Introduction
Mifepristone and Misoprostol are two medicines commonly used in combination to terminate a pregnancy. Mifepristone is an anti-progestin, which blocks the action of progesterone and prevents the pregnancy from progressing. Misoprostol is a prostaglandin, which causes uterine contractions to expel the contents of the uterus.
Uses for
Mifepristone and Misoprostol can be used to terminate a pregnancy up to 10 weeks of gestational age. It is a safe and effective way for a woman to end a pregnancy in the privacy of her own home.
| Brand Name | A-Kit |
|---|---|
| Type | Tablet |
| Weight | 200 mg+200 mcg |
| Generic | Mifepristone + Misoprostol |
| Manufacturer | ACME Laboratories Ltd. |
| Available in | English বাংলা |
Mechanism of Action
Mifepristone is an anti-progesterone, which blocks the action of progesterone. Progesterone helps maintain the lining of the uterus, but when it is blocked, it can cause the uterus to shed its lining, which leads to the expulsion of the pregnancy. Misoprostol is a prostaglandin, which causes the uterus to contract and helps expel the pregnancy.
How Long Does It Take to Work?
Mifepristone and Misoprostol usually take about two to four hours to work. Most women will experience bleeding and cramping, which may last a few hours or up to a few days. In some cases, a second dose of Misoprostol may be necessary.
Absorption
Mifepristone and Misoprostol are both rapidly absorbed after oral administration. Mifepristone is rapidly metabolized to its active metabolites, which can be detected in the blood within 2-3 hours.
Route of Elimination
Mifepristone and Misoprostol are both primarily eliminated in the feces. The metabolites of mifepristone can also be found in the urine.
Dosage
This can only be prescribed by qualified medical professionals who are able to assess the gestational age of an embryo and to diagnose ectopic pregnancies. The qualified medical professionals must also be able to provide surgical Intervention/MVA (Manual Vaccum Aspiration) in cases of incomplete abortion or severe bleeding or have made plans to provide such care through others and be able to assure patient access to medical facilities equipped to provide blood transfusions and resuscitation, if necessary.Day 1 (First visit): Mifepristone administration: One tablet of Mifepristone (200 mg) is taken in a single oral dose under the supervision of a qualified medical professional in a clinic, medical office or hospital.
Day 2 (Second visit): Misoprostol administration: 24-48 hours after ingesting the Mifepristone tablet, the patient takes four 200 microgram tablets (800 micrograms) of Misoprostol buccally or sublingually. Misoprostol tablets can be administered by the patient herself (place two tablets on each side of cheeck & gum or under the tongue). She should wait for 30 minutes. During the period immediately following the administration of Misoprostol, the patient may need medication for cramps or gastrointestinal symptoms. The patient should be given instructions on what to do if significant discomfort, excessive bleeding or other adverse reactions occur and should be given a phone number to call if she has questions following the administration of Misoprostol.
Day 10 to 14 (Third visit): Post-treatment examination: Patients must return to the clinic, medical office or hospital within 10 to 14 days after the administration of mifepristone. This visit is very important to confirm by clinical examination or ultrasonographic scan that a complete termination of pregnancy has occurred.
Patients who have an ongoing pregnancy at this visit have a risk of fetal malformation resulting from the treatment. Surgical termination/MVA is recommended to manage Menstrual Regulation (MR)/termination of pregnancy failures.
The recommended dose of mifepristone and misoprostol to terminate a pregnancy up to 10 weeks of gestation is as follows:
- Mifepristone: 600 mg orally
- Misoprostol: 800 mcg orally
Administration
Mifepristone and Misoprostol should be taken orally with water or juice. The medicines can be taken together or separately, but it is preferred to take them together for the most effective results.
Side Effects
The most common side effects associated with mifepristone and misoprostol include nausea, vomiting, diarrhea, cramping, and vaginal bleeding. Other side effects may include headache, dizziness, and fatigue.
Toxicity
Mifepristone and misoprostol are generally well-tolerated, but an overdose can cause serious complications, including seizures, coma, and death. If an overdose is suspected, it is important to seek medical attention immediately.
Precaution
Mifepristone and misoprostol should not be used in women with an ectopic pregnancy or who have an allergy to mifepristone or misoprostol. It should also not be used in women who are taking other medications, including anticoagulants, corticosteroids, or nonsteroidal anti-inflammatory drugs.
Interaction
Mifepristone and misoprostol can interact with other medications. Before beginning any new medications, women should tell their healthcare provider if they are taking mifepristone or misoprostol.
Disease Interaction
Mifepristone and misoprostol should not be used in women with certain conditions, including heart disease, uncontrolled high blood pressure, anemia, or history of blood clots.
Drug Interaction
Mifepristone and misoprostol can interact with other medications, including anticoagulants, corticosteroids, and other nonsteroidal anti-inflammatories, and can cause serious side effects. Women should inform their healthcare provider if they are currently taking any medications before taking mifepristone or misoprostol.
Food Interactions
Mifepristone and misoprostol should be taken with food to reduce the risk of side effects. Women should not take mifepristone and misoprostol with grapefruit juice or other grapefruit containing products.
Pregnancy Use
Mifepristone and misoprostol should not be used in women who are pregnant. Women should not take this medication if they think they may be pregnant.
Lactation Use
Mifepristone and misoprostol should not be used in women who are breastfeeding. Women should not take this medication if they think they may be breastfeeding.
Acute Overdose
Overdose of mifepristone and misoprostol can be life-threatening and should be immediately treated by a medical professional. Symptoms of an overdose include seizures, pulmonary edema, coma, and death.
Contraindication
Mifepristone and misoprostol should not be used in women with certain medical conditions, including an ectopic pregnancy, allergy to mifepristone or misoprostol, history of blood clots, heart disease, uncontrolled high blood pressure, or anemia.
Use Direction
Mifepristone and misoprostol should be taken orally with food and water. The tablets should not be chewed or crushed before taking them. Women should take the medicines as soon as possible, following the instructions provided by their healthcare provider.
Storage Condition
Mifepristone and misoprostol should be stored in a cool, dry place away from light and moisture. The tablets should not be frozen, and should be kept out of the reach of children.
Volume of Distribution
Mifepristone and misoprostol are rapidly distributed throughout the body. Mifepristone is metabolized in the liver and its active metabolites are distributed to target tissues.
Half Life
The half-life of mifepristone is approximately two hours, and the half-life of misoprostol is approximately three hours.
Clearance
Mifepristone is metabolized in the liver and its active metabolites are rapidly cleared from the body. Misoprostol is rapidly eliminated in the feces.
See in details version A-Kit Tablet 200 mg+200 mcg also A-Kit Tablet 200 mg+200 mcg in bangla
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Some Frequently Asked Questions About A-Kit Tablet 200 mg+200 mcg
1. What is A-Kit Tablet 200 mg+200 mcg used for?
This combination is used for medical abortion (termination of early pregnancy) up to 10 weeks (70 days) of gestation.
2. How does A-Kit Tablet 200 mg+200 mcg work?
- Mifepristone blocks the hormone progesterone, which is necessary to maintain pregnancy.
- Misoprostol causes uterine contractions to expel the pregnancy.
3. How is this medication taken?
First, take Mifepristone (200 mg) orally. After 24-48 hours, take Misoprostol (800 mcg, 4 tablets) either buccally (in the cheek) or vaginally.
4. Can I take it at home?
Yes, but you should follow your doctor’s instructions and have access to emergency medical care if needed.
5. What are the common side effects?
- Heavy bleeding
- Cramping
- Nausea
- Vomiting
- Fever
- Diarrhea
6. How long does the bleeding last?
Bleeding can last up to 2 weeks, with heavy bleeding occurring within the first few hours after taking Misoprostol.
7. What should I do if I experience very heavy bleeding?
Seek emergency medical attention if you soak more than two large pads per hour for more than two consecutive hours.
8. How effective is this medication?
It is about 95-98% effective when used correctly.
9. Can I eat before taking the pills?
Yes, but avoid heavy meals before taking Misoprostol as it may cause nausea or vomiting.
10. What happens if I vomit after taking Mifepristone?
If you vomit within 30 minutes, contact your doctor as you may need another dose.
11. Can I use painkillers for cramps?
Yes, ibuprofen is recommended for pain relief. Avoid aspirin as it may increase bleeding.
12. How long does it take for Misoprostol to start working?
Cramping and bleeding usually start within 1 to 4 hours after taking Misoprostol.
13. Can I take Misoprostol orally?
Yes, it can be taken buccally (placed between the cheek and gums) or vaginally.
14. What if I do not bleed after taking Misoprostol?
Contact your doctor, as the abortion may not be complete, and additional treatment may be required.
15. Is it normal to see large clots?
Yes, passing blood clots up to the size of a lemon is normal during the abortion process.
16. How do I confirm the abortion is complete?
An ultrasound or pregnancy test after two weeks will confirm if the abortion was successful.
17. What if I still feel pregnant after two weeks?
Consult a doctor to check if the pregnancy is continuing or if tissue remains.
18. Can this medication be used for miscarriage management?
Yes, doctors may prescribe this combination to help pass pregnancy tissue after a miscarriage.
19. Can I take this medication if I am breastfeeding?
Misoprostol may pass into breast milk. Consult your doctor before use.
20. Can I get pregnant again after taking this medication?
Yes, ovulation can resume within 2-3 weeks. Use contraception if you do not want to conceive soon.
21. When can I have sex again?
Wait at least 2 weeks or until bleeding stops to reduce the risk of infection.
22. Does this medication affect future pregnancies?
No, it does not affect future fertility or pregnancies.
23. Can I drink alcohol while taking this medication?
No, alcohol may increase the risk of side effects and dehydration.
24. Can I exercise after taking this medication?
Avoid heavy exercise for a few days to prevent excessive bleeding.
25. What if I take the pills in the wrong order?
Mifepristone must be taken first. If taken in reverse, it may not work effectively.
26. Is this medication available over the counter?
It is usually available only with a prescription in most countries.
27. Can I travel after taking the medication?
Avoid long trips until the abortion is complete to ensure access to medical care if needed.
28. Can I use tampons after taking this medication?
Use pads instead to monitor bleeding and avoid infection.
29. Is it normal to have fever after taking Misoprostol?
A mild fever for a few hours is common. A fever lasting over 24 hours may indicate an infection.
30. What should I do if I have severe pain?
Severe pain not relieved by painkillers may require medical attention.
31. Can this medication be used for second-trimester abortion?
No, this combination is approved only for pregnancies up to 10 weeks.
32. What if I take the medication later than 10 weeks?
The effectiveness decreases, and the risk of complications increases.
33. Can I use birth control immediately after abortion?
Yes, you can start most birth control methods immediately.
34. Can this medication be used for ectopic pregnancy?
No, it does not work for ectopic pregnancies.
35. Can I breastfeed after taking Misoprostol?
Wait at least 5 hours after taking Misoprostol before breastfeeding.
36. Does this medication interact with other drugs?
It may interact with corticosteroids and blood thinners. Inform your doctor of all medications you take.
37. Can I take antibiotics with this medication?
Only if prescribed by your doctor.
38. Can this medication cause emotional side effects?
Some people may feel emotional changes, including sadness or relief.
39. Is there an alternative to this medication?
Surgical abortion is an alternative if medical abortion is not suitable.
40. Can I get this medication online?
In some regions, telemedicine services may provide it legally.
41. What happens if I do not take Misoprostol after Mifepristone?
The abortion may be incomplete, leading to complications.
42. Can I get an infection from this medication?
Infections are rare but can occur if abortion is incomplete.
43. Can I take this medication if I have anemia?
If you have severe anemia, consult your doctor as heavy bleeding may worsen the condition.
44. What is the best way to take Misoprostol?
Buccal (cheek) or vaginal administration is preferred over swallowing.
45. Does this medication cause weight gain?
No, it does not affect weight.
46. Can I repeat the dose if the abortion is incomplete?
Consult your doctor before taking an additional dose.
47. What if I have only light bleeding?
Light bleeding may indicate an incomplete abortion.
48. Is nausea normal?
Yes, it is a common side effect.
49. Can I take anti-nausea medication?
Yes, if prescribed by your doctor.
50. When should I seek medical help?
If you have excessive bleeding, high fever, or severe pain, seek medical attention.
