What you need to know about the pill used to terminate pregnancy (Mifepristone)

I understand the weight, uncertainty, and perhaps loneliness you feel when discussing such a sensitive topic. That's why I thought I would explain this drug called Mifepristone accurately, clearly, as if it were your own person speaking. This is a very important decision, so knowing everything about it will be a great strength for you.

Simply put, what is Mifepristone?

Mifepristone is a drug used to terminate early pregnancy. Let's see how it works. Our body has a hormone called progesterone that is essential for maintaining pregnancy. What this Mifepristone pill does is reduce the activity of that hormone. Then the pregnancy cannot continue.

This is usually given with another medication, so it's important to ask your doctor any questions you have about this.

Things you need to tell your doctor before taking this medicine

Your safety comes first. Therefore, if you have any of the following conditions, you should tell your doctor without hiding anything .

• Bleeding disorder: If you have a blood clotting problem or other bleeding disorder.
• Difficulty in getting emergency medical help: If you have an emergency within two weeks of taking this medicine, go to a hospital (ETU) quickly if there is no facility.
• Difficulty returning for a medical check-up: If you are unable to return to see the doctor within a week or two after taking the medicine.
• Ectopic or tubal pregnancy: If there is a suspicion that a pregnancy has occurred outside the uterus, such as in the fallopian tubes. This is a very dangerous condition.
• If you have an intrauterine device (IUD): If you have an intrauterine device (IUD) inserted into your uterus, it should be removed before taking this medicine.
• Pregnancy: If more than 70 days (10 weeks) have passed since the start of your last menstrual period.
• Low adrenal gland function.
• If you have a condition called porphyria.
• If you are taking medication that prevents blood clotting: For example, medications like Warfarin and Apixaban.
• If you are taking steroids: If you are using medications like Prednisone and Dexamethasone.
• Allergies: If you have an allergy to Mifepristone, Misoprostol or any other medicine, food, or dye.
• If you are a mother who is breastfeeding.

How should I use the medicine?

This medicine is a pill that you take by mouth. Follow your doctor's instructions exactly. This is usually a combination treatment. Therefore, you will receive a special instruction leaflet (MedGuide) about this. It is very important to read and understand it carefully.

This medicine is for you only. Do not share it with anyone else for any reason.

What to do if you take too much medicine?

If you think you have taken more medicine than you think, go to a hospital's Emergency Unit (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital .

What other things can interact with this medicine?

Some medications and foods may interact with Mifepristone. Therefore, if you are using the following, tell your doctor about them as well.

Do not take Mifepristone with:

• Some medications that prevent blood clotting (e.g. enoxaparin, dalteparin, apixaban, dabigatran, rivaroxaban)
• Steroid medications that are taken regularly (e.g. dexamethasone, prednisone, cortisone)

Problems can also arise with these:

• Some antibiotics - e.g. clarithromycin, erythromycin
• Some medications for HIV or Hepatitis
• Medicines for fungal infections - e.g. ketoconazole, itraconazole
• Some medications used for seizures - e.g. carbamazepine, phenytoin
• Grapefruit juice
• Rifampin (a medicine for tuberculosis)
• St. John's wort (an herb some people take for mental health)

This list is not complete. So tell your doctor about all the medications you take (including vitamins and herbal supplements) , if you smoke, and if you drink alcohol.

Things to be especially careful about when taking medication

This is a very important part.

1. Medical check-up: For your safety, you must go to the doctor's appointment on the day after taking the medicine. Don't skip this.

2. Unusual effects: If you experience anything unusual, inform your doctor immediately.

3. If the procedure fails: If this medicine does not completely terminate the pregnancy, it can cause birth defects in the baby. In such cases, surgery may be required to clean out the uterus.

4. Bleeding: It is normal to have some vaginal bleeding after taking this medicine. However, if the bleeding is heavy, it is a warning sign.

What are the possible side effects of the medication?

Like any medication, this one can have side effects. Some are normal, while others require immediate attention.

This list does not include all side effects. If you notice anything unusual, talk to your doctor.

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