508 mifepristone, misoprostol
mifepristone (Mifegyne, Mifeprex) and misoprostol (Cytotec)
Mifepristone is used for medical abortion. It blocks the effects of the hormone that maintains
pregnancy. Taken together with misoprostol before 9 weeks of pregnancy, mifepristone is very effective
in causing a complete abor tion. Misoprostol makes the womb contract and expel the pregnancy.
Taking misoprostol by itself is still very effective but it is more effective when both medicines are used
together. Misoprostol can also be used to stop bleeding after childbir th and incomplete abor tion, or if
the placenta takes more than 1 hour to come out. It is also used for stomach ulcers.
Before taking these medicines, read the chapter “Abor tion and Complications from Abor tion,”
especially page 251.
In what forms do
mifepristone: Tablets, 200 mg
misoprostol: Tablets, 100 or
How to take
For medical abortion until 9 weeks
(63 days) of pregnancy: Swallow
1 tablet (200 mg) of mifepristone.
After 1 to 2 days (24 to
48 hours), dissolve 4 tablets
of 200 mcg (800 mcg total) of
misoprostol inside the mouth,
either against the cheek, or under
the tongue. Let them dissolve for
20 to 30 minutes, and swallow
any remaining parts of the tablets.
How to take
For medical abortion: Dissolve
4 tablets (800 mcg) in the mouth
against the cheek, or under the
tongue for 20 to 30 minutes, and
then swallow any remaining parts
of the tablets.
3 hours later take another
4 tablets of misoprostol (800
mcg) in the same way. If bleeding
does not start after 3 hours, take
4 more tablets (800 mcg) for a
total of 12 tablets (2400 mcg).
For heavy bleeding after birth of
a baby, for incomplete abortion,
or if the placenta takes more
than 1 hour to come out: Take
600 mcg by mouth (dissolve
tablets against your cheek or
under your tongue, then swallow
any remaining parts). 600 mcg of
misoprostol can also be inserted
into the rectum to stop heavy
bleeding; wear gloves.
It is normal to have painful
cramping and heavy bleeding
with clots for 3 to 6 hours after
taking misoprostol. You may also
have nausea, vomiting, diarrhea,
headache, and slight fever in the
first few hours. These signs will
go away on their own. Bleeding
lasts 2 to 4 weeks but gets
lighter after 1 to 2 weeks.
Do not take these medicines
if you cannot get to a clinic or
hospital within one hour, especially
if more than 9 weeks pregnant, of
if you think you have a pregancy in
the tube (see page 73).
If you have continued heavy
bleeding (soaking more than
2 cloths or large pads in 1 hour for
2 hours in a row) especially with
dizziness or lightheadedness, get
medical care immediately. You may
have an incomplete abortion (see
page 251) and need an MVA or
D and C (see page 244).
Taking misoprostol with or
without mifepristone is more
effective the earlier it is taken
in pregnancy. After 9 weeks it
becomes less effective and there
are more side effects, especially
heavy vaginal bleeding.
Where Women Have No Doctor 2012