Description and Composition of Medabon
Medabon is a combination drug which contains Mifepristone and Misoprostol as its active ingredients.
Clearly put, Medabon is not formulated into a fixed dose combination. It is only packaged together as they are often used together for Pregnancy termination. More details on usage is written below.
Mifepristone is a synthetic steroid with an anti-progestational action as a result of competition with progesterone at the progesterone receptors. It is almost exclusively used for termination of pregnancy.
Misoprostol is a synthetic prostaglandin E1 analogue. In comparison to other prostaglandin analogues, misoprostol is stable at room temperature, and has fewer side effects. Its clinical applications include medical abortion, treatment of incomplete abortion and miscarriages, cervical priming prior to surgical procedures, induction of labour, and prevention and treatment management of postpartum haemorrhage. It is also used in the prevention and treatment of peptic ulcer disease.
The plasma elimination half-life for mifepristone is 30-40 hours, and for misoprostol is 20-40 minutes. After oral administration, mifepristone is rapidly and almost completely absorbed. Plasma concentrations peak at about 45 minutes.
Mifepristone is primarily metabolised by CYP3A4 enzyme. Following sublingual administration, misoprostol dissolves and is absorbed rapidly, with peak concentrations occurring at about 30 minutes. Bioavailability is very high.
What is Medabon used for?
Medabon is used for abortion (medical termination of intra-uterine pregnancy) of up to 63 days (9 weeks) gestation.
Dosage and how to use Medabon
For medical termination of intra-uterine pregnancy of up to 63 days gestation:
Adult and Adolescent
- Swallow one tablet of Mifepristone (200 mg) as a single dose with a glass of water.
- Wait for 24-48 hours
- Take 4 tablets of Misoprostol (800 µg) as a single dose, sublingually or vaginally
For buccal dose:
- Place the 4 Misoprostol tablets (as a single 800 mcg buccal dose) between your cheeks and gums and allow to dissolve for 30 minutes.
If there are still some tablet pieces left in your mouth after 30 minutes, swallow them with a glass of water. Plan to rest for 3 hours after taking the Misoprostol tablets.
The medications may not work as well if you take misoprostol sooner than 24 hours after taking mifepristone or later than 48 hours after taking mifepristone.
Paracetamol or Ibuprofen may be taken to reduce pain. Applying a heat pack or hot water bottle to below the stomach may help to ease the pain.
Patient are to seek immediate medical attention if they experience severe or persistent abdominal pain or cramping, heavy bleeding or no bleeding, high fever, excess vomiting or diarrhoea.
Contraindications of Medabon
When not to use Medabon to terminate pregnancy include the following:
- Avoid if pregnancy is more than 9 weeks.
- Don’t use if you have uncontrolled severe asthma.
- Do not use it if you have ectopic pregnancy (use other specific means of termination).
- Don’t use in chronic adrenal failure, porphyria.
- Don’t use if you have Intra-uterine contraceptive device (IUD)
The following are precautions you are to observe While taking Mifepak
- If treatment fails, terminate pregnancy using another method.
- Don’t use in a patient with history of caesarean section or major uterine surgery, grand multiparas (risk of rupture) or use with caution
- Asthma (avoid if severe).
- Use with caution in haemorrhagic disorders and anticoagulant therapy
- Use with caution in prosthetic heart valve or history of endocarditis (antibacterial prophylaxis recommended).
- Use with caution in smokers aged over 35 years (increased risk of cardiovascular events).
- Use with caution in adrenal suppression (may require corticosteroid).
- Not recommended in hepatic or renal impairment.
- Avoid aspirin and NSAIDs for analgesia
Pregnancy & Lactation
Recommendations on the use of Mifepristone + Misoprostol in Pregnancy & Lactation:
Mifepristone is used as abortifacient and so contraindicated in wanted pregnancy. However, no significant association with teratogenicity has been reported among pregnancies carried to term after failed termination attempts with mifepristone. There is paucity of data on safety of mifepristone during breastfeeding. No toxic effect has been reported so far among breastfed infants following accidental intake by the lactating mothers
Misoprostol has stimulant effect on the uterus causing miscarriage. It also has teratogenic effects and, therefore, contraindicated during pregnancy. Misoprostol can induce diarrhoea in the breastfeeding infant, otherwise no report of other significant adverse effects.
Interactions of Medabon with Other Drugs and Foods
- Magnesium-containing antacids: May worsen diarrhoea associated with Misoprostol
- CYP3A4 Inhibitors & Inducers: Caution when used with these agents.
- Mifepristone is primarily metabolised by CYP3A4 enzyme. Examples include azole antifungals (itraconazole, ketoconazole); macrolide antibiotics (clarithromycin, erythromycin); rifamycins (rifampicin); AEDs (carbamazepine, phenytoin), etc.
Side effects of Medabon
Nausea, vomiting, gastrointestinal cramps; uterine hyperstimulation, uterine rupture, vaginal bleeding (sometimes severe), fetal distress.
Less commonly hypersensitivity reactions including rash, urticaria, and facial oedema. Rarely malaise, headache, fever, hot flushes, dizziness, chills.
Storage of Medabon
Store in a cool and dry place. Keep away from light and the reach of children.
Where to buy Medabon
You can also buy Medabon from any pharmacy in your neighborhood upon presentation of a valid prescription.
Remember that Medabon is a prescription only medicine, so no pharmacy will sell it to you unless you have a valid prescription for it.