Anti-progestogen + prostaglandin (medical abortion)
Mifepristone and misoprostol (combination pack)
Brand names: Mifegyne + Topogyne, MTPak
Adult dose
Dose: Per current RCOG / NICE protocol — typically mifepristone 200mg PO followed by misoprostol 800 micrograms (vaginal/buccal/sublingual) 24–48h later (regimen varies by gestation)
Route: PO + vaginal/buccal
Frequency: single course
Clinical pearls
- Medical abortion — take both at home in early pregnancy under approved regimen (UK)
- Confirm complete abortion with urine pregnancy test 2 weeks later
Contraindications
- Suspected ectopic pregnancy
- Chronic adrenal failure
- Severe asthma uncontrolled
- Inherited porphyria
- Hypersensitivity
- Bleeding disorder / anticoagulation (caution)
Side effects
- Cramping
- Bleeding
- Nausea
- Diarrhoea (misoprostol)
- Incomplete abortion
- Infection
Interactions
- NSAIDs (caution — may reduce effect of misoprostol)
- Strong CYP3A4 modulators
Monitoring
- Bleeding
- Pregnancy test follow-up
Reference: BNF; RCOG / NICE NG140; https://bnf.nice.org.uk/drugs/mifepristone-and-misoprostol/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- IMPROVE VTE Risk Score for Medical Patients · VTE Risk
- EpiScore for Epistaxis Severity · Epistaxis
- Revised Original International Autoimmune Hepatitis Score (IAIHG) · Autoimmune Liver Disease
- Ho Index for Predicting Response to Medical Therapy in IBD · Inflammatory Bowel Disease
- Padua Prediction Score for VTE Risk in Medical Inpatients · Venous Thromboembolism
- Pack Years Calculator for Smoking History · Oncology Risk
Pathways
- Spinal Anaesthesia Hypotension Management · AAGBI; ASA
- Pre-Eclampsia / Eclampsia in ED · NICE NG133; RCOG Green-top 10A
- Suspected Ectopic Pregnancy · NICE NG126; RCOG Green-top 21
- Polycystic Ovary Syndrome (PCOS) · International PCOS Guideline 2023; NICE CKS
- Pre-eclampsia Management · NICE NG133 2019
- Ectopic Pregnancy · NICE CG154 / RCOG GTG 21