Friday, November 18, 2005

Friday November 18, 2005
RU-486 and septic shock

As sepsis is a major bread n butter of intensivists, it may be of importance to know that abortion pill RU-486 (
Mifeprex/Mifepristone) has been associated with severe septic shock. 8 deaths (4 in USA) have been reported so far. 1 Mechanism of action is not entirely clear but it is secondary to pelvic infections from common vaginal bacteria Clostridium sordellii. Dr. Miech from Brown University proposed that Mifepristone, blocks both progesterone and glucocorticoid receptors and failure of physiologically controlled cortisol and cytokine response eventually results in release of toxins from C. sordellii and lead to life threatening septic shock. 2

References: click to get abstract/article
Mifeprex (mifepristone) - FDA warning
Pathophysiology of Mifepristone-Induced Septic Shock Due to Clostridium sordellii - The Annals of Pharmacotherapy: Vol. 39, No. 9, pp. 1483-1488