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The use of mifepristone (Mifeprex) and misoprostol (Cytotec) for medical abortion carries certain risks and requires careful adherence to safety protocols. It is crucial to understand these risks and follow all medical guidelines to ensure your safety. Below are important safety warnings and precautions:

• Serious Infections: There is a rare risk of serious and potentially life-threatening infections following a medical abortion. Seek immediate medical attention if you experience a fever over 100.4ºF lasting more than 4 hours, severe abdominal or pelvic pain, or tenderness. Also, if you have symptoms such as nausea, vomiting, diarrhea, or weakness persisting more than 24 hours after taking misoprostol, contact your healthcare provider urgently as these could indicate a severe infection.

• Severe Vaginal Bleeding: While vaginal bleeding is expected, extremely heavy bleeding (soaking two full-size sanitary pads per hour for two consecutive hours) requires immediate medical evaluation as it may suggest an incomplete abortion or other complications that could lead to shock.

• Precautions and Contraindications:

  • Do not use this medication if you have a confirmed or suspected ectopic pregnancy, an undiagnosed pelvic mass, or adrenal gland failure.
  • Avoid use if you are on long-term corticosteroid therapy, have allergies to prostaglandins, suffer from blood disorders, or are taking anticoagulants.
  • Ensure any intrauterine device (IUD) is removed before starting this medication.

• Program Requirements: In the U.S., ensure you understand and comply with the REMS Program requirements for mifepristone. For residents of other countries, consult local regulations with your healthcare provider and pharmacist.

• Emergency Instructions: Your healthcare provider should give you detailed instructions on who to contact and what steps to take in case of emergency situations, such as severe bleeding or infection. Always have the Medication Guide ready if you need to visit an emergency room or another healthcare professional.

• Overdose and Emergency: In cases of overdose, seek immediate medical help. Recognizing the signs of potential complications early and getting prompt medical assistance can be crucial.

Always consult with your healthcare provider to address any concerns or questions you may have regarding the use of these medications. Adhering to medical advice is essential for your safety and well-being.

When taking this medication, some common side effects may occur, though they are generally mild and not cause for alarm. These include nausea, which occurs in 51-75% of users, and weakness, affecting 55-58%. Fever or chills might be experienced by 48%, while vomiting can affect 37-48%. Headaches are reported by 41-44%, and dizziness by 39-41%. Diarrhea affects 18-43% of individuals. While these symptoms are typical, it's important to consult your healthcare provider if they persist or worsen.

Other side effects may include stomach pain or cramping, vaginal or uterine bleeding, anemia (a low red blood cell count), a fast heart rate, lightheadedness, and general pain. Although these effects are less common, they should be monitored, and medical advice should be sought if they become severe.

Serious side effects are rare but require immediate medical attention. These include a persistent fever of 100.4ºF or higher (lasting more than four hours), severe stomach pain, or prolonged symptoms such as weakness, nausea, vomiting, or diarrhea beyond 24 hours after taking misoprostol. Heavy vaginal bleeding, especially if it involves soaking through two thick, full-size sanitary pads each hour for two consecutive hours, is a cause for concern. Fainting may also occur and warrants urgent care.

In extremely rare instances, an allergic reaction may occur, characterized by symptoms such as rash, itching or swelling, severe dizziness, or trouble breathing. Should you experience any of these, seek medical help immediately. Always stay vigilant and report any other unusual side effects to your healthcare provider for guidance.

Mifepristone (Mifeprex) can interact with various medications and supplements, which may affect its effectiveness or increase the risk of side effects. It is important to inform your doctor and pharmacist of all the medications and supplements you are currently taking, including prescription, over-the-counter medications, vitamins, and herbal products.

Certain drugs should not be used with Mifepristone as they can cause significant interactions. These include medications like Bepridil, Cisapride, Cyclosporine, Dihydroergotamine, Dronedarone, Ergotamine, Fentanyl, certain antifungals like Fluconazole and Ketoconazole, Lovastatin, Mesoridazine, Pimozide, Piperaquine, Posaconazole, Quinidine, Saquinavir, Simvastatin, Sirolimus, Sparfloxacin, Tacrolimus, Terfenadine, and Thioridazine. Your doctor might avoid prescribing these or adjust your treatment plan accordingly.

In some cases, using Mifepristone with other medications might not be recommended, but it could be necessary depending on your condition. Under these circumstances, your doctor may need to adjust the dosage or frequency of either drug. Such medications include Alfentanil, Alprazolam, Amiodarone, Carbamazepine, Erythromycin, Itraconazole, Phenytoin, Rifampin, St John's Wort, among others.

Additionally, taking Mifepristone alongside certain drugs may increase the risk of side effects, but the combination might be essential for your treatment. If this is the case, your doctor will carefully manage your doses. For instance, Fluvastatin is one such medication.

Aspirin can increase bleeding risk when used with Mifepristone, but if your doctor has prescribed low-dose aspirin (81-162 mg daily) to prevent heart attacks or strokes, continue taking it unless advised otherwise.

Always consult your healthcare provider for more specific advice tailored to your health needs.