Misoprostol is a synthetic prostaglandin E1 analogue that helps to prevent stomach ulcers in patients who take medicines like ibuprofen and aspirin and who are at high risk of complications from ulcers. It is used off-label for a variety of indications in the practice of obstetrics and gynecology, including medication abortion, medical management of miscarriage, induction of labor, cervical ripening before surgical procedures, and the treatment of postpartum hemorrhage.
Due to its wide-ranging applications in reproductive health, misoprostol is on the World Health Organization Model List of Essential Medicines. This article briefly reviews the varied uses of misoprostol in obstetrics and gynecology.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
- Crohn’s disease
- heart disease
- kidney disease
- ulcerative colitis
- an unusual or allergic reaction to misoprostol, prostaglandins, other medicines, foods, dyes, or preservatives
- pregnant or trying to get pregnant
How should I use this medicine?
Take this medicine by mouth with a full glass of water. Follow the directions on the prescription label. Take this medicine with food. Take your medicine at regular intervals. Do not take your medicine more often than directed.
How do I take misprostol pills for abortion?
- You will take the misoprostol pills at home on Day 2 or 3 (24—48 hours after taking the mifepristone at the clinic).
- Take the anti-nausea pills, if your doctor gave them to you, and pain pills to prevent cramps. You can use ibuprofen (Motrin). Follow the directions on the bottle. Do not take aspirin, because it will make you bleed more.
- Wait 30 minutes.
- Take the 4 misoprostol pills. Put 2 pills on one side of your mouth, and the other 2 on the other side of your mouth. Wait 3 minutes for the pill to dissolve. After 30 minutes, swallow what is left of the pills.
Overdosage: If you think you have taken too much of this medicine, contact a poison control center or emergency room at once.
What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
What may interact with this medicine?
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What should I watch for while using this medicine?
Do not smoke cigarettes or drink alcohol. These increase irritation to your stomach and can make it more susceptible to damage from medicine like ibuprofen and aspirin.
If you are female, do not use this medicine if you are pregnant. Do not get pregnant while taking this medicine and for at least one month (one full menstrual cycle) after stopping this medicine. If you can become pregnant, use a reliable form of birth control while taking this medicine. Talk to your doctor about birth control options. If you do become pregnant, think you are pregnant, or want to become pregnant, immediately call your doctor for advice.
What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:
- allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
- chest pain
- fainting spells
- severe diarrhea
- sudden shortness of breath
- unusual vaginal bleeding, pelvic pain, or cramping
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
- menstrual irregularity, spotting, or cramps
- mild diarrhea
- stomach upset or cramps
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Where should I keep my medicine?
Keep out of the reach of children.
Store at room temperature below 25 degrees C (77 degrees F). Keep in a dry place. Protect from moisture. Throw away any unused medicine after the expiration date.
NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.