A-Kit

Uses of A-Kit

Treatment of Medical Abortion

Composition of A-Kit

Each box contains 2 blister strips.

• One strip contains 1 tablet of Mifepristone INN 200 mg.
• Another strip contains 4 tablets of Misoprostol USP 200 microgram each.

Side Effects of A-Kit

• Nausea
• Uterine cramps
• Vomiting
• Diarrhea
• Dizziness
• Infection following abortion
• Uterine bleeding

Quick Suggestions:

• A-Kit is effective if taken within 72 hours of unprotected intercourse.
• It's most effective when taken immediately after unprotected intercourse.
• If vomiting occurs after taking the tablet, another one can be taken under medical supervision.
• If menstruation is delayed three weeks after taking A-Kit, consult a doctor.
• It does not affect fertility. Use contraception to avoid pregnancy.

For Pregnancy Termination:

• Take it no later than 63 days after the first day of your last menstrual period.
• Take Misoprostol 36 – 48 hours after taking Mifepristone.
• Rest for at least 3 hours after taking the Misoprostol.
• Take it only as prescribed by the doctor. Miscarriages, if incomplete, may result in serious medical complications leading to hospitalization, surgery, and possible infertility.
• Vaginal bleeding lasting for approximately 12 days may occur after taking this medicine. Inform your doctor immediately if excessive bleeding occurs or if you suffer from severe abdominal pain.

Pharmacology

Mifepristone functions as a synthetic steroid with anti-progestational properties by competitively interacting with progesterone at progesterone-receptor sites. This interaction inhibits the activity of both endogenous and exogenous progesterone. Studies utilizing varied oral doses in various animal species have shown its effectiveness in Menstrual Regulation (MR) outcomes. During pregnancy, Mifepristone increases the myometrium's sensitivity to the contraction-inducing function of prostaglandins.

Misoprostol, on the other hand, is a synthetic analog of prostaglandin E1. It works by interacting with specific receptors on myometrial cells, leading to contractions of the uterus. This interaction causes a change in calcium concentration, initiating muscle contraction. Additionally, misoprostol softens the cervix and induces contractions of the uterus, facilitating the expulsion of uterine contents by interacting with prostaglandin receptors.

Dosage of A-Kit

A-Kit regimen should only be prescribed by qualified medical professionals capable of assessing embryo gestational age and diagnosing ectopic pregnancies. These professionals must also be equipped to provide surgical intervention, such as Manual Vacuum Aspiration (MVA), in cases of incomplete abortion or severe bleeding. If they cannot provide such care directly, they should have arrangements in place to ensure patient access to medical facilities capable of providing blood transfusions and resuscitation if needed.

Day 1 (First Visit): Mifepristone Administration

• A qualified medical professional administers one tablet of Mifepristone (200 mg) orally in a single dose, typically in a clinic, medical office, or hospital setting.

Day 2 (Second Visit): Misoprostol Administration

• 24-48 hours after taking Mifepristone, the patient self-administers four tablets of Misoprostol (800 micrograms total) buccally or sublingually.
• The patient can place two tablets on each side of the cheek or under the tongue and should wait for 30 minutes.
• Patients may require medication for cramps or gastrointestinal symptoms following Misoprostol administration. They should also receive instructions on managing discomfort, excessive bleeding, or other adverse reactions, along with a contact number for questions or concerns.

Day 10 to 14 (Third Visit): Post-Treatment Examination

• Patients return to the clinic, medical office, or hospital within 10 to 14 days after taking Mifepristone for a post-treatment examination.
• This visit is crucial for confirming the complete termination of pregnancy through clinical examination or ultrasonographic scan.

Patients with ongoing pregnancy at this visit are at risk of fetal malformation due to treatment. Surgical termination or MVA is recommended for managing treatment failures in menstrual regulation or termination of pregnancy.

Administration of A-Kit

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

Interaction

A-Kit interacts with various medications, so it's important to avoid combining it with corticosteroids (such as dexamethasone), antifungals (like ketoconazole and itraconazole), antibiotics (including erythromycin and rifampicin), anti-epileptic drugs (such as phenytoin, phenobarbital, and carbamazepine), immunosuppressants (like cyclosporine, tacrolimus, and sirolimus), and medications for migraine (such as ergotamine). These interactions can lead to adverse effects and should be avoided.

In terms of food interactions, it's crucial to inform your doctor about any vitamins, herbs, or supplements you're taking, as A-Kit may interact with them, causing unwanted side effects. Additionally, A-Kit can interact with St. John's Wort, a natural remedy used for mild depression, as well as grapefruit juice.

Regarding disease interactions, caution is advised when taking A-Kit in individuals with bleeding disorders, confirmed or suspected ectopic pregnancy, heart issues, liver or kidney disease, vaginal bleeding, or porphyria, an inherited blood disorder that may cause nervous system or skin problems. It's essential to discuss any existing health conditions with your doctor before starting treatment with A-Kit.

A-Kit is contraindicated in the following cases:

• Women with a blood clotting disorder.
• Women experiencing abnormal vaginal bleeding.
• Women prone to allergies.
• Women with Porphyria.
• Women with a liver tumor or other liver issues.
• Women at risk of tubal pregnancy.
• Women planning pregnancy.
• Women with diabetes.
• Women use anticoagulants, valproic acid, or antifungal medications.
• Breast cancer patients.
• Stroke patients.

Pregnancy & Lactation

During Pregnancy:

• Mifepristone is indicated for menstrual regulation (MR) up to 63 days of pregnancy and has no other approved use during pregnancy.
• Patients with ongoing pregnancy at the last visit are at risk of fetal malformation from treatment. Surgical termination is recommended for MR treatment failures.

During Lactation:

• Mifepristone: It's unknown if Mifepristone is excreted in human milk, but similar hormones are. Breastfeeding women should consult their doctor to decide whether to discard breast milk for a few days after taking the medication.
• Misoprostol: While it's not confirmed if Misoprostol is excreted in human milk, it should not be given to nursing mothers as potential excretion of misoprostol acid could lead to diarrhea in nursing infants.

Precautions

• Avoid A-Kit if you're allergic to any of its ingredients.
• Refrain from taking A-Kit if you have conditions like high blood pressure, high cholesterol, asthma, bleeding disorders, liver or kidney disease, blood clotting issues, or low hemoglobin levels.
• Do not use A-Kit if you have an artificial heart valve or if you're malnourished.
• Note that A-Kit is not an abortion pill and cannot terminate pregnancy.
• This product is not suitable for children under 16 years of age.

Warnings:

• There are no known side effects if A-Kit is taken with alcohol, but it's best to avoid alcohol consumption while using this product.
• Do not use A-Kit if you're pregnant or suspect you might be. Consult a doctor before use.
• Breastfeeding women should avoid A-Kit as it can pass into breast milk.
• This medication may cause dizziness or fatigue, so refrain from driving if you experience these symptoms.
• If you have a history of liver or kidney disorders, use A-Kit with caution and consult your doctor for dosage adjustments.
• Not recommended for children under 16 years unless under medical supervision.

Safety Information:

• Adhere to the recommended dosage.
• Read the product label carefully before use.
• Keep out of reach of children.
• Use under medical supervision.

Storage Conditions:

Store in a cool & dry place. Keep out of reach of children. Do not freeze.