Mariprist works to terminate early pregnancy through a 2-step process: 
The mifepristone taken first, detaches the pregnancy from the uterus (womb) and makes the womb more receptive to misoprostol. 
The misoprostol taken later works by causing contractions of the womb, and softens the cervix to allow the expulsion of the pregnancy. 

Mariprist is indicated for medical termination of pregnancy for gestational ages up to 9 weeks.  If you’re not sure how many weeks are you, you can calculate here.

If you are over 9 weeks gestation, please speak to your health provider.  

Mariprist is indicated for medical termination of pregnancy for gestational ages up to 9 weeks.
1.  Initially, the single mifepristone 200 mg tablet should be taken orally by the patient.
2. Between 24 and 48 hours after taking mifepristone, the four misoprostol tablets (800 micrograms total) should either be inserted into the vagina, placed under the tongue, or held in the cheek to dissolve.  If the tablets are in your mouth, do not eat or drink anything for 30 minutes, after which any remaining residue can be swallowed with water.

If you would like to watch a video about how to take a combination of Mifepristone and Misoprostol for abortion at home and what to expect during the process, please click here. For a pictorial guide on how to use Mariprist, please click here. 

Mariprist for the termination of pregnancy is contraindicated in patients with any one of the following conditions: 

• History of allergy to mifepristone, misoprostol or other prostaglandins.
• Confirmed or suspected ectopic pregnancy or undiagnosed adnexal mass.
• If an intra-uterine device in place (must be removed prior to administration).
• Chronic adrenal failure.
• Haemorrhagic disorders or concurrent anticoagulant therapy.
• Inherited porphyria.
• Severe asthma uncontrolled by therapy.
• Pregnancy not confirmed by gynaecological examination, ultrasound scan or biological tests.
• If a patient does not have adequate access to medical facilities equipped to provide emergency treatment of complications arising out of medical abortion.

For guidance on how to use Mariprist, please click here.

Mifepristone tablet: 
Although specific drug or food interactions with mifepristone have not been studied, on the basis of this drug’s metabolism by GYP 3A4, it is possible that ketoconazale, itraconazole, erythromycin, and grapefruit juice may inhibit its metabolism (increasing serum levels of mifepristone). Furthermore, rifampicin, dexamethasone, St. John’s Wort, and certain anticonvulsants (phenytoin, phenobarbital, carbamazepine) may induce mifepristone metabolism (lowering serum levels of mifepristone). Based on in vitro Inhibition information, co­ administration of mifepristone may lead to an increase in serum levels of drugs that are GYP 3A4 substrates. Due to the elimination of mifepristone from the body, such interaction may be observed for a prolonged period after its administration. Therefore, caution should be exercised when mifepristone is administered with drug that are GYP 3A4 substance and have narrow therapeutic range,including some agents used during general anaesthesia. 

Misoprostol tablets:  
Misoprostol is predominantly metabolised via fatty acid oxidizing systems and has shown no adverse effect on the hepatic microsomal mixed function oxidase (P450) enzyme system. Concomitant administration of NSAIDs and misoprostol in rare cases can cause a transaminase increase and peripheral oedema. A modest increase in propranolol concentrations has been observed with multiple dosing of misoprostol. Antacids may decrease the bioavailability of misoprostol. Antacids containing magnesium may aggravate diarrhoea or abdominal pain caused by misoprostol. Drug interaction studies with misoprostol and several NSAIDs showed no clinically significant effect on the kinetics of ibuprofen, diclofenac, piroxicam, aspirin, naproxen or indomethacin. In extensive clinical studies,no drug interactions have been attributed to misoprostol. 

The treatment procedure of Mariprist is designed to induce the uterine cramping and vaginal bleeding necessary to produce an abortion. Nearly all of the women who receive MARIPRIST will therefore experience vaginal bleeding and abdominal pain, particularly after misoprostol administration. Other commonly reported side effects are nausea, vomiting, weakness, dizziness, fever/chills, headache, and diarrhoea.

Undesirable effects are ranked under headings of frequency. Within each frequency grouping, the effects are presented in order of decreasing seriousness. Very common (2:1/10); Common (2:1/100, <1/10); Uncommon (2:1/1,000, ,;1/100): Rare (2:1/10,000 ,;1/1,000); Very rare (<1/10,000), not known (cannot be estimated from the available data).  
During medical abortions in the second trimester or labour induction for intrauterine foetal death during the third trimester, uterine rupture has been uncommonly reported after prostaglandin intake. This occurred particularly in multiparous women or in women with a caesarean section scar. Very rare cases of fatal toxic shock caused by Clostridium sordellii endometritis, presenting without fever or other obvious symptoms of infection, have been reported. Clinicians should be aware of this potentially fatal complication. 

For the full Product Information Leaflet (PIL) for Mariprist please click here.

If you have any questions or you’d like to talk through your options, get in touch with one of our contact centres.