The effects of mifepristone (Mifeprex)
are usually mild and do not last long. You may experience nausea or
mild cramping from the mifepristone (Mifeprex). You may already have
had some similar symptoms that are caused by pregnancy. Its also
common to have some bleeding or spotting, but it is rare for a woman to
abort after the mifepristone alone. If you do have the abortion with
the mifepristone alone you still MUST use the Misoprostol.
You will be given four misoprostol tablets
(800 mcg) to take home with you. You will take the misoprostol on day
2 or 3 (24-36 hours after the mifepristone). You will also be given
two prescriptions that you will take to a pharmacy to get filled; one is for
an anti-nausea medication, the other is a prescription pain medication.
These prescriptions generally are not expensive (usually around $10/each).
You can take these prescriptions to any pharmacy to be filled.
How to use the misoprostol:
lightly and drink plenty of water the day before you take the misoprostol
and also while the abortion is taking place.
Eating rich, fried, or spicy foods or not drinking enough water may make you
feel sick to your stomach.
ahead for this day so you are comfortable, have privacy and a support person
available. Make sure you have maxi pads, an over the counter pain
medication such as Ibuprofen or Aleve, a heating pad or hot water bottle and
a thermometer at home. Fill your prescriptions for the pain medication
and the anti-nausea medications before you use the misoprostol. You
might want to have your favorite juices or beverages, your favorite videos,
Choose a time to take
the misoprostol when you can rest for a while.
One hour before you
use the misoprostol have something to eat and take 1 Phenergan tablet
(prescription anti-nausea medication, may be dispensed by the pharmacy
One half hour before you use the
misoprostol take some pain medication; either 1-2 Tylenol or 1-2 Tylenol
with Codeine (prescription pain medication) if needed.
Have a drink of
water and place all four tablets (800 mcgs) of misoprostol between your
cheek and gum (buccally) 2 on each side of your mouth. After 30
minutes, swallow any remaining pill fragments. Swallow the pills
after 30 minutes whether or not the tablets have dissolved completely.
Taking the Misoprostol
In about one to four
hours, you will begin to get cramps that may be quite strong. When you
begin to experience cramps, take 600-800 mg of Ibuprofen. You may take
acetaminophen (Tylenol), or ibuprofen (Motrin) every four to six hours or
other medication for cramps given to you by the clinic. If you are
taking Hydrocodone (generic Vicodin) for pain, you should not drive or do other
things that require concentration. DO NOT take aspirin.
usually starts between 30 minutes and 10 hours after the cramps begin.
If you have bleeding heavier than a period, you may be having the abortion.
You should have some bleeding or spotting. Some women have heavy
bleeding for several hours that may soak through maxi pads.
have some nausea, vomiting, diarrhea, dizziness, or mild fever and chills
for a short period of time.
wait until you are in a lot of pain before taking the pain medication!
for cramps are:
200 mg (Advil, Motrin IB, other over-the-counter products) three tablets
(600 mg) every 6 hours or four tablets (800 mg) every 8 hours. Maximum
2400 mg (12 tablets) in 24 hours.
220mg (Aleve) one or two tablets every 8-12 hours. Maximum 1375mg in
24 hours. Take the maximum dose for only a short period of time (24-48
recommend you use either of these two medications as your main pain
pain medications you can take in addition to Ibuprofen or Naproxen if you
need better pain control are:
(Tylenol and other over-the-counter products) three 325 mg tablets or two
500 mg tablets every 4-6 hours (maximum 4000 mg in 24 hours)
Hydrocodone with Acetaminophen 5/325
one or two tablets every 4-6 hours (maximum 12 tablets in 24
hours). You will be given a prescription for this medication to fill at a
one tablet every 4 hours (maximum 6 tablets in 24 hours). Those who are
unable to take Tylenol #3 may be given a prescription for this medication to
fill at a pharmacy.
things besides medication can provide comfort:
putting a hot water
bottle or heating pad on the abdomen
standing in the
sitting on the
having your support
person rub your back
(massage the lowest part of your abdomen)
standing or walking
Some women experience mild fever (100.4°F)
and chills after taking misoprostol. Acetaminophen (Tylenol) or
ibuprofen (Motrin) should help
Some women experience nausea, vomiting, or diarrhea when they take
women who have had a medication abortion say that it is like having a
miscarriage. Dont be alarmed if the bleeding is quite heavy and you pass
large blood clots during the abortion. The cramps may also be really
strong although some women do report having little to no cramping during the
abortion. The bleeding and cramping can last for several hours.
Blood clots may be up to the size of a lemon. This is to be expected.
The pregnancy tissue itself is very small and may not be noticed with the
bleeding and clots. Occasionally, if the pregnancy has developed about
eight weeks, a recognizable embryo may be seen. Once the pregnancy
tissue has been discharged, the bleeding and cramping usually begin to ease.
After the Abortion
Bleeding after an abortion is perfectly normal. The amount of bleeding
you will have is difficult to predict since womens bodies all react
differently. Some women have little or no bleeding; some spot for a
few days or for several weeks; some bleed, then stop, then start again; some
have bleeding similar to a normal menstrual period for a week or two.
Some women pass clots. In general, your bleeding should get lighter
You should have a
normal menstrual period four to eight weeks after your abortion is complete.
Here is a handy guide
to bleeding - if you need to call us to talk about your bleeding we can know
you are accurately describing your bleeding
After the pregnancy tissue is discharged, there may be some mild cramping.
You may take acetaminophen (Tylenol) or ibuprofen (Motrin), if you need to.
You can alternate it with prescription medication you may have received.
You may use a heating pad or hot water bottle.
Although you can have a
fever on the day you use misoprostol, it is NOT normal to have a fever after
that day. If your temperature goes up, it could be a sign that an
infection is developing. Do not take your temperature right after
smoking, drinking, or eating.
Any pregnancy-related breast tenderness usually goes away
within a few days of discharging the pregnancy tissue but can take up to
several weeks to completely go away. It is possible, though not
likely, that your breasts may leak a milky discharge. If they do, wear
a snug-fitting bra; this should go away in a day or two.
Any pregnancy related nausea should go away within 2448 hours.
Because there is a sudden change in your hormones after the pregnancy tissue
is discharged, you may feel tired and/or a little depressed for a few days.
You may go back to your usual activities school, working, driving, as soon
as you feel up to it. Some women feel well enough to do so right after
the abortion, though most prefer to rest and relax until the next day.
You should not take part in strenuous activity, such as heavy exercise,
swimming, lifting, horseback riding, bicycling, jogging, etc., for several
days. You should not do strenuous activities if you are bleeding more
heavily than with a period.
Its best to wait until heavier bleeding has lightened up and
you have chosen a method of birth control. We recommend that you wait
to have sex for one week after medication abortion.
Your body will not be in its regular cycle at first. It will be
impossible to predict when you are at risk of getting pregnant. Assume
you can become pregnant ANY TIME after the abortion. Use a
birth control method EVERY TIME you have intercourse.
you were prescribed birth control, start it the day after you use the
Misoprostol or within 7 days. Do NOT wait for your first period.
Tampons or Pads? When
you use pads, it makes it easier to tell how much youre bleeding.
While you are having the abortion, you should use maxi pads. We
recommend you continue to use pads for one week after your abortion.
medication abortion patients are sent home with an antibiotic.
Azithromycin is the usual antibiotic you will receive. If you are
allergic to Azithromycin, please tell us now and we will find a
different antibiotic to give to you. Azithromycin is an antibiotic used
to prevent an infection. Please take the Azithromycin today with your
KEEP ALL MEDICATIONS
If you are
having a medical emergency or are worried about what you are experiencing OR
if you are experiencing any of the warning signs listed below, please call
us at our local number 701-298-9999 or toll-free 1-888-928-9009. After
normal business hours you will reach our answering service. We WILL
return your call, so be at a phone we can call you back at.
Do NOT wait
for your follow up appointment if you:
a fever of 100.4°F or higher that lasts for more than four hours
heavy vaginal bleeding and are soaking through two or more maxi pads an
hour, for two hours or more in a row
clots for two hours or more that are larger than a lemon
-Bleed heavily for more than 12 hours in a row
-Throw up for more than four to six hours and are not able to keep anything
severe abdominal pain or discomfort not helped by medication, rest, hot
water bottle, or heating pad
severe cramping 24 hours after the misoprostol
-Feel sick including weakness, nausea, abdominal pain or
discomfort, vomiting, or diarrhea more than 24 hours after taking