Drug interactions
Lepirudin + Mifepristone
Severity: Major
Lepirudin and Mifepristone: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Mifepristone used for pregnancy termination can cause prolonged or heavy uterine bleeding. A patient on a direct thrombin inhibitor such as lepirudin has impaired clotting, so bleeding may be more severe and harder to control.
What this interaction means in plain words
Lepirudin and Mifepristone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive bleeding risk from lepirudin's anticoagulant effect on top of mifepristone-induced uterine bleeding.
What to do
Avoid mifepristone for termination in patients who are fully anticoagulated, or arrange surgical management with hemostatic monitoring. Monitor aPTT and hemoglobin closely if the combination cannot be avoided.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Frequently asked questions
Can I take Lepirudin with Mifepristone?
MediHelp rates the interaction as major. Lepirudin and Mifepristone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Mifepristone used for pregnancy termination can cause prolonged or heavy uterine bleeding. A patient on a direct thrombin inhibitor such as lepirudin has impaired clotting, so bleeding may be more severe and harder to control.
How serious is the interaction between Lepirudin and Mifepristone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid mifepristone for termination in patients who are fully anticoagulated, or arrange surgical management with hemostatic monitoring. Monitor aPTT and hemoglobin closely if the combination cannot be avoided.
What other medicines interact with Mifepristone?
MediHelp also lists interactions of Mifepristone with, for example, Apixaban, Argatroban, Cisapride. The full list is on the Mifepristone page.
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