These dosage guidelines are produced by FIGO and based on guidelines produced by WHO, FIGO and Bellagio group.
NOTE: Tablet numbers are based on 200mcg tablets. Double the number of tablets if you are using 100mcg tablets.
| Indication | Dosage | Notes |
|---|---|---|
| Induced abortion (0-12 weeks) | 800mcg (4 tabs) placed under the tongue every 3 hours (use 2-3 doses) | 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 (4 tabs) inserted into the vagina every 3 hours or 600mcg (3 tabs) placed under the tongue every 3 hours | Give 2 doses and leave to work for 1-2 weeks (unless heavy bleeding or infection) |
| Incomplete abortion (0-12 weeks) | 600mcg (3 tabs) swallowed as a single dose or 400mcg (2 tabs) taken under the tongue as a single dosea | Leave to work for 2 weeks (unless heavy bleeding or infection) |
| Induced abortion (13-24 weeks and 25-26 weeks) | 13-24 weeks: 400mcg (2 tabs) inserted into the vagina or taken under the tongue every 3 hours 25-26 weeks: 200mcg (1 tablet) inserted into the vagina or taken under the tongue every 4 hours | Use 200mcg only in women with caesarean scar. Ideally used 48h after mifepristone 200mg |
References
- WHO/RHR. Safe abortion: technical and policy guidance for health systems (2nd edition), 2012
- 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.