ABO Kit Tablet

ABO Kit is a combination of two medicines, which is used for medical abortion (terminating a pregnancy). This medicine blocks the action of progesterone, a female hormone required to maintain pregnancy and induce contractions in the uterus, which further helps in abortion. ABO Kit should be taken with food or as your doctor's advice. You must start with dose of Mifepristone. It should be taken orally, by swallow the tablets whole with a drink of water. If you experience vomiting within 30 minutes of tablet intake, inform your doctor or take another tablet. The medicine may take 24- 48 hours to show its action and you might experience spotting or bleeding. After a period of 36-48 hours, you have take misoprostol tablets, either orally or vaginally. You are suggested to have proper rest after dose intake as it may cause severe stomach pain or vaginal bleeding leading to abortion. The most common side effects of this medicine include nausea, vomiting, diarrhea and stomach cramps. If these bother you, or appear serious, let your doctor know. There may be ways of reducing or preventing them. Some side effects may mean you should inform your doctor immediately include heavy vaginal bleeding or abdominal pain. Before taking this medicine, tell your doctor if you have ever had an ectopic pregnancy, or you are breastfeeding or using intrauterine device. Your doctor should also know about all other medicines you are taking as many of these may make this medicine less effective or change the way it works. You must avoid strenuous activity like heavy exercise, running and driving while abortion as it can affect the bleeding. Your doctor may perform an ultrasound or pelvic examination to check for abortion completion.

Uses of ABO Kit

Medical abortion

Side effects of ABO Kit

Common

Nausea

Vomiting

Diarrhea

Stomach cramp

Uterine contractions

Menorrhagia (heavy menstrual bleeding)

How to use ABO Kit

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. ABO Kit is to be taken with food.

How ABO Kit works

ABO Kit is a combination of two medicines: Mifepristone and Misoprostol, which causes abortion. Mifepristone blocks the effects of progesterone, a natural female hormone which is needed for the pregnancy to sustain. Without this hormone, the lining of the uterus (womb) breaks down as it does during a menstrual period and stops the growth of the pregnancy. Mifepristone increases contractions of the uterus to cause abortion.

Quick Tips

ABO Kit helps terminate a pregnancy.

Use caution while driving or doing anything that requires concentration as it can cause dizziness and sleepiness.

It does not affect fertility. Use contraception to avoid pregnancy.

For pregnancy termination:

Brief Description

Indication

Termination of pregnancy upto 9th week(63 days) of gestation, Early menstrual regulation.

Adult Dose

Day 1 (First visit): Mifepristone administration Day 1 One tablet of Mifepristone (200 mg) is taken in a single oral dose under the supervision of a qualified medical professional in a clinic, medical office or hospital. Day 2 (second visit): Misoprostol administration 24-48 hours after ingesting of Mifepristone tablet, the patient takes 4 tablets of 200 microgram (800 micrograms) of Misoprostol buccally. Misoprostol tablets can be administered by the patient herself (place two tablets on each side of cheek & gum). She should wait for 30 minutes. During the period immediately following the administration of Misoprostol, the patients may need medication for cramps or gestational symptoms. The patient should be given a phone number to call if she has questions following the administration of Misoprostol. Day 10 to 14 Patients must return to the clinic, medical office or hospital within 10 to 14 days after the administration of Mifepristone. This visit is very important to confirm by clinical examination or ultrasonographic scan that a complete termination of pregnancy has occurred. Patients who have an ongoing pregnancy at this visit have a risk of fetal malformation resulting from the treatment. Surgical termination/MVA (Manual vaccum Aspiration) is recommended to manage Menstrual Regulation (MR)/termination of pregnancy failures.

Contraindication

Confirmed or suspected ectopic pregnancy, chronic adrenal failure, concurrent long-term corticosteroid therapy, history of allergy to mifepristone, misoprostol or other prostaglandin, haemorrhagic disorders or concurrent anticoagulant therapy, porphyria, hepatic or renal impairment; pregnancy and lactation; IUD in place; undiagnosed adnexal mass.

Mode of Action

Mifepristone is a progesterone antagonist with antiglucocorticoid activity. It binds to the intracellular progesterone receptor where it competitively inhibits progesterone attachment. It is also a partial progesterone agonist. Misoprostol, a synthetic prostaglandin E1 analogue, exerts its antisecretory activity by directly acting on specific prostaglandin receptors found on the surface of gastric parietal cells. It exerts its protective effects on the mucosa by replacing the prostaglandins consumed during prostaglandin-inhibiting therapies e.g. NSAIDs.

Precaution

Mifepristone + Misoprostol must not be administered if there is doubt as to the existence or age of the pregnancy or if an extra-uterine pregnancy is suspected. An ultrasound scan and/or measurement of Beta-hCG must be performed before administration. For first trimester abortions, Mifepristone is contraindicated if the pregnancy is beyond 49 days of amenorrhoea when used with Misoprostol. Mifepristone + Misoprostol should never be prescribed in patients with chronic adrenal failure, known allergy to Mifepristone or to any component of the product, severe asthma uncontrolled by corticosteroid therapy, porphyrias and renal failure, liver failure or malnutrition, or during breast feeding. Patients w/ conditions that predispose to diarrhoea (e.g. inflammatory bowel disease); CV disease; disease states where hypotension may precipitate severe complications (e.g. cerebrovascular disease, coronary artery disease or severe peripheral vascular disease including HTN). Patients in whom dehydration would be dangerous. Renal impairment. Lactation. Monitoring Parameters Conduct pregnancy test in women of reproductive potential prior to therapy. Monitor uterine activity and foetal condition when used for labour induction.

Side Effect

Mifepristone: The treatment is designed to induce the vaginal bleeding and uterine cramping necessary for menstrual Regulation (MR). Commonly reported side effects were nausea, vomiting and diarrhea, pelvic pain, fainting, headache, dizziness and asthenia occurred rarely. Misoprostol: Gastro-intestinal side effects like diarrhea, abdominal pain, nausea, flatulence, dyspepsia, headache, vomiting and constipation, shivering, hyperthermia, dizziness, pain due to uterine contractions, severe vaginal bleeding, shock, pelvic pain, uterine rupture (requiring surgical repair, hysterectomy and/or salpingo-oophorectomy).

Interaction

Decreased efficacy with aspirin and NSAIDs. Efficacy of corticosteroids (including inhaled) decreased, monitor patients during co-admin and for several days afterwards. May increase effects of oxytocin. Increased risk of misoprostol-induced diarrhoea with magnesium-containing antacids.