China
Africa
Explore chapters and articles related to this topic
Endocrine Disorders, Contraception, and Hormone Therapy during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
The morning after pill, formerly RU-486, contains mifepristone. Other formulations may sometimes contain levonorgestrel. These drugs act by preventing implantation, rather than by preventing conception. The effects of either of these drugs on a post implantation pregnancy are unknown. Friedman and Polifka (2006) state that the risk of congenital anomalies is unknown following a failed attempt at abortion but “this risk may be substantial because the process of attempted abortion may disrupt normal embryogenesis or fetal development.”
Dejar pasar
Published in Hanna Laako, Georgina Sánchez-Ramírez, Midwives in Mexico, 2021
Georgina Sánchez-Ramírez, Geicel Llamileth Benítez Fuentes
In Mexico, these pharmaceuticals are legally available in abortion support centers which perform safe abortions (in Mexico City) and illegally (in the rest of the country). However, in Mexico City, where voluntary pregnancy interruption is not penalized, only misoprostol is sold freely in pharmacies. Mifepristone is not, despite being an essential medicine according to the WHO. Thus, there is an urgent need to guarantee that mifepristone is legally and de facto available, including as an indispensable element in health centers for cases of incomplete abortions.
Miscarriage
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Erich T. Wyckoff, Hadeer Usama Ebrahem Metwally
Medical regimens such as mifepristone plus misoprostol, commonly used in non–medically indicated abortions, can also be used effectively to treat miscarriage (Table 16.3). Mifepristone is a pregnancy termination drug, which is an antagonist of progesterone receptors at the level of the endometrium and myometrium. Like misoprostol, regimens may vary; however, one of the most common regimens is to begin with mifepristone 200 mg orally as pretreatment, followed approximately 24 hours later by 800 µg of intravaginal misoprostol. A trial including 300 women with miscarriages between 5 and 12 weeks of gestation reported that mifepristone pretreatment followed by misoprostol therapy resulted in higher rates of complete expulsion by an average of 3 days after treatment compared with misoprostol alone (84% vs 67%) and lower rates of surgical uterine aspiration (9% vs 24%) [20]. This combination regimen may significantly improve treatment efficacy and should be considered when mifepristone is available [21]. Even though this method is the most effective, it is not always feasible because it cannot be purchased in retail pharmacies secondary to FDA regulations. Less commonly used drug regimens have been documented such as methotrexate and tamoxifen with or without mifepristone or misoprostol. The use of these drugs shows no benefit over simpler regimens [2].
The latest advances in the pharmacological management of endometriosis
Published in Expert Opinion on Pharmacotherapy, 2023
Gabriel Hartner, Heinrich Husslein, Lorenz Kuessel, Manuela Gstoettner, Denise Tiringer, René Wenzl, Alexandra Perricos
Mifepristone, combined with misoprostol, is used for medically induced abortions. In 1991, this drug was first studied for the treatment of endometriosis and showed an improvement in endometriosis-associated symptoms at a dose of 100 mg per day, however without regression of endometriotic lesions [62]. A double-blinded, placebo-controlled study evaluated the safety and efficacy of mifepristone (2.5 mg, 5 mg, and 10 mg) after a treatment period of 6 months, assessing changes in dysmenorrhea, as well as the occurrence of side-effects, such as nausea, vomiting, fatigue, or rise in hepatic transaminases. Finally, the study showed a significant decrease in the prevalence of symptoms in women receiving doses higher than 2.5 mg. A dose of 5 mg appeared to be the most effective, taking into account symptom alleviation and safety of the treatment [67].
The efficacy of mifepristone combined with methotrexate for the treatment of ectopic pregnancy: a systematic review and meta-analysis*
Published in Annals of Medicine, 2022
Qiling Su, Huiyan Feng, Tian Tian, Xiaoqian Liao, Yunhui Li, Xiaomao Li
The principle of methotrexate in treating EP is that it has a high affinity with dihydrofolate reductase and binds to it in a competitive manner. During the treatment, the growth of trophoblast cells is blocked and the placental villi are damaged, so that the embryo stops developing and the tissues are necrotic and fall off. Mifepristone is a kind of receptor-level antiprogesterone drug that competes with progesterone for receptors and terminates a pregnancy that depends on luteal maintenance. According to the results above, the combination of mifepristone and methotrexate in the treatment of EP can improve the cure rate more effectively, more significantly reduce β-HCG level, improve symptoms such as vaginal bleeding and abdominal pain and promote the absorption of mass. Thus, combination therapy has better clinical efficacy compared with mifepristone-alone therapy.
Mifepristone regulates Tregs function mediated by dendritic cells through suppressing the expression of TGF-β
Published in Immunopharmacology and Immunotoxicology, 2021
Yinghua Li, Lili Cao, Zhida Qian, Qingyun Guo, Xiaocen Niu, Lili Huang
Mifepristone, a competitive glucocorticoid receptor (GR) antagonist, has ever been used as a synthetic steroid for the therapy of patients with psychotic depression (PD) [1,2]. Mifepristone is currently used as an agent for inducing abortion clinically in some countries, based on its antagonistic action of progesterone receptor in the luteal phase of the cycle [3]. Moreover, mifepristone also has been widely used as a medical alternative for emergency contraceptive through inhibition of ovulation [4,5]. Recently, numerous studies have ever shown that the treatment with daily low-dose mifepristone can inhibit the development of the endometrium in order to achieve the purpose of contraception [6,7]. Some studies demonstrated mifepristone could alter innate immune response and increases life span both in human and other species [8–10]. However, the underlying mechanism of mifepristone in inducing alteration of endometrial function, especially endometrium immune balance, remains poorly investigated.