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Mifepristone,misoprostol,contraceptive pill

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Internal Medicine Specialist
Practicing since : 1998
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I wish to know how is the mankind's unwanted kit? And whats the preferred procedure to consume it? As from the kit, I got to know that mifepristone should bt taken orally (through mouth, by water) and after 1-3 days 4 tablets of miseprostol are taken vaginally. So, can misoprostol be taken orally (dissolved under tongue)? Whats the efficiency in both the ways? I am 24 years, 53 kgs, 5.6'' height, and its 38th day of my pregnancy.
Posted Fri, 13 Apr 2012 in Abortion and Stillbirth
 
 
Answered by Dr. Jasvinder Singh 23 minutes later
Hello XXXXXXX

Thanks for posting your query.

Mankind's unwanted 72 is an emergency contraceptive pill containing Levonorgesterol, which has to be taken within 72 hrs of unprotected sexual intercourse and is 80% effective if taken within 6 hrs of unprotected sexual intercourse. As mentioned it is an emergency contraceptive and not to taken as regular contraceptive or for abortions.

Usually when doing a medical abortion, it is advisable to take mifepristone pill orally. Then 24 to 72 hours later, you take the second medication, misoprostol.

Misoprostol causes contractions resulting in a miscarriage. When used in combination, mifepristone and misoprostol are 95-97% effective and result in miscarriage.

You can take tablets of misoprostol by mouth, bucally between the gums and cheek, sublingually (under tongue) or insert them vaginally, usually within 48 hours of mifepristone. Misoprostol is slightly more effective when given vaginally than when taken by mouth.

However few doctors follow oral misoprostol because of reports of a rare, fatal infection that affected a few women after using vaginal misoprostol. But studies have shown that taking misoprostol buccally works as well as when it is given vaginally or orally. So you can take it orally or vaginally.

However it is always better to get a medical abortion done under a medical supervision as if there is any incomplete abortion then the retained products of conception can be removed by a gynecologist.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.
Above answer was peer-reviewed by
 
Follow-up: Mifepristone,misoprostol,contraceptive pill 17 minutes later
If a vaginal administration of misoprostol is done, and which somehow does not result in bleeding after like 3 hours, so what should be done? Should another same dosage be taken vaginally? or orally? I am more apprehensive about which route to take for misoprostol. Kindly clear this very point deeply. And what should be the time difference between the mifepristone and misoprostol?
Follow-up: Mifepristone,misoprostol,contraceptive pill 18 minutes later
Thanks for the clarification Dr. Jasvinder XXXXXXX So, from your answer i get that misoprostol is taken after 24-72 hours of mifepristone. And following are the ways to take it: (1) orally as mifepristone is taken; (2) bucally, as you said, between the gums and cheeks so that it gets dissolved; (3) sublingually and (4) vaginally. Am i right? I am writing this to confirm that i have got it correct what you have suggested. As mentioned, I am more confused about which route to take for misoprostol by myself. If vaginally or subligually, then for how long should i wait to know that abortion has happened, if in case the bleeding doesnt start? And what should be the next step?
 
 
Answered by Dr. Jasvinder Singh 34 minutes later
Hello XXXXXXX

Thanks for writing back. You have got it right.

You can take 4 tablets of misoprostol vaginally or bucally and if taken vaginally, it should be 6-72 hours after Mifepristone and if taken bucally, misoprostol should be taken 24-36 hours after mifepristone.

Mucosal misoprostol administration increases efficacy and minimizes gastrointestinal side effects, hence it is recommended that misoprostol be used vaginally.

If expulsion (i.e., cramping and bleeding) does not occur within 24 hours of the initial misoprostol dose, then you should consult your doctor. A second dose of misoprostol may be indicated. For this you have to consult your gynecologist.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.





Above answer was peer-reviewed by
 
Follow-up: Mifepristone,misoprostol,contraceptive pill 11 hours later
Thanks for the answer Dr. This helps. Well, I have taken mifepristone orally yesterday around 9pm. So, according to the time gap, I can take misoprostol VAGINALLY tomorrow after 9 pm and last by day after tomorrow before 9pm? So, its like 72 hours should be the maximum time gap, if taken vaginally? And 36 hours, if taken bucally? Thats my last query, and you can add on if you want to suggest anything.
Follow-up: Mifepristone,misoprostol,contraceptive pill 22 minutes later
So, the main thing is what is the maximum time gap between the 2 medicines? And, does mifepristone have side effects like nausea, tiredness? Is there any indication to know that mifepristone is working or has worked?

Thanks for your kind help and suggestions. Its really appreciating to receive your response such early and quick. I appreciate the way its all working for the patients.

Thanks.
 
 
Answered by Dr. Jasvinder Singh 12 hours later
Hello,

Thanks for writing again.

Yes, the usual time gap between mifiprestone and misoprostol if taken vaginally is 72 hours and 36 hours if taken bucally.

Mifiprestone may cause side effects like abdominal (menstrual-like) pain and/or cramping; anxiety; back pain; chills/shaking; diarrhea; dizziness; headache; indigestion; nausea; tiredness; vaginal bleeding or discharge and vomitings.

There is no symptom as such to indicate that mifiprestone is working other than minor abdominal cramps.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards.
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