Mifepristone is an essential part of the medical abortion procedure. It is an antiprogesterone pill taken on the first day of starting the pregnancy termination. It is highly effective and when combined with the prostaglandin, Misoprostol, you experience a successful and safe abortion in early pregnancy.

→ Mifepristone and Misoprostol pills are found together in an MTP Kit, and these pills are FDA-approved.

→ The Mifepristone is effective in its own way to kickstart the abortion. It brings some hormonal and physiological changes in the body, facilitating pregnancy termination.

→It is available in many countries under several brands such as Mifeprex, RU486, etc. The availability of this medicine depends on the regional laws for abortion.

Let us understand the action mechanism of this progesterone blockers, and its role in expelling the pregnancy.

The Role of Progesterone in a Pregnancy

Before understanding how Mifepristone works, it is important to understand what progesterone hormone does. This is often labelled as the pregnancy hormone, which maintains the right uterine ambiance to support the conception.

→ When the fertilized egg implants, the production of progesterone increases in the body. This hormone prepares the uterine lining, also known as the endometrium.

→This lining is nutrient-rich and thick to keep the embryo attached to the uterus.

→ However, if this hormone production decreases than the required levels, the uterine lining starts to shed and break, disallowing healthy continuation of a pregnancy.

The Mechanism of Action: How Mifepristone Works

As an antiprogesterone, Mifepristone works as a receptor antagonist affecting the secretion and availability of progesterone hormone.

1. Blocking the Receptors

As understood, progesterone is vital for development and continuation of a pregnancy. Mifepristone has elements that replicate progesterone and bind to uterine receptors, stopping actual progesterone to act within this space. Thus, the pill disables progesterone supply in the womb.

2. Altering the Uterine Lining

After Mifepristone blocks out the progesterone, the pregnancy stops developing. The embryo detaches from the uterus as the endometrium starts to shed. The process is like that during a menstrual cycle, but with a more specific mechanism.

3. Sensitizing the Uterus

The Mifepristone 200mg pill sensitizes the myometrium or uterus muscles to respond better to Misoprostol prostaglandin activity. It helps the uterus to prepare for the next stage of abortion. So, when Misoprostol begins to induce uterine contractions, Mifepristone causes the priming effect, making the medicine dose work swiftly and cause expulsion of pregnancy portions.

The Two-Step Process: Mifepristone and Misoprostol

Mifepristone is important in a medical abortion but alone it performs a certain level of activity. To complete the abortion successfully, a second medicine, Misoprostol also needs to be administered. Here is how to use the MTP Kit pills to cause a pregnancy termination:

1) Mifepristone

Taken orally with water and swallowed whole, this 200mg pill is the foundation of the medical abortion procedure. Usually, no significant side effects happen immediately on using Mifepristone. But some women may encounter light spotting. In this phase, the pregnancy stops as the progesterone hormone supply ends in the uterus. The endometrial lining sheds, separating the fertilized egg from the nutrition support.

2) Misoprostol

After 24 to 48 hours of consuming Mifepristone, it is time to start with the Misoprostol 800mcg dose (4 x 200mcg pills). This medicine causes uterine contractions and cervical ripening. It also dilates the pregnancy so that the weakened and shed pregnancy products caused by Mifepristone activity, are easily removed from the uterus via contractions aided by Misoprostol pills.

How Effective and Successful is Mifepristone?

The World Health Organization (WHO) recognizes Mifepristone as a vital medicine for medical abortion. Here is more about Mifepristone:

→It has high success rates when used with Misoprostol for a pregnancy within the initial 10 to 11 weeks. The success rate of Mifepristone and Misoprostol together is 95% to 98%.

→ In some cases, it can stay effective even up to 12 weeks of pregnancy.  It is also a safe medicine with risks less than 0.5% for severe and rare complications.

→The common side effects are part of the normal abortion process. Some temporary side effects are nausea, bleeding, and cramping.

→Using this progesterone blocker, you can start to end an early pregnancy non-invasively without the need of surgical instruments, anesthesia, and medical supervision when administering the pill.

What to Expect During a Medical Abortion?

Mifepristone is basically a pill that helps initiate a medical abortion. It also prepares the reproductive system and uterus with cervix to support the abortion easily, allowing Misoprostol pills to work even better and as expected. Here is what to expect during a medication pregnancy termination:

1)   Immediate Effect: After ingesting Mifepristone, you may not feel much difference and can continue with regular chores. In some individuals, light bleeding and nausea may happen. However, until the second medicine is taken, heavy bleeding and cramping mostly do not begin.

2)   Occurrences Between the Two Doses: The interval between Mifepristone and Misoprostol pill administration serves a crucial purpose. Within 24 to 48 hours, Mifepristone blocks progesterone, and successfully begins to shed the uterine lining. It may thus take some time for the medicine to completely disintegrate the endometrium and detach the fertilized egg.

3)  After Misoprostol: Once the Misoprostol pill intake happens either buccally or sublingually, and sometimes administered vaginally, the separated and shed contents in the uterus are expelled via uterine contractions and heavy vaginal bleeding.

4)  Common Side Effects: Some gastrointestinal side effects are expected due to hormonal changes. These include diarrhea, stomach upset, vomiting, nausea, etc. Some people may feel dizzy, have a headache, experience abdominal pain and cramps from the contractions.

Frequently Asked Questions (FAQs)

Here are some common queries about Mifepristone abortion pill and other MTP Kit pills used in an early pregnancy termination:

1)  How long does it take for Mifepristone to start working?

After ingesting this medicine, the effect of blocking the progesterone receptors starts happening soon. However, physical signs such as bleeding may not always happen for every user until the second medicine, Misoprostol, is taken buccally, sublingually, or vaginally.

2)  Can I reverse the effects of Mifepristone once taken?

There is no proven reversal treatment despite claims of undoing abortion effect after taking Mifepristone. This medicine is ideal to start blocking progesterone immediately after intake. So, it is unsafe to continue a pregnancy once you have used Mifepristone or try for reversing the process.

3)   Is Mifepristone used for things other than abortion?

Apart from its use in a medical abortion, in different dose strengths, Mifepristone may prove effective in managing early pregnancy loss or miscarriage, as well as in treating Cushing’s syndrome.

4)  Will taking Mifepristone affect my future fertility?

There is no scientific study that have shown a consistent effect of Mifepristone negatively affecting future chances of pregnancy, fertility, or causing issues during childbirth.

5)  What should I do if I vomit after taking the pill?

If you vomit within 30 minutes of taking Mifepristone, contact a doctor immediately as you may need another dose to substitute the early taken medicine.