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Guidelines for non-doctors

These dosage guidelines are produced by FIGO and based on guidelines produced by WHO, FIGO and Bellagio group.

Indication      Dosage                       Notes

Induced abortion   

(0-12 weeks)

800mcg inserted into the vagina or placed under the tongue every 3 hours (use a maximum of 3 dosages within 12 hrs)a Effective in around 80% of cases. It is more effective if used 48h after mifepristone (but this is difficult to get hold of). Help is available for women who want to self-administer this drug from www.womenonwaves.org

Missed abortion  

(0-12 weeks)

(also known as a silent miscarriage)

800mcg inserted into the vagina every 3 hours

or

600mcg placed under the tongue every 3 hoursb


Give 2 doses and leave to work for 1-2 weeks (unless heavy bleeding or infection)
Incomplete abortion   
(0-12 weeks)
600mcg swallowed as a single dosea

or

400mcg taken under the tongue as a single dosea
Leave to work for 2 weeks (unless heavy bleeding or infection)
Induced abortion  
(13-22 weeks)
400mcg inserted into the vagina or taken under the tongue every 3 hours (maximum of 5 doses)a Use 200mcg only in women with caesarean scar. Ideally used 48h after mifepristone 200mg

References

a. WHO/RHR. Safe abortion: technical and policy guidance for health systems (2nd edition), 2012

b. Gemzell-Danielsson et al. IJGO, 2007


Warning!

Misoprostol is a very powerful stimulator of uterine contractions in late pregnancy and can cause fetal death and uterine rupture if used in high doses.  Follow the dosage regimes carefully and do not exceed those doses.

Misoprostol dosage graph