MIFTY KIT – IS IT SAFE? USES, SIDE EFFECTS, DOSAGE

What is Mifty Kit?

Mifty kit is a synthetic steroid with many indications and is generally used to prevent unwanted pregnancy in its initial stage. It has a combination of two tablets, Mifepristone and Misoprostol. It is taken orally only in form of tablets. It blocks the hormone required for facilitating pregnancy thus causing abortion. However, it is useful mostly in the first nine weeks of pregnancy. It is manufactured by Aristo Pharmaceuticals Pvt Ltd.

MIFTY KIT – IS IT SAFE? USES, SIDE EFFECTS, DOSAGE

What is the Generic name(s)?
What is its composition?
How does it work?
What are its uses?
How effective is this medicine?
Is it addictive?
What is the dosage?
How to use Mifty kit for abortion?
What if I miss a dose?
What to do in case of overdosage?
What to do if there is an allergic reaction?
What are the side effects?
Who should not use this medicine?
Does this medicine has any drug interactions?
Can it be taken with food?
Can it be taken with alcohol?
Can it be taken on any empty stomach?
Precautions
Is it safe to use if I am pregnant?
Is it safe to use if I am breastfeeding?
Can this medicine be given to children and infants?
Is this medicine available as over the counter product?
Frequently asked questions?
Reference

What is the Generic name(s)?

Its generic name is Mifepristone.

What is its composition?

It has two active salts:

MIFEPRISTONE-200 mcg

MISOPROSTOL-200 mcg

It is available in other strengths too.

How does it work?

The drugs involved block the effects of the pregnancy hormone, progesterone which has a very crucial role and without it, pregnancy can’t sustain. The medicine binds to certain receptors which make the uterus layers sensitive. The coverings of uterus break down (similar to that like in menstruation) and that puts a stop in pregnancy. Also, the drugs participate in facilitating contraction of uterus to abort the fetus. There is a blockade of the effects caused by excess progesterone secreted due to pregnancy by blocking cortisol at certain targeted receptors.

What are its uses?

The medicine is used for various conditions. Some are for treatment purpose, while others for the prevention or control of some of the conditions, which can be:

• Prevention of both early and normal pregnancy
• Abortion(done legally)
• Cushing’s syndrome to control hyperglycemia
• To cause menstruation
• Endometriosis
• Meningioma
• For softening cervix before surgery for abortion in the first trimester
• Breast cancer
• Labor induction
• Birth control
• As a pre-medicine before giving Prostaglandins to terminate the pregnancy
• Uterine Leiomyoma
• NSAID associated intestinal injury
• Progesterone-related malignant conditions
• Extrauterine pregnancy

Gastro-intestinal conditions can also be treated. These are:

• Duodenal ulcers
• NSAID associated gastrointestinal injury
• Gastric ulcer

How effective is this medicine?

Mifty kit is most effective in termination of pregnancy where fertilization was not more than 9 weeks back. However, this is useful only if all instructions are properly followed with consumption of prescribed dosage.

Is it addictive?

Medicines are not usually addictive. If they have that potential, the government will declare them as “controlled substances”.They usually are labelled H or Z. Check the package of the medication to see if this medicine belongs to any of these categories. Also, long-term use can lead to certain dependency and adaptation of receptors on which it acts. After completion of course, the body will require some time to return to normal. Therefore one should have follow-ups with their doctor. Also, take the recommended dosage only and never opt for self-medication.

What is the dosage?

The dosage is suggested by the doctor according to the patient’s health status and her weight and height.

For abortion of early pregnancy,

• 200 mcg of Mifepristone is given for the first day which is a single dose.
• 2-3 days after that 800 mcg of Misoprostol is given every 24-48 hours. (also a single dose).

Considerations while deciding dosages for early pregnancy:

• The beginning of pregnancy is determined as the first date of the last menstrual period(LMP). This is not the same as the embryologic date.
• Duration of gestation period is determined using history of menstrual cycles and other clinical histories.
• To determine if the pregnancy is Ectopic(outside womb) or not, ultrasonography scan can be done.

 For treatment of ulcers,

200 mcg dosage taken twice in a day with food.

Alternatively,200 mcg can be taken 4 times a day with regular intervals in between. It should be taken with food too.

Duration of treatment-Usually 28 days. It can be given for 56 days also if the ulcer is not healed.

For prevention of ulcers during treatment where NSAID’s are used:

200 mcg tablet given for 2-4 times a day. The dosage is adjusted by a doctor according to individual Health status. The duration depends on how much longer the gut needs to be protected. The doctor will take this decision.

For treatment of Cushing’s syndrome,

Initially,300mg orally is given once a day

It can be further increased to 1200mg/day.

The dosage should not be over 20/mg/kg/day

• The increment in dosage should be done every 2-4 weeks and not earlier than that. This should be done by monitoring the blood glucose level, requirements of anti-diabetics, insulin level and psychiatric signs and symptoms observed by the doctor.

How to use Mifty kit for abortion?

• The tablets have to put in cheek pouch of each side for 30 minutes. Then a glass of water is gulped down to swallow any remaining medicine. Do not chew or crush the medicine.
• The next dose has to be taken after 24 hours. Do not prolong the interval beyond 48 hours.
• The dosage prescribed to the patient must be followed strictly.
• After taking it for 7 days, visit the doctor to check if termination of pregnancy has been completed or not. This can be done by hCG testing, clinical examination of the patient, ultrasonographic scan, Blood test, etc.
• If the pregnancy has been stopped but the expulsion is not complete, one more high dose of Misoprostol is advised. The follow up should be done after 7-14 days.
• Also during the course, check the amount and frequency of vaginal bleeding. Lack of bleeding indicates failure of medicine. But even heavy bleeding is not a sure sign of complete termination.
• If it doesn’t work, for the next course, take the first dosage 2 times.
• Surgical evacuation is usually recommended to deal with the ongoing pregnancies after abortion.

What if I miss a dose?

If you miss a dose, take the medicine as soon as you notice. If your next dose is near the time, skip the missed dose and continue your course. Do not use an extra dose or any other medicine to compensate for it.

Set an alarm to take medicine as a reminder for taking the medication or ask a family member or friend to do so. If too many doses are missing, consult your doctor to take advice on what needs to be done.

What to do in case of overdosage?

• Firstly, one shouldn’t use more than the prescribed dose as given by the doctor. Taking more medicines will not improve the symptoms, but can lead to intoxication or serious toxic side effects.
• If the patient or any family member is suspected of overdosing, rush to the emergency department of the nearest local hospital. Bring the medicine container and prescription to the doctor.
• Do not give your medicines to another person even if he/she has similar symptoms. The prescribed dosages are intended for individual patients and may lead to overdosing if taken by another person. Ask that person to call a doctor for proper diagnosis and treatment.

What to do if there is an allergic reaction?

Get medical professional’s help immediately in case of an allergic reaction. The symptoms to draw attention are:

• Swelling at the face
• Swollen tongue
• Swollen lips
• Swollen throat with running nose
• There might be difficulty in breathing and/or sneezing.

What are the side effects?

There are some very common side effects observed after using Mifty kit but might not be seen in all. If any unusual effect is seen, report it to the physician as soon as possible.

Genitourinary:

• Vaginal bleeding in excess
• Excess and painful menstrual blood flow
• Abnormal contractions of the uterus
• Bleeding of womb
• Pain during sexual intercourse
• Infection of uterus
• Vaginal fluid discharge
• Haemorrhage at uterus
• Itching at genital region

  Central nervous system:

• Weakness and a constant feeling of fatigue
• Insomnia
• Tremors
• Dizziness
• Chills
• Nausea

 Gastrointestinal:

• Gas in the intestinal canal
• Indigestion
• Diarrhoea
• Constipation
• Vomiting
• Abdominal cramps
• Abdominal pain

Musculoskeletal :

• A backache
• Joint pain

Metabolic:

• Decreased appetite
• High temperatures
• Swelling in the extremities
• Symptoms of flu

Miscellaneous:

• Infection after all this procedure
• Hot flashes
• Chest pain
• Breathlessness
• Belching
• Pale skin
• A cough
• Tenderness at the area around eyes
• Heartburn
• Rashes

Who should not use this medicine?

Using this medicine should be prevented for patients with the following conditions:

• Hypersensitivity to Mifty kit
• Inherited porphyrias
• Hemorrhagic disorder
• Elderly and renal impairment
• Cardiovascular disease
• Suspected ectopic pregnancy
• Cerebrovascular disease
• Chronic adrenal disease
• Patients using an intra-uterine device(IUD’s)
• Patients on corticosteroids for immune system disorder
• Women whose vaginal bleeding is not explained
• Bleeding disorders
• If pregnancy is not confirmed
• If pregnancy is of more than of 9 weeks

Does this medicine has any drug interactions?

Mifty kit’s action can be altered to rendered less effective in presence of other drugs which may be over the counter(OTC) ones or prescribed by another doctor beforehand To prevent this, inform your doctor about all the medications, Ayurvedic and herbal substitutes, vitamins and supplements being used in the present. While taking Mifty kit, do not consume other medications without first asking your doctor.

Some of the drugs with which its interactions have been reported are:

• Corticosteroids, which are given for conditions like asthma
• Prepidil
• Cervidil
• Antifungal drugs like Ketoconazole and Itraconazole
• Aspirin and other NSAID’s
• Ergometrine
• Certinib
• Prostin E2
• Herbal products like St. John’s wort(used for treating depression)
• Antibiotics like Rifampicin and erythromycin
• Amprenavir
• Anti-coagulants like Warfarin
• Phenytoin, Carbamazepine and Phenobarbitone, used for treatment for epilepsy and seizures
•  Danaparoid
• Tenoxicam
• Bepridil
• Gemeprost
• Corticotropin
• Diprostone topical

 Can it be taken with food?

To prevent stomach upset, Mifty kit can be consumed either with milk or food. Although, do avoid consuming it with fatty or fried foods and grape juice. Taking it with antacids can reduce nausea as a side effect unless you have Diarrhoea, which will then worsen.

 Can it be taken with alcohol?

It is possible that alcohol can intensify the side effects caused by Mifty Kit like drowsiness, dizziness, nausea, fall in heart rate, etc. Therefore it is recommended to avoid alcohol during the course of the treatment.

 Can it be taken on an empty stomach?

It can surely be taken on an empty stomach but the action of the drug might not be effective enough. Either acidity or loose motions can also be caused. Do consult the physician regarding this.

Precautions

• Inform doctor about any pre-existing diseases or illness (including asthma, Hypertension, Diabetes, lung/renal/hepatic diseases).
• The medication should be given after all the allergies of the patient(if any) are declared by the physician as irrelevant for the consumption of this drug.
• The minimum age to purchase this medicine and use it is 18 years.
• Take the medicine as per the dosage prescribed and avoid taking more dosage as it can cause toxicity.
• Let the doctor know about any upcoming surgeries or pregnancy.
• Inform physician about your age, your smoking habits(if any), if you are going to undergo anaesthesia anytime soon, etc.
• Report to the doctor in case any side effects show.
• Do not use this medicine in case of hypersensitivity.
• Do not smoke throughout the course of treatment.
• Do not consume the drug if you feel dizziness already.
• This medicine will not work if the patient has Ectopic pregnancy. Therefore confirm the type of pregnancy and only then use it. If it does turn out to be Ectopic, avoid using Mifty kit.
• Always check for the expiry date on the package.
• Store it in a dry place and at room temperature. Avoid exposure to direct sunlight.

Is it safe to use if I am pregnant?

Using this medicine will abort the fetus and cause miscarriage. If the pregnancy is a planned one and you want to continue it, do not take this medicine.

Is it safe to use if I am breastfeeding?

The ingredients in Mifty kit might be unsafe during lactation. The drug can enter the milk and can harm the baby. Thus, a doctor should be consulted before taking this medicine during breastfeeding.

Can this medicine be given to children and infants?

The medicine should be out of reach for children and infants as it is meant to abort pregnancies.

Is this medicine available as over the counter product?

No. A prescription by the doctor would be required for purchasing Mifty kit.

Frequently asked questions?

Q: Can I drive after taking this medicine?

Using this medicine can cause dizziness, nausea and tiredness. It is therefore unsafe to drive or operate any heavy machinery.

Q: Can I stop this medicine immediately?

Stopping medication immediately can lead to rebound effects which can give rise to new complications. Hence, the course of treatment should be completed. Consult the doctor first if the symptoms of the condition stop and follow instructions accordingly.

Q: What to do if I consumed expired medicine?

Usually taking one dose of expired Mifty kit does not affect the body or lead to any side effects. To be on the safer side, do inform your doctor.

Q: Can it be used just after unprotected sex?

Consult the doctor for this. Usually, if intercourse happens within 48 hours, emergency contraceptive pills are advised. Mifty kit is used for within 9 weeks of unprotected sex.

Q: What if I am still pregnant after using Mifty kit?

Consult your gynaecologist immediately in this case.

Q: Will using this medicine make me infertile?

No. One can get pregnant in future once the course of Mifty kit is completed. But one should avoid getting pregnant until after the next menstrual cycle.

Reference

Wikipedia page on Steroid

 

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