Misoprostol Usage Instructions

36-48 Hours Later:
Misoprostol should not be swallowed immediately. Instead, place the pills inside your cheeks or under your tongue—whichever method you prefer. Hold them in place for 30 minutes to allow absorption, then swallow any remaining fragments with a drink.

• If your period was 8 weeks or less ago: Take 4 misoprostol pills (200 mcg each).

• If your period was over 8 weeks ago: Take 4 pills first, then another 4 pills after 4 hours.

• If your period was more than 11 weeks ago: Take 4 pills initially, then 2 pills every 3 hours until the pregnancy passes.

Note: In fewer than 1% of cases, aftercare is required for complications. If necessary, vaginal use of the pills may be detected, but oral absorption followed by swallowing leaves no trace.

Misoprostol-Only Protocol

We also provide Misoprostol separately, with each pill containing 200 mcg of the active ingredient.

1. Take 4 pills orally (e.g., at noon).

2. Three hours later, take 4 more pills (e.g., at 3 PM).

3. After another three hours, take the final 4 pills (e.g., at 6 PM).

Again, in fewer than 1% of cases, aftercare may be needed. Oral use remains undetectable after absorption.

Misoprostol can be used for abortion throughout pregnancy. For official dosage guidelines, refer to the International Federation of Obstetrics and Gynecology (FIGO) guidelines:

• [FIGO Dosage Chart – English]

• [FIGO Dosage Chart – Spanish]

Pain Management

To manage pain, use Ibuprofen or Paracetamol as needed.

• After taking Mifepristone, vaginal bleeding will typically begin within 3-5 days.

• Bleeding may last between 2-6 weeks.

• An ultrasound is recommended 7-10 days after taking Misoprostol to confirm completion.

Possible Complications

1. Common Side Effects:

   • Dizziness, headache, nausea, vomiting, weakness, fever, diarrhea.

   • If vomiting occurs within one hour of taking Mifepristone or Misoprostol, repeat the same dose.

   • If experiencing early pregnancy nausea (toxicosis), an injection of Cerucal (2ml intramuscularly) can help. Eat 30 minutes later before taking the pill.

2. Severe Abdominal Pain:

   • If pain is severe, take a spasmolytic such as Nospa.

   • Do not take non-steroidal anti-inflammatory drugs (NSAIDs).

3. Heavy Bleeding:

   • Bleeding may be heavier than a normal period but typically does not require medical intervention.

4. Incomplete Abortion:

   • If Mifepristone and Misoprostol fail to terminate the pregnancy completely, vacuum aspiration may be needed to remove remaining tissue.

Contraindications

Misoprostol should not be used in individuals with:

• Chronic obstructive pulmonary disease (COPD)

• Asthma

• Chronic heart disease

• Kidney or liver failure

• Severe hypertension

• Blood clotting disorders

• Smoking women over 35 years old who smoke more than 10 cigarettes per day

Breastfeeding mothers:

• Stop breastfeeding for 7 days after taking Mifepristone.

Spontaneous miscarriage:

• The Mifepristone + Misoprostol combination can still be used to facilitate pregnancy tissue expulsion and reduce the risk of incomplete abortion.

Rehabilitation After Medical Abortion

To restore hormonal balance after a medical abortion, consider using monophasic oral contraceptives (e.g., Marvelon).

• • Begin taking contraceptives on the 5th day of bleeding following the medical abortion.

  • Continue for the next few menstrual cycles to regulate hormone levels.