Drug/Small Molecule:
mifepristone

2D structure

Overview

Generic Names: Mifepriston; Mifepristona [Spanish]; Mifepristonum [Latin]; RU486; mifepristone
Trade Names: Corlux; Mifegyne; Mifeprex
PharmGKB Accession Id: PA450500

Description

A progestational and glucocorticoid hormone antagonist. Its inhibition of progesterone induces bleeding during the luteal phase and in early pregnancy by releasing endogenous prostaglandins from the endometrium or decidua. As a glucocorticoid receptor antagonist, the drug has been used to treat hypercortisolism in patients with nonpituitary cushing syndrome. PubChem (source: Drug Bank)

Indication

For the medical termination of intrauterine pregnancy through 49 days' pregnancy. (source: Drug Bank)

ATC Therapeutic Category

  • G03XB:Antiprogestogens

Pharmacology, Interactions, and Contraindications

Mechanism Of Action

The anti-progestational activity of mifepristone results from competitive interaction with progesterone at progesterone-receptor sites. Based on studies with various oral doses in several animal species (mouse, rat, rabbit and monkey), the compound inhibits the activity of endogenous or exogenous progesterone. The termination of pregnancy results. (source: Drug Bank)

Pharmacology

Mifepristone is a synthetic steroid with antiprogestational effects indicated for the medical termination of intrauterine pregnancy through 49 days' pregnancy. Doses of 1 mg/kg or greater of mifepristone have been shown to antagonize the endometrial and myometrial effects of progesterone in women. During pregnancy, the compound sensitizes the myometrium to the contraction-inducing activity of prostaglandins. Mifepristone also exhibits antiglucocorticoid and weak antiandrogenic activity. The activity of the glucocorticoid dexamethasone in rats was inhibited following doses of 10 to 25 mg/kg of mifepristone. Doses of 4.5 mg/kg or greater in human beings resulted in a compensatory elevation of adrenocorticotropic hormone (ACTH) and cortisol. (source: Drug Bank)

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic. Hepatic, by Cytochrome P450 3A4 isoenzyme to the N-monodemethylated metabolite (RU 42 633); RU 42 698, which results from the loss of two methyl groups from position 11 beta; and RU 42 698, which results from terminal hydroxylation of the 17–propynyl chain. (source: Drug Bank)

Protein Binding

98% (bound to plasma proteins, albumin and a 1-acid glycoprotein) (source: Drug Bank)

Absorption

The absolute bioavailability of a 20 mg oral dose is 69% (source: Drug Bank)

Toxicity

Nearly all of the women who receive mifepristone will report adverse reactions, and many can be expected to report more than one such reaction. About 90% of patients report adverse reactions following administration of misoprostol on day three of the treatment procedure. Side effects include more heavy bleeding than a heavy manstrual period, abdominal pain, uterine cramping, nausea, vomiting, and diarrhea. (source: Drug Bank)

Isomeric SMILES Code:

CC#C[C@@]1(CC[C@@H]2[C@@]1(C[C@@H](C3=C4CCC(=O)C=C4CC[C@@H]23)C5=CC=C(C=C5)N(C)C)C)O (source: Drug Bank)

The following genes are in curated knowledge about this drug.

  Gene Relationship Evidence
No phenotype data No genotype data Literature annotations available Has annotations
BRCA1
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  • FA
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Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A4
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  • FA
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Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
ESR1
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  • FA
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Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
NR1I2
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  • FA
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Publications
No phenotype data No genotype data Literature annotations available Not annotated
PGR
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  • FA
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Publications
No phenotype data Genotype Data Available Literature annotations available Has annotations
SLCO1B1
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  • PK
  • FA
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Publications

A list of non-curated publications that mention this drug along with other genes is available.

Drug Targets

Gene Description
NR3C1 Uncurated Annotation (source: Drug Bank)
PGR Uncurated Annotation (source: Drug Bank)

A list of non-curated publications that mention this drug along with other drugs is available.

Curated Information

The following diseases are in curated knowledge about this drug.

  Disease Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Not annotated
Breast Neoplasms
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  • FA
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Publications
No phenotype data No genotype data Literature annotations available Not annotated
Ovarian Neoplasms
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  • FA
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Publications

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

Additional Datasets

These datasets are minimally curated and are sorted alphabetically by title.

  1. The Connectivity Map: using gene-expression signatures to connect small molecules, genes, and disease

LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB00834
KEGG Compound ID:
C07652
KEGG Drug ID:
D00585
PubChem Compound ID:
55245
PubChem Substance ID:
7847651

Common Searches

Search PubMed
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Non-Curated Publications

A list of non-curated publications that mention this drug is available.

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