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mifepristone

Generic Mifeprex
Used for Birth Control, Cushing's Syndrome
Used for Birth Control, Cushing's Syndrome

Mifepristone (Mifeprex) is used together with misoprostol (Cytotec) for medical abortion (using prescribed medications to end a pregnancy). These medications are typically used in people no more than 10 weeks pregnant. In some cases, it can be prescribed to people up to 11 weeks pregnant. Mifepristone (Mifeprex) is only available by prescription in certain U.S. states from certain healthcare providers (including some pharmacies). Taking mifepristone (Mifeprex) with misoprostol (Cytotec) can cause side effects like nausea and cramps. Vaginal bleeding is also an expected symptom after you've taken these abortion pills, but a lot of heavy bleeding can be a sign of serious complications. You'll need to follow up with your provider to make sure your pregnancy has ended completely.

Reviewed by:
reviewer
Cydnee Ng, PharmD
reviewer
Daisy Chau, PharmD
Last reviewed on July 26, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsContraindicationsLatest newsReferencesPricesMedicare
basics-icon

What is Mifepristone (Mifeprex)?

What is Mifepristone (Mifeprex) used for?

How Mifepristone (Mifeprex) works

Mifepristone (Mifeprex) is an antiprogestin medication. It blocks the effects of progesterone, a natural sex hormone that's important in starting and continuing a pregnancy. By blocking progesterone, mifepristone (Mifeprex) prevents a pregnancy from continuing.

Mifepristone (Mifeprex) is taken along with misoprostol (Cytotec). This additional medication causes your uterus to contract and push the pregnancy tissue out of your body. These two medications work together to end a pregnancy.

Are you looking for information on Korlym (mifepristone) for diabetes caused by Cushing's syndrome or misoprostol (Cytotec) instead?

Drug Facts

Common BrandsMifeprex
Drug ClassAntiprogestin
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only

More on Mifepristone (Mifeprex) essentials

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What are the side effects of Mifepristone (Mifeprex)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Nausea (51-75%)
  • Weakness (55-58%)
  • Fever or chills (48%)
  • Vomiting (37-48%)
  • Headache (41-44%)
  • Diarrhea (18-43%)
  • Dizziness (39-41%)

Other Side Effects

  • Stomach pain or cramping
  • Vaginal or uterine bleeding
  • Anemia (low red blood cell count)
  • Fast heart rate
  • Lightheadedness
  • General pain

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Serious infection: fever that doesn't go away (temperature of 100.4ºF or greater for more than 4 hours); severe stomach pain; stomach discomfort; weakness, nausea, vomiting, or diarrhea for more than 24 hours after taking misoprostol (Cytotec)
  • Heavy vaginal bleeding for a long time
  • Fainting

Source: DailyMed

More on Mifepristone (Mifeprex) side effects

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The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

Excessively heavy vaginal bleeding

unusual tiredness or weakness

Incidence not known

Chest pain or discomfort

confusion

cough or hoarseness

fast, weak pulse

fever or chills

lower back or side pain

pain or discomfort in the arms, jaw, back, or neck

painful or difficult urination

pale, cold, or clammy skin

shortness of breath

sudden increase in stomach or shoulder pain

sweating

unusual or large amount of vaginal bleeding

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Abdominal or stomach pain or uterine cramping

back pain

diarrhea

dizziness

headache

nausea or vomiting

Less common

Acid or sour stomach

anxiety

belching

cough

fainting or lightheadedness when getting up from a lying or sitting position

fever

flu-like symptoms

headache

heartburn

increased clear or white vaginal discharge

indigestion

itching of the vagina or genital area

lack or loss of strength

pain during sexual intercourse

pain or tenderness around the eyes and cheekbones

pale skin

shaking chills

stomach discomfort, upset, or pain

stuffy or runny nose

tightness of the chest

trouble sleeping

troubled breathing

troubled breathing, exertional

unusual bleeding or bruising

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Mifepristone (Mifeprex)

thumbs-up

Pros

No surgery required to end pregnancy

Between 93% and 98% effective at ending pregnancy through 10 weeks

Might be more affordable than a surgery to end pregnancy

Can safely take at home under the care of a certified healthcare provider

thumbs-down

Cons

Requires close contact with your healthcare provider to make sure the medication worked

Commonly causes cramps, vaginal bleeding, and nausea

Risk of serious bleeding or infections

Can't take if you have an ectopic pregnancy

pharmacist-tips

Pharmacist tips for Mifepristone (Mifeprex)

pharmacist

  • Be sure to discuss with your healthcare provider about what to expect after you take mifepristone (Mifeprex). There can be some side effects such as cramping, nausea, and heavy bleeding.

    • You must follow up with your healthcare provider 1 to 2 weeks after you take mifepristone (Mifeprex). Your provider will need to examine you to make sure the medications worked and that there are no complications.

      • If you need to go to the emergency room or see a different provider for any reason during the process, make sure to let them know you're currently having a medical abortion.

        • Although mifepristone (Mifeprex) with misoprostol (Cytotec) works very well at ending a pregnancy, there's a small chance that it won't work. If this is the case, your healthcare provider will discuss with you about your options to complete the abortion. One possible option is through certain surgical procedures.

          • Let your healthcare provider know about all the medications you're taking, including over-the-counter (OTC) medications and supplements, so they can make sure mifepristone (Mifeprex) is safe for you to take. Certain medications, like carbamazepine (Tegretol), can affect how well mifepristone (Mifeprex) works. Other medications might raise your risk for side effects.

            • Let your healthcare provider know if you're currently breastfeeding when you're discussing plans for medical abortion. Mifepristone (Mifeprex) can pass into your breast milk, but we don't know the effects of this medication in breastfed babies. Mifepristone (Mifeprex) might not be the best option for you.

              faqs

              Frequently asked questions about Mifepristone (Mifeprex)

              How long does mifepristone (Mifeprex) stay in your system?
              Mifepristone (Mifeprex) can stay in your system for a few days to a few weeks. This is an estimated time frame that's based on the half-life of mifepristone (Mifeprex), which is a measure of how long it takes your body to remove the medication from your system. Keep in mind that how fast the body can get rid of the medication from its system can vary from person to person.
              What happens after taking mifepristone (Mifeprex) and misoprostol (Cytotec)?
              After you take mifepristone (Mifeprex) and misoprostol (Cytotec), vaginal bleeding and cramping normally happens. You also might feel nauseous, dizzy, or have chills. These side effects typically start within the first several hours of taking misoprostol (Cytotec). More specifically, heavy bleeding (sometimes with clots and tissue) usually occurs 1 to 4 hours after taking misoprostol (Cytotec). This is why it's a good idea to find a quiet and comfortable place before you take the medication. Some symptoms get better in the days following the medical abortion, but bleeding and cramping might continue for a few weeks. In fact, some people have had heavy bleeding for about 2 days. But it's typical to see spotting (light bleeding) for 1 to 2 weeks and up to 1 month or longer. To prepare for your medical abortion, review the timeline of when to expect side effects, how to manage them, and when you should get medical help.
              Is mifepristone (Mifeprex) the morning-after pill (Plan B)?
              No, mifepristone (Mifeprex) is not a morning-after pill (or emergency contraception). Mifepristone (Mifeprex) is used for medical abortion, or ending a pregnancy that's already confirmed. Morning-after pills, like levonorgestrel (Plan B One-Step) and Ella (ullipristal), are used after you've had unprotected sex to prevent a pregnancy from happening in the first place.
              Is mifepristone (Mifeprex) used for miscarriages?
              Mifepristone (Mifeprex) is FDA approved for medical abortion when it's taken together with misoprostol (Cytotec) for pregnancies up to 10 weeks. But the National Abortion Federation (NAF) guidelines state that this combination of medications can also be used off-label to manage certain miscarriages (or pregnancy loss). Speak with your provider to find out more information about possibly using mifepristone (Mifeprex) to help with miscarriages.
              Can mifepristone (Mifeprex) be used alone?
              Mifepristone (Mifeprex) is approved for medical abortion when it's taken together with misoprostol (Cytotec) for pregnancies up to 10 weeks. In addition, National Abortion Federation (NAF) guidelines recommend taking this combination regimen for medical abortion and don't mention using mifepristone (Mifeprex) alone. But the guidelines say that it's possible to use misoprostol (Cytotec) alone in certain situations, though this might cause more bleeding than taking the two medications together. Talk to your healthcare provider about the medical abortion plan that's right for you.
              How long does it take for mifepristone (Mifeprex) to work?
              Mifepristone (Mifeprex) is taken together with misoprostol (Cytotec) to end a pregnancy. Most people will pass the pregnancy tissue and thus end the pregnancy within 2 to 24 hours of taking misoprostol (Cytotec). Before you start the medical abortion process, make sure you're in an appropriate and comfortable place when you take misoprostol (Cytotec), since it can cause cramps and vaginal bleeding. After taking the medications, you must follow up with your healthcare provider within 1 to 2 weeks to make sure the pregnancy has ended completely.
              When should you take mifepristone (Mifeprex): in the morning or evening?
              Mifepristone (Mifeprex) is used with misoprostol (Cytotec) for medical abortions for pregnancies up to 10 weeks. Mifepristone (Mifeprex) can be taken at any time of day. But it might be more important to consider when you take your misoprostol (Cytotec). You'll want to make sure to take misoprostol (Cytotec) at a time where you can find a quiet and comfortable place to get situated. This is because you can start having side effects, like cramping, nausea, and bleeding, within a few hours of taking that medication. Review the timeline of when you should take mifepristone (Mifeprex) and misoprostol (Cytotec), when to expect side effects, and how to manage them to prepare for your medical abortion.
              Where can I find mifepristone (Mifeprex)?
              Mifepristone (Mifeprex) requires a prescription from a healthcare provider. You can get mifepristone (Mifeprex) in certain U.S. states from certain clinics, provider's offices, and hospitals. It can also be delivered to your home through mail order from a certified (trained) provider. In January 2023, the FDA allowed mifepristone (Mifeprex) to be picked up at or mail-ordered through certified pharmacies. Mifepristone (Mifeprex) is used with misoprostol (Cytotec), which can be found at many pharmacies with a prescription from your provider. Discuss with your provider about the best way for you to get these two medical abortion medications.
              Why is mifepristone (Mifeprex) only available from certain healthcare providers and pharmacies?
              Because of the risks of serious complications, mifepristone (Mifeprex) is only available through a restricted program called the Mifepristone Risk Evaluation and Mitigation Strategies (REMS) program. This program makes sure that you, your healthcare provider, and your pharmacy understand the serious risks of mifepristone (Mifeprex). Only certain healthcare providers who are certified under the Mifepristone REMS program are able to prescribe the medication. As of January 2023, only certain pharmacies that are also certified under this REMS program are able to provide mifepristone (Mifeprex). Visit the mifepristone (Mifeprex) website for more information.
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              What are the risks and warnings for Mifepristone (Mifeprex)?

              Mifepristone (Mifeprex) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Serious infection

              Rarely, serious and sometimes life-threatening infections have happened after an abortion happens, including after taking mifepristone (Mifeprex). If you have a fever greater than 100.4ºF for more than 4 hours, severe stomach pain, or tenderness in the pelvic area during the days following your medical abortion, contact your healthcare provider or get emergency help right away. Also get medical attention right away if you experience stomach pain or discomfort, weakness, nausea, vomiting, or diarrhea for more than 24 hours after taking misoprostol (Cytotec). These all might be signs of a serious infection.

              risk-warning

              Serious vaginal bleeding

              Vaginal bleeding is normal and expected during a medical abortion. But if it lasts for a long time and is extremely heavy (soaking through two thick, full-size sanitary pads per hour for two consecutive hours), then go to the emergency room right away. This can be a sign of an incomplete abortion, which needs to be immediately resolved to prevent shock.

              dosage

              Mifepristone (Mifeprex) dosage forms

              Typical dosing for Mifepristone (Mifeprex)

              This medication is used together with misoprostol (Cytotec). It must be taken as directed by your healthcare provider.

              • Day 1: Take one 200 mg tablet of mifepristone (Mifeprex) by mouth as a single dose.

              • Day 2 or 3 (between 24 and 48 hours after mifepristone (Mifeprex)): Take 800 mcg (four 200 mcg tablets) of misoprostol (Cytotec) by placing the tablets in your mouth alongside your cheeks and letting them dissolve. Place two tablets between the cheek and gum on the left side of your mouth. Place the other two tablets on the right side of your mouth in a similar way as the first two. Allow them to dissolve against your cheek over 30 minutes. Then, swallow any remaining tablet bits with water or other liquid.

              Note:

              • Discuss with your provider about your medical abortion plan and dosing, since it might differ depending on your situation.

              • You must follow up with your healthcare provider 1 to 2 weeks after taking mifepristone (Mifeprex) to make sure the pregnancy has ended completely.

              interactions

              Interactions between Mifepristone (Mifeprex) and other drugs

              Mifepristone (Mifeprex) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Mifepristone (Mifeprex). Please note that only the generic name of each medication is listed below.

              Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

              Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

              Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

              contraindications-icon

              Mifepristone (Mifeprex) contraindications

              Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Mifepristone (Mifeprex) will not be safe for you to take.
              latest news

              What is the latest news about Mifepristone (Mifeprex)?

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              The Facts About Plan C (Medication Abortion)

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              References

              Best studies we found

              American College of Obstetricians and Gynecologists. (2023). What is the difference between abortion pills and morning-after pills?

              American College of Obstetricians and Gynecologists. (2023). What to know about abortion and miscarriages with or without mifepristone.

              Anderson, K. E. (2022). Porphyrias. National Organization for Rare Disorders.

              View All References (5)

              Danco Laboratories, LLC. (2023). Mifeprex [package insert]. DailyMed.

              Mifeprex Danco. (n.d.). How do I get mifeprex?

              National Abortion Federation. (2022). 2022 Clinical policy guidelines for abortion care.

              Planned Parenthood. (n.d.). How does the abortion pill work?

              Society for Endocrinology. (2021). Adrenal glands.

              U.S. Food and Drug Administration. (2023). Questions and answers on mifepristone for medical termination of pregnancy through ten weeks gestation.

              GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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