MTP KIT – IS IT SAFE? USES, SIDE-EFFECTS, DOSAGE

Friday, February 1, 2019

WHAT IS MTP KIT?

MTP Kit is a synthetic steroid used for the abortion of intrauterine pregnancy in women of up to 7 weeks to 63 days gestation. It is used for the non-surgical expel of the embryo from the womb. It is a kit of five tablets in which there is one tablet for oral use and four tablets for vaginal use. The manufacturer of this kit is Zydus Cadila Pharma.

MTP KIT – IS IT SAFE? USES, SIDE-EFFECT, 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?
What if I miss a dose?
What to do in case of overdosage?
CAN I TAKE IT WITH ALCOHOL?
CAN I TAKE IT WITH FOOD?
CAN I TAKE IT ON AN EMPTY STOMACH?
CAN I DRIVE AFTER TAKING IT?
WHAT TO DO IF THERE IS AN ALLERGIC REACTION?
WHAT ARE THE SIDE-EFFECTS?
DOES THIS KIT HAS ANY DRUG INTERACTIONS?
PRECAUTIONS
IS IT SAFE IF I AM PREGNANT?
IS IT SAFE IF I AM BREASTFEEDING?
CAN THIS KIT BE USED FOR INFANTS AND CHILDREN?
IS THIS KIT AVAILABLE AS OVER THE COUNTER(OTC) PRODUCT?
FREQUENTLY ASKED QUESTIONS
Reference

WHAT IS THE GENERIC NAME(S)?

The generic names of MTP kit are:

Mifepristone
[1]
Misoprostol
[2]

WHAT IS THE COMPOSITION?

MTP kit contains five tablets in each packet in which there is one Mifepristone tablet and four tablets of Misoprostol.

The Mifepristone is for oral use and, the Misoprostol tablets are for vaginal use. The composition of each tablet is as follows.

Active Ingredients

Mifepristone – 200 mg
4 Misoprostol tabs – 200 mcg each

HOW DOES IT WORK?

All the 5 tablets of this kit work separately to abort the embryo
[3] from the uterus
[4].

Mifepristone

This medicine works by getting into the bloodstream rapidly upon oral administration and within 1-2 hours reaches the peak levels of plasma concentration of 1.98 mg/L. It causes fetal death
[5] along with killing some fast-growing cells of the body. There is 69% of the absolute bioavailability of a 20 mg oral dose.

The Mifepristone blocks the effect of progesterone
[6] and competitively binds the specific receptors by sensitizing the inner linings of the uterus inducing bleeding and contractions. It blocks the effect of cortisol
[7] at the specific receptors to reduce the effects of progesterone.

Due to the unavailability of progesterone, the uterine wall becomes unable to keep the fertilized egg
[8] attached to its lining, dislodging the fetus. As a result, the uterus starts to shed and disintegrate fetus.

Misoprostol

Remaining 4 tablets of Misoprostol work to squish out the fetus from the womb through cervix out in the vagina
[9]. After the administration into the vagina, the plasma concentration of the medicine peaks in 1-2 hours and decreases slowly.

This medicine, a synthetic prostaglandin E1
[10], causes myometrial contractions
[11] by interacting with some specific receptors on myometrial cells. This interaction with the receptors changes the calcium concentration, thereby initiating the muscle contraction.

After interacting with the prostaglandin receptors, the medicine works to soften the cervix and to contract the uterus for the expulsion of the uterine contents.

This medicine is also used as an NSAID induced gastric ulcers.

WHAT ARE THE USES?

This medicine is used for terminating pregnancy which are less than ten weeks old. To use this medicine for abortion, the pregnancy is dated from the 1st day of the last menstrual period
[12] in women in a presumed 28-day cycle with ovulation
[13] occurring at mid-cycle.
This is also used for labor induction
[14] before surgical procedures in case of fetal death to terminate a pregnancy.
It is also used to manage elevated blood sugar levels in patients who are suffering from Cushing’s syndrome
[15] coupled with type two diabetes mellitus or glucose intolerance. In this treatment, you have to use the Misoprostol tablets orally by following certain rules of intake.
This kit also used for the treatment of some other diseases like blood loss, breast cancer, menses induction, immediate postcoital emergency contraception, labor induction in fetus death and extrauterine pregnancy.

All the mentioned use of this kit has been taken from different sources after thorough research. But it is strictly recommended not to use these medicines without the guidance, consultation, or observation of a gynaecologist.

HOW EFFECTIVE IS THIS KIT?

This is a combined drug therapy quite effective for the complete removal of the pregnancy. It gives more than 95% success to end the pregnancy if taken as directed by following the usage protocols properly.

It is not effective to remove an ectopic pregnancy or a pregnancy of more than 63 days. Gynaecologists suggest the pregnant women for a clinical examination or an ultrasound for analyzing the actual gestation period before using this kit.

It is also recommended that the patient should go for another clinical check up after 14 days of the oral administration. The doctor may do an ultrasound to confirm the complete termination of the pregnancy. It will be cleared that whether any remaining part of the fetus left in the uterus or it is cleared.

IS IT ADDICTIVE?

This is a kit of the medicines in which there are no ingredients present which can be addictive or habit forming.

WHAT IS THE DOSAGE?

The MTP kit contains one oral tablet of Mifepristone 200mg and 4 tablets of Misoprostol 200mcg to be taken vaginally.

You have to take the oral tablet after taking food to avoid any gastric issues or as directed by your doctor.

You have to take the 800mcg or 4 tablets of Misoprostol vaginally 1-3 days later or as directed by your doctor.

It is recommended to administrate the Misoprostol by a healthcare provider for safe administration.

WHAT IF I MISS A DOSE?

Any missed dose of this kit may hamper the treatment process and may not give the effective results. Though it is a combination of medicines and all the medicines play the same important role for safe termination of pregnancy, any missed dose will hamper the treatment process.

Therefore, it is recommended not to miss any of the dosages of MTP kit, and if in case you have missed a dose, it is recommended to consult your gynaecologist immediately.

WHAT TO DO IN CASE OF OVERDOSAGE?

An overdose of this medicinal kit may cause adverse effects like:

Tremors
Massive ingestion
Adrenal failure
Acute intoxication
Sedation
Convulsions
Diarrhea
Bradycardia
Severe abdominal pain

In such cases, you may require special treatment like administration of Dexamethasone treatment. Some of the after effects may be treated with supported therapy.

Therefore, if you have taken an overdose of this medicine, it is recommended to consult the doctor as soon as possible for required adaption of standard supportive measures.

CAN I TAKE IT WITH ALCOHOL?

As we have mentioned previously, this medicinal kit causes excessive drowsiness and dizziness after the administration. It will arise more severe after effects if taken with alcohol.

You may go through blood vomiting, fainting, unconsciousness, and short of breath which could be fatal for you if taken with alcohol.

CAN I TAKE IT WITH FOOD?

Take the oral tablet of this kit after taking your food not withing the food-taking. You must take the tablet with a full glass of water or a glass of lukewarm milk.

CAN I TAKE IT IN AN EMPTY STOMACH?

Do not take the Mifepristone tablet of this kit in an empty stomach because it is an oral medicine. But for the other tablets which are intended for vaginal administration, you have to consult the gynaecologist for the proper usage.

CAN I DRIVE AFTER TAKING IT?

This medication causes severe dizziness and drowsiness along with lack of strength in your limbs. You may experience excess weakness and tiredness after taking the oral tablet of this kit. Therefore, during the administration of this kit, it is not recommended to drive or to do any heavy machinery works.

Rather, it is recommended to take complete rest during this medication.

WHAT TO DO IF THERE IS AN ALLERGIC REACTION?

During the administration of this kit, you may go through the allergic reactions like:

Nausea
Vomiting
Diarrhea
Weakness
Tiredness
Lack of strength in your limbs
A sustained fever of 100.4 degrees or higher

If all these allergic reactions sustain more than 24 hours immediately consult your doctor or rush to the nearby hospital for emergency treatment. It is recommended not to ignore these after effects of the medicine. These reactions may be the symptoms of the infection inside the womb and could be fatal for you.

WHAT ARE THE SIDE-EFFECTS?

During the administration of the MTP kit, you may go through the side-effects mentioned below.

Excess vaginal bleeding
Fatigue
A cough
Chest pain
Fever
Difficulty in urination
Body sores
Difficulty in breathing
Anxiety
Sweating
Diarrhea
Nausea and vomiting
Increased abdominal pain
Lightheartedness
Tremors
Paleness in face
Unusual tiredness and weakness
Insomnia
Indigestion
Acidity
Abdominal cramps
Large clots in bleeding
A headache
Unusual dizziness
Severe pain in arms and legs
Loss of appetite
Sleeplessness
Lack of strength in limbs
Pelvic tenderness
Pelvic inflammatory disease
Salpingitis
Fainting
Asthenia
Serious bacterial infection
Syncope
Nervous system disorders
Dyspepsia
Skin rashes (0.2%)
Hypersensitivity
Urticaria
Erythroderma
Toxic epidermal necrolysis
Erythema nodosum
Endometritis
Viral infection
Vaginitis
Hypotension (0.25%)
Hot flashes
Chills
Rigors
Back pain
Vagal symptoms
Hives
Orthostatic
Loss of consciousness
Post-abortal infection
Parametritis
Tachycardia
Shortness of breath
Heart pounding and heart palpitations
Shivering
Hyperthermia
Flatulence
Constipation
Uterine rupture which needs surgical repair

Though all the side-effects of this kit have mentioned above are taken from different sources after thorough research it is advised not to be panic before taking the medicines. Always go through the guidance of a doctor before the administration of the MTP kit.

DOES THIS KIT HAS ANY DRUG INTERACTIONS?

The MTP kit has interaction with certain drugs as follows.

Ketoconazole
Erythromycin
Itraconazole
Grapefruit juice
Rifampin
St. John’s Wort
Dexamethasone
Phenytoin
Carbamazepine
Phenobarbital
Anticonvulsants
Aspirin
Antipyrine
Diazepam
Diclofenac
Ibuprofen
Piroxicam
Indomethacin
Naproxen
Magnesium-containing Antacids
Itraconazole
Dexamethasone

PRECAUTIONS

MTP kit is a prescription drug, and the administration should be under the supervision of a qualified gynecologist. The use of this kit should be assumed to require the same precautions as those taken before surgical abortion.

Do not use any of the contraceptive methods during the next menstruation period.
A follow-up visit to the doctor is must to complete the treatment schedule.
You must be ready for emergency surgery if the treatment procedure of this medicine fails to terminate the pregnancy.
Do not take the prolonged or heavy bleeding as a complete abortion. It may be a risk of fetal malformation.
You must inform your doctor about some specific health issues s follows.

Allergic to any of the ingredients present in the medicines
Ectopic pregnancy (Pregnancy outside of the uterus)
If you are taking any anticoagulants
If you have an active or history of cardiovascular disorders
Older than 35 years
Excess Smoking
Asthma
Kidney related diseases
Liver problems
Lung-related problems
If you are currently using an intrauterine device
Long Term adrenal gland failure or malfunction
If you are using corticosteroids for any serious diseases.
Disorder of the immune system
Uterine cancer
Active or history of unexplained vaginal bleeding
Inherited Porphyria
Women have more than 5 pregnancies
Malnutrition
Hepatic failure
Renal failure
Low haemoglobin concentration

IS IT SAFE IF I AM PREGNANT?

This medicine is intended for the medical termination of 63-70 days of pregnancy. But it is not recommended for a pregnancy of more than the target date or the women suffering from elevated blood sugar levels along with an elevated cortisol level.

Therefore, you can take this medicine in pregnancy under the supervision of a gynaecologist. Otherwise, it will result in severe complications and may be fatal for some cases.

IS IT SAFE IF I AM BREASTFEEDING?

This medicine should be avoided by women who are breastfeeding. There are proves that the effects of Mifepristone and Misoprostol stay in the breast milk for some time which causes gastric problems in the breastfed child.

If in case, you are using this medicine in an emergency, it is recommended to stop the breastfeeding for 14-15 days until the complete termination of the pregnancy.

CAN THIS KIT BE USED FOR INFANTS AND CHILDREN?

No, this kit is only intended for the termination of pregnancy in women above than 18 years of age. Therefore it can not be used for the infants and the children.

IS THIS KIT AVAILABLE AS OVER THE COUNTER(OTC) PRODUCT?

The MTP kit is not available as an over the counter(OTC) product. Rather, it is strictly recommended that the administration of this kit must be under the supervision of a qualified gynaecologist.

FREQUENTLY ASKED QUESTIONS

How long do the effects of the medicine last?

Ans – The effects of MTP Kit lasts for an average duration of 8-10 day after taking the medicines.

Can I smoke during this medication?

Ans – It is strictly prohibited to smoke during this medication. Even you are recommended to inform your doctor about smoking before starting this medication.

How to store this medicine?

Ans – Store this medicine in a room temperature within 25 degrees. Keep it away from sunlight, children, and pets. Do not refrigerate this medicine.

Can I take this kit more than once in a year?

Ans – Taking of MTP kit more than once in a year can harm the fertility and the future pregnancy.

Reference

Wikipedia page on Pregnancy

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