Side Effects of mifepristone (korlym): A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Major Research Findings

Mifepristone is a medication used for a variety of purposes, including early pregnancy termination, treatment of uterine fibroids, and cervical cancer treatment. The studies cited in this article investigate the efficacy and safety of mifepristone, reporting a range of side effects.

For instance, 8 indicates that mifepristone is an effective treatment option for early pregnancy termination due to miscarriage. Additionally, 9 suggests mifepristone's effectiveness in cervical ripening and labor induction.

Furthermore, 3 implies that mifepristone could potentially enhance the efficacy of BRAF-related therapy for metastatic melanoma with BRAFV600E mutation.

Reasons for Side Effects

The side effects of mifepristone are attributed to its mechanism of action, specifically its antagonism to the progesterone receptor. Progesterone plays a crucial role in maintaining pregnancy and regulating the growth of uterine fibroids. When mifepristone binds to the progesterone receptor, it inhibits the action of progesterone, leading to the termination of pregnancy or the reduction of uterine fibroids. However, this blockage also hinders the normal functioning of progesterone, potentially causing various side effects.

Common Side Effects

Bleeding

Bleeding is the most frequent side effect of mifepristone, often stemming from the shedding of the uterine lining or uterine contractions. 8 , 6 , 26 , and 9 document instances of bleeding during mifepristone use.

Nausea and Vomiting

Nausea and vomiting are reported side effects of mifepristone. 2 reports the occurrence of side effects such as nausea and vomiting associated with mifepristone use.

Abdominal Pain

Abdominal pain is another side effect associated with mifepristone. Studies 8 , 2 , 26 , and 10 document cases of abdominal pain experienced during mifepristone use.

Fever

Fever is identified as a potential side effect of mifepristone. 2 reports the occurrence of side effects like fever associated with mifepristone use.

Gastrointestinal Symptoms

Gastrointestinal symptoms, including diarrhea, constipation, and digestive discomfort, are reported side effects of mifepristone. 2 reports the occurrence of gastrointestinal symptoms as side effects during mifepristone use.

Other Side Effects

Other side effects linked to mifepristone include dizziness, headache, fatigue, and breast tenderness. 2 reports the occurrence of side effects like dizziness, headache, fatigue, and breast tenderness associated with mifepristone use.

Side Effects Management

Bleeding Management

Bleeding associated with mifepristone is typically mild and resolves within a few days. However, in case of excessive bleeding, it's crucial to seek medical attention. Rest and, if necessary, blood-clotting medications are recommended for managing bleeding.

Nausea and Vomiting Management

Nausea and vomiting caused by mifepristone can often be mitigated by consuming small, frequent meals and staying adequately hydrated. Anti-nausea medications might also be effective. For early pregnancy termination via medication, administering anti-nausea medications prior to mifepristone dosage could help alleviate nausea and vomiting.

Abdominal Pain Management

Pain relievers can help reduce abdominal pain associated with mifepristone. Applying heat and rest can also be beneficial. During early pregnancy termination through medication, administering pain relievers after mifepristone administration could effectively alleviate abdominal pain.

Fever Management

Fever due to mifepristone can be managed with fever-reducing medications. Maintaining adequate hydration is essential. If the fever persists, seeking medical advice is necessary.

Gastrointestinal Symptom Management

Gastrointestinal symptoms caused by mifepristone might be alleviated by consuming easy-to-digest foods and adjusting dietary choices. If necessary, using laxatives or other medications could be helpful.

Other Side Effect Management

Side effects like dizziness, headache, fatigue, and breast tenderness related to mifepristone might improve with rest and adequate hydration. In case of severe symptoms, consulting a doctor is advisable.

Comparison Across Studies

Commonalities

These studies share a common theme: mifepristone is utilized for various purposes, including early pregnancy termination, uterine fibroid treatment, and cervical cancer treatment. Furthermore, the studies consistently demonstrate that mifepristone is generally considered a safe and effective drug.

Differences

These studies differ in their objectives, dosage and administration methods, and evaluated populations. Consequently, the research findings vary accordingly. For instance, 8 highlights mifepristone's effectiveness in treating early pregnancy termination due to miscarriage, while 9 emphasizes its efficacy in cervical ripening and labor induction.

Real-World Application Precautions

Although mifepristone has diverse applications, it's important to remember that it can induce side effects. Therefore, consulting a doctor before using mifepristone and avoiding self-medication is crucial. During mifepristone use, adhering to the doctor's instructions and undergoing regular checkups is essential.

Current Research Limitations

Research concerning mifepristone is still inadequate, particularly in understanding its long-term side effects. Further investigations are necessary to explore the efficacy and safety of mifepristone across various populations and circumstances.

Future Research Directions

Future research should focus on investigating the long-term side effects of mifepristone and exploring its efficacy and safety across diverse populations and situations. Investigating the interactions between mifepristone and other medications is also essential.

Conclusion

Mifepristone is a medication with diverse applications, including early pregnancy termination, uterine fibroid treatment, and cervical cancer treatment. While generally considered safe and effective, mifepristone can induce side effects. Consult a doctor before using mifepristone, avoid self-medication, and adhere to medical instructions. Regular checkups during mifepristone use are essential.

Literature analysis of 28 papers
Positive Content
26
Neutral Content
1
Negative Content
1
Article Type
3
1
2
5
28
2.

Acceptability and feasibility of outpatient medical abortion with mifepristone and misoprostol up to 70 days gestation in Singapore.

Author: TanYi-Ling, SinghKuldip, TanKok Hian, GosaviArundhati, KohDaniel, AbbasDina, WinikoffBeverly

Successful abortion
Side effects

Outpatient medical abortion with mifepristone and misoprostol up to 70 days gestation is acceptable and feasible, with 96.8% of women having successful abortions without recourse to surgical intervention.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Glucocorticoid receptor antagonism overcomes resistance to BRAF inhibition in BRAF<sup>V600E</sup>-mutated metastatic melanoma.

Author: EstrelaJosé M, SalvadorRosario, MarchioPatricia, VallesSoraya L, López-BlanchRafael, RiveraPilar, BenllochMaría, AlcácerJavier, PérezCarlos L, PellicerJosé A, ObradorElena

Melanoma treatment

RU486, a GR antagonist, increased the efficacy of vemurafenib in BRAF<sup>V600E</sup>-mutated metastatic melanoma, especially in early stages. However, resistance developed at advanced stages, linked to overexpression of Bcl-xL and Mcl-1. Blocking AKT and NF-κB pathways reduced this resistance.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Management of first-trimester miscarriage: a systematic review and network meta-analysis.

Author: H Al WattarBassel, MurugesuNilaani, TobiasAurelio, ZamoraJavier, KhanKhalid S

Effective miscarriage treatment
Reduced analgesia need
Post-treatment infection
Serious complications

Medical treatments for first-trimester miscarriage have similar effectiveness and side effects compared to surgery. The addition of MIFE could increase the effectiveness of MISO and reduce side effects, although evidence is limited due to inconsistency. EXP has lower effectiveness compared to other treatment options.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Uterine fibroids: an update on current and emerging medical treatment options.

Author: FarrisManuela, BastianelliCarlo, RosatoElena, BrosensIvo, BenagianoGiuseppe

Medical treatment
Uterine fibroid treatment
Liver complications

This article provides a comprehensive review of medical treatments for uterine fibroids, a common gynecological disorder. It discusses the evolution of treatment options, from progestins and GnRH analogues to selective progesterone receptor modulators. The article highlights the progress made in long-term medical management of fibroids, particularly with the use of ulipristal acetate.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

The Potential of Hormonal Therapies for Treatment of Triple-Negative Breast Cancer.

Author: KirkbyMelanie, PopatiaAlyanna M, LavoieJessie R, WangLisheng

TNBC treatment
Drug resistance
Side effects

Triple-negative breast cancer (TNBC) lacks targeted therapies and often develops resistance to conventional treatments. This review explores the potential of targeting estrogen receptor beta, the androgen receptor, and the glucocorticoid receptor as novel therapies for TNBC. Ongoing clinical trials investigating these hormone receptors offer hope for improved treatment options.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Prospective open-label non-inferiority randomised controlled trial comparing letrozole and mifepristone pretreatment in medical management of first trimester missed miscarriage: study protocol.

Author: DuLibei, LiRaymond Hang Wun, Gemzell-DanielssonKristina, DuYan Hong, ZhangLi, DiaoWei Yu, HoPak Chung

Treat missed miscarriage

This randomized controlled trial will evaluate the non-inferiority of letrozole pretreatment compared to mifepristone pretreatment followed by misoprostol in terms of complete abortion rate for first-trimester missed miscarriage.

Clinical Trial ProtocolA plan for conducting a clinical trial. It describes in detail the purpose, design, methodology, and statistical considerations of the trial, ensuring the transparency and consistency of the trial.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Outcomes of mifepristone usage for cervical ripening and induction of labour in full-term pregnancy. Randomized controlled trial.

Author: BaevOleg R, RumyantsevaValentina P, TysyachnyuOleg V, KozlovaOlga A, SukhikhGennady T

Labor induction

Mifepristone is a drug that is used to terminate early pregnancies. It can also be used to soften the cervix before an abortion or to induce labor in cases of fetal death. This study looked at the safety and effectiveness of using mifepristone to ripen the cervix and induce labor in women with a live fetus at full term.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Liposomes Co-Encapsulating Cisplatin/Mifepristone Improve the Effect on Cervical Cancer: In Vitro and In Vivo Assessment.

Author: Ledezma-GallegosFabricio, JuradoRafael, MirRoser, MedinaLuis Alberto, Mondragon-FuentesLaura, Garcia-LopezPatricia

Cervical cancer treatment

This study aimed to prepare liposome nanoparticles that co-encapsulate cisplatin and mifepristone, evaluate their cytotoxicity against HeLa cells and in vivo with subcutaneous inoculations of xenografts in nu/nu mice, and examine some plausible mechanisms of action.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Cabergoline for Lactation Inhibition After Second-Trimester Abortion or Pregnancy Loss: A Randomized Controlled Trial.

Author: HenkelAndrea, JohnsonSarah A, ReevesMatthew F, CahillErica P, BlumenthalPaul D, ShawKate A

Reduced breast symptoms
Well tolerated
Constipation
Fatigue
Headache

Cabergoline is an effective and well-tolerated strategy to prevent breast symptoms after second-trimester abortion or pregnancy loss.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Medical methods for first trimester abortion.

Author: ZhangJing, ZhouKunyan, ShanDan, LuoXiaoyan

Medical abortion

This review explores medical abortion methods, including the use of prostaglandins, mifepristone, and letrozole, focusing on the most widely researched drugs. The authors highlight the need for more research to determine optimal dosages, regimens, and routes of administration to maximize patient outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

13.

Oral mometasone furoate administration preserves anti-inflammatory action with fewer metabolic adverse effects in rats.

Author: ZimathPriscila L, AlmeidaMilena S, BruxelMaciel A, RafachoAlex

Anti-inflammatory actions
Diabetogenic actions

This study investigates the effects of mometasone furoate (MF), a glucocorticoid, on inflammation and metabolism. It examines whether MF can maintain anti-inflammatory effects without significant metabolic side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

A randomised comparative study of sublingual and vaginal misoprostol for cervical priming before minor gynaecological procedures.

Author: ChidambaramVidhya, PallaveeP, SamalRupal, GhoseSeetesh

Cervical priming
Easier dilatation

This study compared the effectiveness of vaginal and sublingual misoprostol in cervical priming for minor gynaecological procedures. The findings show that vaginal misoprostol is more effective than sublingual misoprostol in reaching a higher baseline cervical dilatation, reducing the need and time required for further dilatation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

19.

The safety of available and emerging options for emergency contraception.

Author: LeeJessica K, SchwarzEleanor Bimla

Pregnancy prevention
Mild side effects

This review summarizes the available literature on the safety of emergency contraception (EC). All currently available methods of EC, including ulipristal acetate pills, levonorgestrel pills, and the copper IUD, have a favorable safety profile. The copper IUD is the most effective method of EC.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

21.

Contrast-Enhanced Ultrasound Evaluation of Mifepristone for Treatment of Low-Risk Cesarean Scar Pregnancy.

Author: XiongXi, GaoChun-Yan, YingDe-Mei, YanPing, ZhangZhi-Jia, KuangNa, TianHong-Ju, LuoLi, LongShu-Yu, ChenZheng-Qiong

Mifepristone treatment for low-risk CSP showed comparable effects to that in IUP based on contrast-enhanced ultrasound monitoring.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Effect of laparoscopy combined with mifepristone in the treatment of endometriosis and drug reaction analysis.

Author: LiJing, YangHuilin, SongJie

Effective treatment of endometriosis

Small dose mifepristone was found to be an effective treatment for recurrent endometriosis with high remission and good curative effect.

Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

25.

Pathways to seeking medication abortion care: A qualitative research in Uttar Pradesh, India.

Author: SrivastavaAradhana, SaxenaMalvika, PercherJoanna, Diamond-SmithNadia

Improved MA care
MA complications

This study investigates the decision-making pathways of medication abortion (MA) users in Uttar Pradesh, India, where MA is legal and increasingly purchased directly from pharmacies. The findings highlight knowledge and behavior gaps and recommend ways to improve the quality of care at service delivery points.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

27.

Anticraving therapy for alcohol use disorder: A clinical review.

Author: ShenWinston W

Reduced alcohol cravings
Side effects

Anticraving drugs such as acamprosate and naltrexone are FDA-approved for alcohol use disorder (AUD), and other promising drugs like topiramate, gabapentin, and varenicline are under development.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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