Danco Laboratories , the manufacturer of the abortion pill RU-486 issued this warning to emergency room doctors. Below are exerpts of the letter:
November 15, 2004
Dear Emergency Room Director:
Danco Laboratories is providing this information to assist you in taking care of patients who may present in an emergency room setting following treatment with Mifeprex ® (mifepristone) and misoprostol. In particular, you should be aware of the rare events – serious infection, prolonged heavy bleeding and ruptured ectopic pregnancy – discussed below.
There may be some women who present to an emergency room with serious and sometimes fatal infections and bleeding that occur rarely following spontaneous (miscarriage), surgical and medical abortions, including following Mifeprex use, and childbirth. A high index of suspicion is needed for timely diagnosis and intervention in these patients.
A summary of the updated warnings follows:
Infection and Sepsis
In postmarketing experience following the use of Mifeprex and misoprostol, we have received a few reports of cases of serious bacterial infection, including very rare cases of fatal septic shock
Vaginal Bleeding
Vaginal bleeding occurs in almost all patients during the treatment procedure (see WARNINGS). According to data from the U.S. and French trials, women should expect toexperience vaginal bleeding or spotting for an average of nine to 16 days, while up to 8% of all subjects may experience some type of bleeding for 30 days or more. Prolonged heavy bleeding (soaking through two thick full-size sanitary pads per hour for two consecutive hours) may be a sign of incomplete abortion or other complications and prompt medical or surgical intervention may be needed to prevent the development of hypovolemic shock. Patients should be counseled to seek immediate medical attention if they experience prolonged heavy vaginal bleeding following a medical abortion. Excessive vaginal bleeding usually requires treatment by uterotonics, vasoconstrictor drugs, curettage, administration of saline infusions, and/or blood transfusions.
Ectopic Pregnancy
Additionally, in postmarketing experience we have received a small number of reports of ruptured ectopic pregnancy. Physicians should remain alert to the possibility that a patient who is undergoing a medical abortion could have an undiagnosed ectopic pregnancy since some of the expected symptoms of a medical abortion may be similar to those of a ruptured ectopic pregnancy. The presence of an ectopic pregnancy may have been missed even if the patient underwent ultrasonography prior to being prescribed Mifeprex.
We rely on medical feedback from health care professionals and therefore remind you to report serious adverse events and any on-going pregnancies following treatment with the Mifeprex regimen to us.
Please provide a brief clinical synopsis (by postal mail, email or phone):
Medical Director
Danco Laboratories, LLC
P.O. Box 4816
New York, NY 10185
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