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The mifepristone-misoprostol combination is, by far, the most recommended drug regimen for medical abortions, but other drug combinations are available. Misoprostol alone, without mifepristone, may be used in some circumstances for medical abortion, and has even been demonstrated to be successful in the second trimester. [37]
Misoprostol by mouth is the least effective treatment for producing complete abortion in a period of 24 hours due to the liver's first-pass effect which reduces the bioavailability of the misoprostol. Vaginal and sublingual routes result in greater efficacy and extended duration of action because these routes of administration allow the drug to ...
[62] [66] Medical abortion regimens involving mifepristone followed by misoprostol in the cheek between 24 and 48 hours later are effective when performed before 70 days' gestation. [65] [64] Shown here is the typical regimen for early medical abortions (200 mg mifepristone and 800 μg misoprostol).
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The medication can also protect against stomach ulcers in people who take NSAIDs such as ibuprofen on a daily basis. [21] Misoprostol can cause nausea, nausea, stomach pain, and stomach cramps. [22] In rare cases, it may lead to uterine rupture, which requires immediate emergency surgery. [17]
Gov. Gavin Newsom announced a stockpile of 2 million abortion pills known as misoprostol after a Texas judge ruled against using a mifepristone, another medication to terminate pregnancies.
Mifepristone combined with misoprostol is the preferred medication regimen for management of early pregnancy loss. While misoprostol alone can be used, the addition of a dose of mifepristone twenty-four hours before misoprostol administration improves treatment efficacy. [30]
The American College of Rheumatology and a Canadian consensus report both recommend GI-protective agents such as misoprostol be combined with long term NSAID therapy and a review concluded that diclofenac/misoprostol is a cost effective treatment in patients requiring long term NSAID therapy who are at increased risk of developing gastropathy. [4]