name Korlym, is a medication primarily used for medical abortion and, in some cases, to manage certain medical conditions like Cushing’s syndrome. While it can be effective for its intended purposes, it also carries several risks and potential side effects. Here’s a brief overview of the risks associated with Mifepristone:

• Incomplete Abortion: In the context of medical abortion, there is a risk of incomplete abortion, which may require surgical intervention to complete the procedure.
• Heavy Bleeding: Mifepristone can cause heavy bleeding, which can be severe in some cases. This bleeding may require medical attention.
• Infection: Any abortion procedure carries a risk of infection, and Mifepristone is no exception. Signs of infection include fever, abdominal pain, and unusual discharge.
• Allergic Reactions: Some individuals may experience allergic reactions to Mifepristone, such as rash, itching, swelling, severe dizziness, or difficulty breathing. Seek immediate medical attention if you experience these symptoms.
• Ectopic Pregnancy: Mifepristone is not effective for treating ectopic pregnancies, and taking it in such cases can be dangerous. An ectopic pregnancy requires different medical intervention.
• Cushing’s Syndrome: In the context of treating Cushing’s syndrome, Mifepristone can lead to low potassium levels, which can cause weakness, muscle cramps, and abnormal heart rhythms.
• Drug Interactions: Mifepristone can interact with other medications, potentially reducing their effectiveness or causing adverse reactions. It’s crucial to inform your healthcare provider of all medications you are taking.
• Psychological Impact: Undergoing a medical abortion can have a psychological impact on some individuals. It’s essential to have access to emotional support during this process.
• Unintended Pregnancies: If the medication fails to induce abortion, there is a risk of an unintended pregnancy, which may require additional intervention.
• Rare but Serious Complications: While rare, some individuals may experience serious complications such as heavy bleeding that requires a blood transfusion, infection that spreads to other organs, or severe abdominal pain.

It’s crucial to discuss all potential risks and benefits of Mifepristone with your healthcare provider before taking the medication. They can provide guidance tailored to your specific situation and ensure that you understand the potential risks involved. Additionally, always follow your healthcare provider’s instructions and seek prompt medical attention if you experience any concerning symptoms or side effects while taking Mifepristone.

Why is this medication prescribed?

Mifepristone, often marketed under the brand name Korlym, is prescribed for several medical purposes:

• Medical Abortion: One of the primary uses of Mifepristone is for medical abortion, which is the termination of a pregnancy in its early stages. It is typically used in combination with another medication called misoprostol. Mifepristone works by blocking the hormone progesterone, which is necessary for maintaining a pregnancy. This leads to the detachment of the embryo from the uterine wall and, when followed by misoprostol, causes the uterus to contract and expel the pregnancy.
• Cushing’s Syndrome: Mifepristone is also prescribed for the treatment of Cushing’s syndrome, a rare hormonal disorder characterized by the overproduction of cortisol. By blocking the effects of cortisol, Mifepristone helps manage the symptoms of Cushing’s syndrome, such as weight gain, high blood pressure, and diabetes.

How should this medicine be used?

The usage instructions for Mifepristone can vary depending on the medical condition for which it is prescribed:

For Medical Abortion:

• Typically, the regimen starts with a single oral dose of Mifepristone, usually taken under the supervision of a healthcare provider in a clinical setting.
• Follow-up medication with misoprostol is usually taken 24 to 48 hours after Mifepristone, either at a healthcare facility or at home, as instructed by the healthcare provider.
• It’s crucial to follow your healthcare provider’s specific dosing instructions and guidance for managing potential side effects, bleeding, and follow-up appointments.

For Cushing’s Syndrome:

• The dosing and schedule for Mifepristone in the treatment of Cushing’s syndrome are determined by a healthcare provider based on the patient’s individual needs.
• Monitoring for potassium levels, liver function, and other parameters is typically required during treatment.
• Your healthcare provider will provide specific instructions on how to take Mifepristone, and it’s essential to follow these instructions closely.

In both cases, it’s crucial to have regular follow-up appointments with your healthcare provider to monitor your progress and address any concerns or side effects. Additionally, it’s important to inform your healthcare provider about any other medications or supplements you are taking, as they can interact with Mifepristone.

Please note that the information provided here is a general overview, and individual circumstances and dosing may vary. Always consult with your healthcare provider for personalized guidance on the use of Mifepristone for your specific condition.

Other uses for this medicine

Mifepristone, under the brand name Korlym, is also approved for the treatment of a specific medical condition:

• Cushing’s Syndrome: It is used to control high blood sugar (hyperglycemia) in adults with Cushing’s syndrome who have type 2 diabetes or glucose intolerance and cannot undergo surgery or have not responded to other treatments.

Mifepristone should only be used for these approved indications and always under the supervision of a healthcare provider.

What special precautions should I follow?

Special precautions and considerations when using Mifepristone (Korlym) include:

• Prescription and Supervision: Mifepristone is typically prescribed by healthcare providers who are experienced in its use. It may be administered under medical supervision for safety.
• Pregnancy Testing: Before initiating Mifepristone treatment for any indication, it’s crucial to rule out pregnancy. This is particularly important because Mifepristone is contraindicated during pregnancy.
• Cushing’s Syndrome: When used for Cushing’s syndrome, close monitoring of potassium levels and other relevant laboratory parameters is essential. Adjustments to the medication may be necessary based on individual response.
• Drug Interactions: Mifepristone can interact with other medications, including certain drugs that are metabolized by the liver. Inform your healthcare provider about all medications, supplements, and herbal products you are taking.
• Follow-up Care: For both medical abortion and Cushing’s syndrome treatment, follow-up appointments with your healthcare provider are crucial to monitor your progress, manage side effects, and ensure the desired outcomes.
• Emergency Care: In case of severe adverse reactions or complications, seek immediate medical attention. Emergency care and surgical intervention may be necessary in some cases.
• Psychological Support: Women undergoing a medical abortion with Mifepristone may benefit from access to emotional and psychological support, as the process can have a significant emotional impact.

It’s essential to discuss the specific risks, benefits, and precautions related to Mifepristone with your healthcare provider, especially if it is being considered for off-label use. Your provider will be able to provide personalized guidance based on your medical history and the condition being treated. Always follow your healthcare provider’s instructions and report any concerning symptoms or side effects promptly.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Mifepristone use. However, if you are using it to manage high blood sugar levels in the context of Cushing’s syndrome, it’s essential to maintain a balanced diet and follow any dietary recommendations provided by your healthcare provider. High blood sugar levels may require dietary modifications or adjustments to your diabetes management plan.

What should I do if I forget a dose?

If you miss a dose of Mifepristone, take it as soon as you remember, unless it’s close to the time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses to make up for a missed one.

It’s crucial not to miss doses, especially if you’re taking Mifepristone to manage a medical condition like Cushing’s syndrome, as inconsistent dosing can affect the effectiveness of treatment. If you have concerns about missed doses or have difficulty adhering to the prescribed regimen, discuss this with your healthcare provider for guidance.

What side effects can this medication cause?

Mifepristone (Korlym) can cause various side effects, and the specific side effects experienced by an individual may vary. Some common side effects associated with Mifepristone use include:

For Medical Abortion:

• Bleeding and Spotting: It is normal to experience bleeding and spotting after taking Mifepristone as part of a medical abortion. This bleeding can be heavy in some cases.
• Cramping: Abdominal cramping and discomfort are common side effects during a medical abortion.
• Nausea and Vomiting: Some individuals may feel nauseous or vomit after taking Mifepristone, although this is less common than with the follow-up medication, misoprostol.
• Fatigue: Feeling tired or fatigued is a common side effect during a medical abortion.
• Headache: Headaches are a possible side effect.
• Dizziness: Some individuals may experience dizziness or lightheadedness.
• Fever: A mild fever can occur as a side effect.
• Diarrhea: Diarrhea is a less common side effect but can occur.
• Incomplete Abortion: While not technically a side effect, it’s important to be aware that in some cases, Mifepristone may not induce a complete abortion, and surgical intervention may be needed.

For Cushing’s Syndrome or Other Indications:

• Nausea and Vomiting: Nausea and vomiting can occur in individuals taking Mifepristone for conditions like Cushing’s syndrome.
• Weakness and Fatigue: Some people may experience weakness or fatigue.
• Hypokalemia: Low potassium levels in the blood can occur as a result of Mifepristone treatment for Cushing’s syndrome, leading to symptoms like muscle weakness and abnormal heart rhythms.
• Edema: Swelling (edema) can be a side effect.
• Hypertension: In some cases, Mifepristone may lead to an increase in blood pressure.
• Headache: Headaches can also occur in individuals taking Mifepristone for Cushing’s syndrome.

It’s important to note that while these side effects can occur, not everyone will experience them, and some people may have a relatively mild experience. Additionally, there can be serious, albeit rare, side effects associated with Mifepristone, such as severe allergic reactions or heavy bleeding that requires medical attention.

If you are prescribed Mifepristone, your healthcare provider will discuss potential side effects with you and provide guidance on how to manage them. It’s crucial to follow their instructions closely, attend all follow-up appointments, and seek medical attention if you experience severe or concerning side effects while taking Mifepristone. Your healthcare provider will be able to provide you with the most accurate information and support regarding the use of this medication.

What should I know about storage and disposal of this medication?

Storage:

• Store as Directed: Always store Mifepristone as directed by your healthcare provider or the medication’s label. Typically, it should be stored at room temperature, away from moisture and heat.
• Keep Out of Reach: Ensure that Mifepristone is stored out of the reach of children and pets.
• Protect from Light: Some medications may be sensitive to light, so check the packaging for specific instructions regarding light exposure.

Disposal:

• Follow Local Regulations: Dispose of Mifepristone and any unused medication in accordance with local regulations and guidelines for safe medication disposal. Do not flush it down the toilet or pour it down the drain unless instructed to do so.
• Ask Your Pharmacist: You can also consult your pharmacist for guidance on the safe disposal of Mifepristone, especially if you have concerns about proper disposal methods.

In case of emergency/overdose

• In case of an emergency or suspected overdose, such as taking too much Mifepristone, seek immediate medical attention or contact your local poison control center. The specific treatment for overdose will depend on the symptoms and severity.
• Be prepared to provide information about the medication, the amount taken, and any symptoms you or the individual experiencing the overdose may be experiencing.

What other information should I know

• Pregnancy Test: If you are taking Mifepristone for medical abortion, it is essential to confirm that you are not pregnant before starting the medication.
• Follow-Up Appointments: Attend all scheduled follow-up appointments with your healthcare provider. These appointments are crucial to monitor your progress and ensure that the treatment is proceeding as expected.
• Medication Interactions: Inform your healthcare provider about all other medications, supplements, and herbal products you are taking, as Mifepristone can interact with certain drugs.
• Allergic Reactions: Be aware of signs of allergic reactions, such as rash, itching, swelling, severe dizziness, or difficulty breathing. Seek immediate medical attention if you experience any of these symptoms.
• Symptoms of Concern: Familiarize yourself with potential side effects and symptoms that may require immediate medical attention, such as heavy bleeding, severe abdominal pain, fever, or other severe adverse reactions.
• Privacy and Support: If you are using Mifepristone for a medical abortion, ensure you have a supportive and private environment during the process. Access to emotional support can be essential during this time.
• Follow Instructions: Always follow your healthcare provider’s instructions for the proper use of Mifepristone. If you have any questions or concerns, do not hesitate to contact them for clarification.

It’s essential to be well-informed about the specific details related to your prescription of Mifepristone, and if you have any doubts or questions, consult your healthcare provider or pharmacist for guidance. Your healthcare team can provide you with the most accurate and personalized information for safe and effective use.