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MIFEPRISTONE: It is a steroidal antiprogestin and antiglucocorticoid acting at the receptor level. It is used in combination with a prostagirandin such as misoprostol for termination of pregnancy. It is a synthetic 19-nonsteroidal related to norethinodrone. It binds to the intracellular progesterone cepetor where it competitively inhibits progesterone attachement and thus antagonizes the effects of endogenous progesterone.

Indications: Termination of early pregnancy in combination with prostaglandins. Termination of pregnancy with prostaglandins. Termination of pregnancy during trimester II and III. Inductions of labour in the case of foetus mortus. Immediate post-coital emergency contraception. Contraception with continuous/intermittent administration. Progesterone dependent malignancies, breast cancer, meningioma. Endometriosis, Uterine leiomyoma, induction of normal labour, Extracterine pregnancy, Induction of menses (Once a month administration)

Dosage : For termination of pregnancy (49 days or less duration) : Oral 600mg (three 200mg tablets) as a single oral dose followed two days later by 400 micrograms (mcg) (two 200mcg tablets) of misoprostol as a single oral dose.

Contra Indications: confirmed or suspected ectopic pregnancy, Chronic adrenal, Failure. Concurrent long-term corticosteroid therapy, History of allergy to mifepristone, misoprotol of other prostaglndin. Hemorrhagic disorders of concrrent anticoagulant therapy, Inherited prophyrias.

Drug Interaction: Ketoconazole, itraconazole, erythromycin, and graperfruit juice inhibit imfepristone metabolism. Rifampin, daxamethasone, St. John’s wort, and certain anticonvulsant (phenytoin,phenobarbital carbamazepine, induce mifepristone metabolism.