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When using mifepristone, it's crucial to be aware of potential serious medical complications that may arise following the termination of a pregnancy, such as potentially fatal infections and severe bleeding. Here are some key points to consider:

• Medication Guide and Agreements: Ensure you read and sign the Patient Agreement and thoroughly review the Medication Guide. Consult with your healthcare provider to clarify any concerns or questions you may have.

• Regulatory Compliance: In the United States, you must comply with the REMS Program requirements before receiving mifepristone. If you reside in Canada or another country, consult local healthcare providers and pharmacists for specific regulations applicable to your region.

• Emergency Preparedness: Your healthcare provider should furnish you with explicit guidelines regarding whom to contact and the actions to take in case of an emergency, such as experiencing severe bleeding or infection.

• Medical Guide Presentation: If you require emergency medical attention or consult another healthcare professional, present them with the Medication Guide to inform them that you are in the process of terminating a pregnancy.

• Emergency Symptoms: Seek immediate medical assistance if you notice any of the following symptoms: intense abdominal pain, fainting, rapid heart rate, or a fever persisting beyond four hours. Be aware that a serious infection could occur without the presence of a fever.

• Post-Misoprostol Symptoms: If, more than 24 hours after taking misoprostol, you experience abdominal pain or feel unwell (including symptoms like nausea, vomiting, diarrhea, or weakness), even in the absence of fever, seek medical care promptly.

• Persistent Bleeding: If heavy bleeding continues, this might indicate that the pregnancy has not ended or another serious medical issue, necessitating further medical intervention such as surgery.

It is imperative to follow these instructions closely to ensure your safety and well-being during the medication process.

You may experience nausea, vomiting, diarrhea, weakness, or dizziness after taking the medication. These are common side effects and should subside within 24 hours. If they persist beyond this time after taking misoprostol, seek medical attention immediately, as they may indicate a serious issue. Bleeding and cramping are typical during this treatment and usually mean the medication is working. However, it is possible to experience these symptoms and still be pregnant; therefore, attending all follow-up appointments is crucial. Nausea and cramping might intensify within 24 hours after taking misoprostol. Your healthcare provider might recommend additional medications to alleviate these symptoms. If any side effects persist or worsen, consult your healthcare provider or pharmacist promptly.

Bleeding and spotting could continue for up to 30 days and may be heavier than a normal period. In rare instances, surgery might be necessary to stop the bleeding. Seek immediate medical help if you bleed heavily, soaking through two thick, full-size sanitary pads per hour for two consecutive hours, or if you are concerned about the bleeding. Serious side effects requiring urgent medical attention include a fever of 100.4°F (38°C) or higher, fainting, a rapid heartbeat, or stomach/abdominal pain or tenderness.

Allergic reactions to this drug are extremely rare but severe. If you notice a rash, itching/swelling (particularly of the face, tongue, or throat), severe dizziness, or difficulty breathing, seek immediate medical assistance. If you experience any side effects not listed here, contact your healthcare provider or pharmacist.

Certain medications can interact with this drug. Long-term use of corticosteroids like prednisone, and drugs that increase bleeding risk, including antiplatelet medications such as clopidogrel, NSAIDs like ibuprofen or naproxen, and blood thinners like warfarin or dabigatran, can interact with it. Taking aspirin with this medication can raise bleeding risk. However, if your healthcare provider has advised you to take low-dose aspirin (81-162 mg daily) for heart attack or stroke prevention, continue unless instructed otherwise. Consult your doctor or pharmacist for more information.

Some drugs can alter how mifepristone is removed from your body, affecting its efficacy. These include azole antifungals (e.g., itraconazole), dexamethasone, macrolide antibiotics (e.g., erythromycin), rifamycins (e.g., rifabutin), St. John's wort, and seizure medications (e.g., carbamazepine, phenytoin), among others.

Mifepristone may also slow down the clearance of other drugs from your body, impacting their effectiveness. This may involve medications such as cyclosporine, ergot alkaloids (e.g., dihydroergotamine, ergotamine), fentanyl, pimozide, quinidine, certain statins (e.g., fluvastatin, lovastatin, simvastatin), sirolimus, tacrolimus, and warfarin, among others.