Mifepristone + Misoprostol: Brands, Price & Uses in Bangladesh

Approved Indications

Mifepristone + Misoprostol is a two-drug regimen combining a progesterone receptor antagonist (mifepristone) with a prostaglandin E1 analogue (misoprostol), used under strict medical supervision for:

• Medical termination of confirmed intrauterine pregnancy, up to the gestational age limit specified in the approved product labeling/local regulatory authority (commonly through the early first trimester, calculated from the first day of the last menstrual period and confirmed by clinical assessment and/or ultrasound before use).

Guideline-Supported / Additional Use

• Management of early pregnancy loss (missed miscarriage) — in some markets and clinical guidelines, Mifepristone + Misoprostol is used as a medical alternative to surgical uterine evacuation for confirmed non-viable early intrauterine pregnancy, at the treating physician's discretion.

Mifepristone + Misoprostol must only be used after an intrauterine pregnancy has been confirmed and an ectopic pregnancy has been excluded (see Contraindications), and requires a follow-up visit to confirm the pregnancy has been completely terminated.

Standard Regimen for Medical Termination of Pregnancy

Mifepristone + Misoprostol is approved for use only up to the gestational age limit stated in the approved product labeling/local regulatory guidance; it is not intended for use beyond this limit. Treatment must be initiated and supervised by a physician who has confirmed an intrauterine pregnancy and has excluded ectopic pregnancy.

Early Pregnancy Loss (Missed Miscarriage) Regimen

Where used for medical management of confirmed early pregnancy loss, a physician may direct a modified sequence or dose of Mifepristone + Misoprostol's components per current clinical guidelines; this must always be individualized by the treating physician.

Pediatric Dosing

Mifepristone + Misoprostol is used in pregnant adolescents of reproductive age under the same physician-supervised regimen as adults, with appropriate counselling; it is not used in pre-menarchal children (see Pediatric Uses).

Renal/Hepatic Impairment

Data on dose adjustment in significant renal or hepatic impairment are limited; Mifepristone + Misoprostol should be used with added caution and closer monitoring in these patients under specialist supervision (see Use in Special Populations).

Common / Expected Effects

• Vaginal bleeding — expected and part of how Mifepristone + Misoprostol works; can be heavier and longer than a normal menstrual period
• Abdominal pain and uterine cramping
• Nausea and vomiting
• Diarrhea
• Fever or chills (mainly related to the misoprostol component)
• Headache, dizziness, and weakness

Less Common but Clinically Important Effects

• Heavy or prolonged bleeding requiring medical intervention
• Incomplete termination of pregnancy, requiring further medical or surgical treatment

Rare but Serious Effects

• Serious infection, including rare cases of severe or fatal sepsis, which can occasionally occur without the typical signs of fever
• Severe allergic/hypersensitivity reactions

Patients should seek urgent medical attention for soaking through more than two sanitary pads per hour for two or more consecutive hours, severe or worsening abdominal pain, fever lasting more than 24 hours, or feeling generally unwell after taking Mifepristone + Misoprostol (see Precautions and Warnings).