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There are increased side effects with sublingual or oral misoprostol, compared to a low dose (400 μg) vaginal misoprostol. However, low dose vaginal misoprostol was linked with low complete abortion rate. [42] The study concluded that sublingually administered misoprostol dosed at 600 μg or 400 μg had greater instances of fever and diarrhea ...
Most women will have cramping and bleeding heavier than a menstrual period. [45] Other adverse effects may include nausea, vomiting, fever, chills, diarrhea, headache, dizziness, warmth or hot flashes. [50] [43] [20] When used inside the vagina, misoprostol tends to have fewer gastrointestinal side effects. [6]
Vaginally administered misoprostol had improved outcomes of inducing labor within twenty four hours compared to oxytocin, but was associated with uterine hyperstimulation. [15] Misoprostol is an agonist of EP1 and EP3 receptors, and can cause a greater stimulation at lower concentrations.
Aid Access is a nonprofit organization that provides access to medication abortion by mail to the United States and worldwide. It describes its work as a harm reduction strategy designed to provide safe access to mifepristone and misoprostol for those able to become pregnant in the United States who may not otherwise have access to abortion or miscarriage management services. [2]
Early medical abortion regimens using mifepristone, followed 24–48 hours later by buccal or vaginal misoprostol are 98% effective up to 9 weeks gestational age; from 9 to 10 weeks efficacy decreases modestly to 94%. [64] [68] If medical abortion fails, surgical abortion must be used to complete the procedure. [69]
Misoprostol can cause unpleasant side effects such as very high body temperatures and shivering. [27] Lower doses of misoprostol appear to be safer and cause less side effects. [27] Giving oxytocin in a solution of saline into the umbilical vein is a method of administering the drug directly to the placental bed and uterus. [28]
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For first-trimester abortion, it is dissolved in the cheek or under the tongue; for later abortions, it can also be given as a vaginal suppository. Misoprostol may also be used to ripen the cervix in preparation for surgical abortion. [20] Misoprostol is given orally for the treatment of ulcers.