How long does misoprostol take to work

Want to leave feedback for improvement? Take our short Patient Satisfaction Snapshot survey to tell us how we did. Take the survey. Aftercare Instructions: Medication Abortion This information is a summary of the instructions you will be provided following a medication abortion. When to go to the emergency room If you are having a life-threatening emergency, call immediately.

Day One: The Day of Your Appointment at the Clinic What you should have when you leave the clinic 4 misoprostol tablets Possible prescription for pain medication These instructions and a summary of your procedure including medications and blood type Information on birth control methods that you are considering Antibiotics What to expect after you go home After taking Mifeprex mifepristone : Most women do not have side effects from mifepristone, although some women feel nauseated or have vaginal spotting or bleeding.

When to call the clinic If you vomited shortly after you took the Mifeprex pill, call the clinic and talk to one of the doctors. If you start to bleed heavily and you soak more than two maxi-pads in an hour for two hours in a row, please call the clinic or the doctor at any hour of the day or night.

This does not mean you will definitely have to come to the hospital. If you have strong cramps and heavy bleeding and think you might have passed the pregnancy, you may call the clinic the next clinic day to discuss with a doctor if you should use the misoprostol pills or come in for a check. If you are concerned about the amount of bleeding, call at any time. Preparing for your misoprostol insertion Pick a place to insert the pills that is comfortable and private.

You should have a phone, a bathroom, and your support person with you for the day. If you are hungry, eat a light meal before you start and drink plenty of water during the day.

Since the process may take five to seven hours or more , many women prefer placing the tablets in the morning or early afternoon. Make sure you have: Your misoprostol tablets Your pain medication Vicodin and ibuprofen handy A box of maxi-pads How to place the misoprostol in your vagina Wash your hands well with soap and water. Lie down on your back and bend your knees. Hold one pill between your first and second fingers your pointer and your middle fingers and push the pill as high up into your vagina as you can reach with one of the fingers.

Repeat this procedure with all four pills. If one of the pills comes out in your hand, push it back up. If any of the pills fall out within 30 minutes, replace it into your vagina. If a pill falls out more than 30 minutes after you insert them, you do not need to replace it. Wash your hands when you are done and rest for 30 minutes. You may do regular activities around the house after placing the misoprostol. This means no sex and no tampons. The results of the acceptability questionnaire are shown in Table 6.

Approximately three quarters found the associated pain acceptable. The only major difference between groups was in the percentage who found the waiting time to complete abortion acceptable. Patients clearly preferred the shortest waiting time possible. The results of the 2 logistic regression analyses are shown in Table 7. Women who had experienced 1 or more prior live births were more likely to find pain acceptable odds ratio [OR], 2.

Variables found to influence overall acceptability were acceptability of waiting OR, 4. Younger women found the procedure somewhat more acceptable OR, 0. A regimen that requires misoprostol to be given in an office setting 2 days after mifepristone, followed by 4 hours of observation, as currently occurs in France and as occurred in the Population Council's multicenter trial in the United States, 3 is unnecessarily restrictive and creates scheduling and additional cost barriers to women.

These findings mean that clinics that offer mifepristone administration only on Monday through Wednesday can now offer it Monday through Friday, even if they wish to observe patients taking both drugs and remain closed on weekends.

The logistic regression analyses have the advantage over bivariate analyses of simultaneously controlling for the effects of several variables on pain and overall acceptability. Patients who had had a prior live birth found the pain associated with the procedure more acceptable, which is likely related to prior dilatation of the cervix due to childbirth. While the day of misoprostol administration did not affect the overall acceptability of the procedure, patients assigned to take misoprostol 3 days after mifepristone were more likely to take the misoprostol earlier than assigned.

They were also significantly less likely to characterize the waiting interval to complete abortion as acceptable. This study also provides additional information about the safety and acceptability of home administration of misoprostol. No interventions were required within 4 hours or during the time that the standard protocol requires patients to be observed.

These results are consistent with the safety noted with home administration of misoprostol in our other published trials involving patients 4 , 8 , 10 and the US experience with methotrexate for abortion. Although 40 patients 1. The standard reasons to monitor patients in the office after misoprostol have been to identify any medical complications and to provide emotional support to the patient throughout the process. Complications are rare during these initial 4 hours and do not appear to warrant requiring women to spend time under medical supervision.

Most patients prefer the privacy of their homes. Home use of misoprostol also has the advantage of reducing the costs of treatment by decreasing the number of office visits and eliminating the most lengthy visit. The safety of medical abortion with mifepristone has been consistent in studies worldwide. This trial used geographically diverse clinical sites in the United States and found no differences in safety. Patients who want or need additional medical supervision should have the option of using misoprostol in the clinical setting.

Patients will need advice about and access to pain medications. Clinicians should expect telephone calls from women using misoprostol at home. That adverse effects were common yet acceptable to our patients likely reflects the success of detailed counseling and provision of information. In our study, patients preferred the shortest regimen.

On September 28, , the US Food and Drug Administration approved mifepristone trade name, Mifeprex for the termination of intrauterine pregnancy at 49 days' gestation or less from the beginning of the last menstrual period. Labeling does not include clinical monitoring after taking misoprostol, but does include ensurance of access to medical facilities should adverse reactions occur.

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. Table 1. Table 2. Table 3. Table 4. Table 5. Table 6. Table 7. Early termination of pregnancy with mifepristone RU and orally active prostaglandin misoprostol. N Engl J Med. Google Scholar. Voluntary interruption of pregnancy with mifepristone RU and a prostaglandin analog: a large-scale French experience.

Early pregnancy termination with mifepristone and misoprostol in the United States. Low-dose mifepristone, mg, and vaginal misoprostol for induced abortion. Induction of abortion with mifepristone RU and oral or vaginal misoprostol. Absorption kinetics of misoprostol with oral or vaginal administration. Obstet Gynecol. Combined methotrexate and misoprostol for early induced abortion. Bleeding is often the first sign that the abortion has begun.

If the abortion continues, bleeding and cramps become more severe. Bleeding is often heavier than a normal menstruation, and it is normal to have clots. The longer the pregnancy has developed, the heavier the cramps and the bleeding will be.

If the abortion is complete, the bleeding and the cramps diminish. The moment of abortion can be noticed with a peak of heavier blood loss and more pain and cramps.