Note: This document contains side effect information about mifepristone. Some dosage forms listed on this page may not apply to the brand name Korlym.
Summary
Common side effects of Korlym include: drowsiness, fatigue, and hypokalemia. Continue reading for a comprehensive list of adverse effects.
Applies to mifepristone: oral tablet.
Warning
Oral route (Tablet)
Korlym(TM): Mifepristone has potent antiprogestational effects and will result in the termination of pregnancy. Pregnancy must therefore be excluded before the initiation of treatment or if treatment is interrupted for more than 14 days in females of reproductive potential. Pregnancy should be prevented during treatment and for one month after stopping treatment by the use of a nonhormonal medically acceptable method of contraception unless the patient has had a surgical sterilization.
Oral route (Tablet)
Mifeprex®: Serious and sometimes fatal infections and bleeding occur very rarely following spontaneous, surgical, and medical abortions, including following mifepristone use. Atypical Presentation of Infection: Patients with serious bacterial infections and sepsis can present without fever, bacteremia or significant findings on pelvic examination; use a high index of suspicion to rule out serious infection and sepsis. Bleeding: Prolonged heavy bleeding may be a sign of incomplete abortion or other complications and prompt medical or surgical intervention may be needed. Mifepristone is only available through a restricted program called the mifepristone REMS Program. Before prescribing mifepristone, advise the patient about these serious risks, ensure that she knows what to do if she experiences symptoms of these events, and discuss the medication guide and the patient agreement with her.
Serious side effects of Korlym
Along with its needed effects, mifepristone (the active ingredient contained in Korlym) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking mifepristone:
Less common
- Excessively heavy vaginal bleeding
- unusual tiredness or weakness
Incidence not known
- Chest pain or discomfort
- confusion
- cough or hoarseness
- fast, weak pulse
- fever or chills
- lower back or side pain
- pain or discomfort in the arms, jaw, back, or neck
- painful or difficult urination
- pale, cold, or clammy skin
- shortness of breath
- sudden increase in stomach or shoulder pain
- sweating
- unusual or large amount of vaginal bleeding
Other side effects of Korlym
Some side effects of mifepristone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
- Abdominal or stomach pain or uterine cramping
- back pain
- diarrhea
- dizziness
- headache
- nausea or vomiting
Less common
- Acid or sour stomach
- anxiety
- belching
- cough
- fainting or lightheadedness when getting up from a lying or sitting position
- fever
- flu-like symptoms
- headache
- heartburn
- increased clear or white vaginal discharge
- indigestion
- itching of the vagina or genital area
- lack or loss of strength
- pain during sexual intercourse
- pain or tenderness around the eyes and cheekbones
- pale skin
- shaking chills
- stomach discomfort, upset, or pain
- stuffy or runny nose
- tightness of the chest
- trouble sleeping
- troubled breathing
- troubled breathing, exertional
- unusual bleeding or bruising
For Healthcare Professionals
Applies to mifepristone: oral tablet.
General
The most commonly reported adverse reactions were nausea, weakness, fever/chills, vomiting, headache, diarrhea, and dizziness.[Ref]
Cardiovascular
Very common (10% or more): Hypertension (24%)
Uncommon (0.1% to 1%): Hypotension (0.25%), hot flush
Rare (less than 0.1%): Myocardial infarction, induced Adam-Stokes syndrome, superficial thrombophlebitis
Postmarketing reports: Syncope, fainting, loss of consciousness, hypotension (including orthostatic), light-headedness, tachycardia (including racing pulse, heart palpitations, heart pounding)[Ref]
Endocrine
It was reported that of the 42 Cushing syndrome patients with detectable TSH at baseline, eight (19%) had increases in TSH above the normal range, while remaining asymptomatic. The TSH levels returned to normal in most patients when this drug was discontinued at the end of the study.
Adrenal insufficiency was reported in two subjects (4%) in Study 400. The most typical symptoms of adrenal insufficiency were nausea and decreased appetite. Adrenal insufficiency resolved in both cases with interruption of this drug and/or dexamethasone administration.[Ref]
Very common (10% or more): Thyroid function test abnormal (18%) in patients with Cushing syndrome[Ref]
Gastrointestinal
Very common (10% or more): Nausea (48%), vomiting (26%), dry mouth (18%), diarrhea (12%), constipation (10%), gastric discomfort, abdominal pain
Common (1% to 10%): Light or moderate cramping
Rare (less than 0.1%): Gastric bleeding, necrotising pancreatitis
Postmarketing reports: Dyspepsia, gastroesophageal reflux[Ref]
Genitourinary
Heavy bleeding occurs in about 5% of the cases and may require hemostatic curettage in up to 1.4% of the cases.
In clinical trials surgical evacuation was needed in 10% to 12% of women, with some studies reporting a rate as high as 20% to 30%. Bleeding can be prolonged for several days after prostaglandin analog administration and sometimes leads to a decrease in hemoglobin levels.[Ref]
Very common (10% or more): Uterine contractions or cramping (up to 45%) following prostaglandin intake, endometrial hypertrophy (38%), vaginal bleeding, uterine spasm
Common (1% to 10%): Endometritis, pelvic inflammatory disease, heavy uterine bleeding, prolonged post abortion bleeding, spotting, severe hemorrhage, breast tenderness
Uncommon (0.1% to 1%): Uterine rupture after prostaglandin intake (during induction of second trimester termination of pregnancy or labor induction for fetal death in utero during the third trimester), hemorrhagic shock, salpingitis
Rare (less than 0.1%): Hydatiform mole, ectopic pregnancy, amniotic band syndrome, gestational trophoblastic tumor, uteroplacental apoplexy, bilateral adnexal mass, intrauterine adhesion, ovarian cyst rupture, breast abscess, hematosalpinx, uterine rupture
Postmarketing reports: Post-abortal infection (including endometritis, endomyometritis, parametritis, pelvic infection, pelvic inflammatory disease, salpingitis); hematometra, leukorrhea, vaginal hemorrhage, metrorrhagia[Ref]
Hematologic
Very common (10% or more): Blood potassium decreased (34%) in Cushing syndrome patients
Rare (less than 0.1%): Thrombotic thrombocytopenic purpura, thrombocytopenia, induced systemic lupus erythematosus
Postmarketing reports: Anemia[Ref]
Metabolic
In Cushing syndrome patients:
Very common (10% or more): Decreased appetite (20%), anorexia (10%)
Postmarketing reports: Increased triglycerides, hypoglycemia[Ref]
Musculoskeletal
Very common (10% or more): Arthralgia (30%), back pain (16%), myalgia (14%), pain in the extremity (12%)
Rare (less than 0.1%): Limb spasm
Postmarketing reports: Muscular weakness, flank pain, musculoskeletal chest pain[Ref]
Nervous system
Very common (10% or more): Headache (44%), dizziness (22%), somnolence (10%)
Rare (less than 0.1%): Vagal symptoms (hot flushes, dizziness, chills), epilepsy, neurogenic tinnitus[Ref]
Other
Very common (10% or more): Fatigue (48%), peripheral edema (26%), pain (14%), chill, fever
Common (1% to 10%): Fainting
Rare (0.01% to 0.1%): Malaise
Very rare (less than 0.01%): Fatal toxic shock caused by Clostridium sordellii endometritis or Escherichia coli (use of mifepristone (the active ingredient contained in Korlym) followed by non authorized vaginal administration of misoprostol oral tablets)
Postmarketing reports: Asthenia, edema, pitting edema, thirst[Ref]
Psychiatric
Very common (10% or more): Anxiety (10%)
Rare (less than 0.1%): Mania
Postmarketing reports: Insomnia[Ref]
Respiratory
Very common (10% or more): Dyspnea (16%), sinusitis (14%), nasopharyngitis (12%)
Rare (less than 0.1%): Bronchospasm, induced bronchial asthma
Frequency not reported: Shortness of breath[Ref]
Dermatologic
Uncommon (0.1% to 1%): Skin rashes (0.2%), pruritus
Rare (0.01% to 0.1%): Urticaria, erythroderma, erythema nodosum, toxic epidermal necrolysis
Very rare (less than 0.01%): Angioedema[Ref]
Hepatic
Rare (less than 0.1%): Abnormal liver function tests, hepatic failure, hepatorenal failure[Ref]
Hypersensitivity
Rare (less than 0.1%): Anaphylaxis
Postmarketing reports: Allergic reaction (including anaphylaxis, angioedema, hives, rash, itching)[Ref]
Ocular
Rare (less than 0.1%): Ophthalmoplegia, periorbital edema[Ref]
Oncologic
Rare (less than 0.1%): Elevated alpha-feto protein, elevated carcinoembryonic antigen[Ref]
Renal
Rare (less than 0.1%): Renal failure[Ref]