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Misoprostol and mifespritone

The timing when you administer your medication is important.

  • You will swallow the first medicine (mifepristone) with water at the clinic,
  • You will take the second medicine (misoprostol) 1 to 2 days later at home.
  • 3 to 4 hours after the first dose of misoprostol you will take another dose
  • You will pass the pregnancy at home.

Step 1 (at the clinic) Mifepristone

Swallow the mifepristone tablet with water.

You may have nausea or vomiting after swallowing the mifepristone. If you do vomit you should still use the misoprostol as outlined in step 2 below. contact us if you have any concerns.

Most women do not have bleeding or pain until they take the second medication (misoprostol). Bleeding can occur after taking mifepristone but it is usually light. If bleeding does happen you should still use the misoprostol (second medication). Contact us if you have any concerns.

Step 2 (at home) Misoprostol

Misoprostol tablets are placed in the vagina or between the cheek and gum – see below for more detail.

They cause strong, painful cramps and heavy bleeding.

Bleeding and cramping usually start 1 to 2 hours after using the tablets. Bleeding and pain are often greatest when the pregnancy is being expelled. Most women pass the pregnancy within 4 hours – timings vary, but it is OK if this happens sooner or later. Almost all women miscarry within a few days.

You may be given codeine to help you manage the pain, and can also use pain relief from supermarkets and pharmacies too. Please refer to the ‘Pain Control’ section on this page, for information about managing your pain.

Instructions for using misoprostol (second medication)

You will be given 6  tablets of misoprostol to take home

  1. Use 4 tablets by either placing them into your vagina or between your cheek and gum
  2. Then 3 to 4 hours later use the remaining 2 tablets

Into the vagina

Insert 4 tablets as high as possible in the vagina; the exact location is not important only that they do not fall out. You can do this while laying down, squatting, or standing with one leg up – whatever is most comfortable for you.  Insert the remaining 2 tablets 3 to 4 hours later.


Into the mouth between cheek and gum

Place 4 tablets into the mouth between the upper cheek and gum (2 on each side) and allow the tablets to dissolve for 30 minutes.  If the tablets have not completely dissolved within 30 minutes, you may swallow what is left with water.  Repeat with the remaining 2 tablets 3 to 4 hours later.

Some clients describe the taste of misoprostol as unpleasant and the texture chalky. Placing the tablets between the cheek and gum is associated with higher rates of nausea, vomiting, and diarrhea.


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