Also known as Corlux, Korlym, Mifegyne, Mifeprex, Mifepriston, Mifepristona, Mifepristonum, Mifépristone, RU 486, RU-38486, RU-486, RU486

A derivative of the synthetic progestin norethindrone with antiprogesterone activity. Mifepristone competitively binds to the progesterone receptor, resulting in inhibition of the effects of endogenous or exogenous progesterone. This agent also exhibits antiglucocorticoid and weak antiandrogenic activities.

Originator: NCI Thesaurus | Source: The website of the National Cancer Institute (http://www.cancer.gov)

Can I take Mifepristone while breastfeeding?

Limited information indicates that breastfeeding need not be interrupted after a single dose of mifepristone. A dose of 200 mg might be preferable to a 600 mg dose in nursing mothers

Drug levels

Maternal Levels. Twelve women (most 6 to 12 months postpartum) who had undergone a medical abortion using mifepristone and misoprostol provided milk samples for up to 5 days after the procedure for measurement of mifepristone. In the 2 women who received a single dose of 200 mg orally, mifepristone was undetectable (<5.6 mcg/L) in breastmilk at all times. Among the 10 women who received a single oral dose of 600 mg, average mifepristone breastmilk levels were 172 mcg/L on day 1 (n = 9) ; 66 mcg/L on day 2 (n = 9); 31 mcg/L on day 3 (n = 10); 24 mcg/L on day 4 (n = 4); and, 25 mcg/L on day 5 (n = 3). Breastmilk levels of mifepristone were highest in the samples collected between 6 and 9 hours after drug administration. Samples collected between 9 and 15 hours after the dose had much lower mifepristone levels. The authors estimated that a fully breastfed infant would receive a weight-adjusted dosage of 0.5% of the maternal dosage. They suggested that breastfeeding need not be interrupted after a single dose of mifepristone and that a dose of 200 mg might be preferable to a 600 mg dose in nursing mothers.[1] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Maternal Levels. Twelve women (most 6 to 12 months postpartum) who had undergone a medical abortion using mifepristone and misoprostol provided milk samples for up to 5 days after the procedure for measurement of mifepristone. In the 2 women who received a single dose of 200 mg orally, mifepristone was undetectable (<5.6 mcg/L) in breastmilk at all times. Among the 10 women who received a single oral dose of 600 mg, average mifepristone breastmilk levels were 172 mcg/L on day 1 (n = 9) ; 66 mcg/L on day 2 (n = 9); 31 mcg/L on day 3 (n = 10); 24 mcg/L on day 4 (n = 4); and, 25 mcg/L on day 5 (n = 3). Breastmilk levels of mifepristone were highest in the samples collected between 6 and 9 hours after drug administration. Samples collected between 9 and 15 hours after the dose had much lower mifepristone levels. The authors estimated that a fully breastfed infant would receive a weight-adjusted dosage of 0.5% of the maternal dosage. They suggested that breastfeeding need not be interrupted after a single dose of mifepristone and that a dose of 200 mg might be preferable to a 600 mg dose in nursing mothers.[1] Infant Levels. Relevant published information was not found as of the revision date.

Possible effects on lactation

Based on animal data, some authors suggest that mifepristone used at term might shorten the onset of lactation, increase milk flow and increase the initial growth rate of breastfed infants.[2][3][4] However, no human data are available.

References

1. Saav I, Fiala C, Hamalainen JM et al. Medical abortion in lactating women – low levels of mifepristone in breast milk. Acta Obstet Gynecol Scand. 2010. PMID: 20367522

2. Baird DT. Antigestogens. Br Med Bull. 1993;49:73-87. PMID: 8324617

3. Permezel M. The antiprogesterone steroid, RU 486 (mifepristone). Aust N Z J Obstet Gynaecol. 1990;30:77-80. PMID: 2189395

4. Ulmann A, Dubois C. Anti-progesterones in obstetrics, ectopic pregnancies and gynaecological malignancy. Baillieres Clin Obstet Gynaecol. 1988;2:631-8. PMID: 3069266

Last Revision Date

20150310

Disclaimer:Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Source: LactMed – National Library of Medicine (NLM)

3D Model of the Mifepristone molecule

MolView – data visualization platform