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What Causes Severe Abdominal Cramps, Diarrhea And Chills After Taking Misoprostol?

Posted on Fri, 18 Mar 2016

Question: I took misoprostol for a 2nd trimester abortion. I took 400mcg at 5am and 400more at 8am. I am due to take another 400 in the next 15 minutes. I am experiencing severe cramps, diarrhea, and chills but no bleeding yet. Is this normal?

Answered by Dr. Manisha Jain (12 minutes later)

Brief Answer:
Common side effect

Detailed Answer:
Hello Mam, thanks for trusting Health Care Magic.

Yes all these are common side effects of misoprostol and occur in 80-90% of patients.

Nothing to worry about as these cramps will eventually culminate in abortion pains and bleeding.

You can take tablet paracetamol to get relieved of chills and fever in case feeling very uncomfortable.

Second trimester abortion can take s while so keep patience and keep drinking lots of water and if possible fresh juices to keep your energy and hydration replenished.

Take care
Regards
Dr Manisha

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Manisha Jain (2 hours later)

Ok thank you. Do I only take 400mcg every 3 hours 5 times? What if I have not started bleeding after the 5th dose? The side effects are very intense so I thought I would be bleeding and passing the pregnancy by now.

Answered by Dr. Manisha Jain (6 hours later)

Brief Answer:
Process will start soon

Detailed Answer:
No dear keep taking it as advised and it is quite unlikely to not to have bleeding even after 5th dose.
In case still there is no bleeding then we will wait for 48 hours after 5th dose and wait for bleeding otherwise same dose will be repeated.
But since you are having severe symptoms already the abortion process will start soon.
Take care

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Manisha Jain (17 minutes later)

Ok i took my 5th dose 2.5 hours ago. I will wait 48 hours and see what happens. Still having side effects but no bleeding

Answered by Dr. Manisha Jain (2 minutes later)

Brief Answer:
Unusual phenomenon

Detailed Answer:
It is an unusual phenomenon but still not really worrisome but I would like to know if you have had any ultrasound in this pregnancy?
If yes then kindly upload the report so that I can advise you better.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Manisha Jain (22 minutes later)

I do not have a copy of the ultrasound. I have had no pregnancy symtoms at all just irregular periods all of a sudden. Took a test and was told im 21 weeks

Answered by Dr. Manisha Jain (1 hour later)

Brief Answer:
Keep patience

Detailed Answer:
Alright then it's going to take a while so you will have to keep patience.
I hope you are doing this all under the supervision of a gynaecologist.
The uterus at this gestation takes time to react but once the process starts it is completed in few minutes.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Manisha Jain (11 hours later)

Ok thank you. It has now been 28 hours since i started my first dose of misoprostol and 13 since my 5th dose. I am still cramping though not as bad and have had a couple instances of spotting. Do I wait for 48 hours before starting another cycle of misoprostol?

Answered by Dr. Manisha Jain (22 minutes later)

Brief Answer:
Wait for 48 hours after last dose

Detailed Answer:
Yes dear wait for 48 hours after the last dose of misoprostol.
Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Jain (11 hours later)

Thank you. What is the chance that I will have no bleeding after the next process of misoprostol?

Answered by Dr. Manisha Jain (1 hour later)

Brief Answer:
high chances of need for second set of doses

Detailed Answer:
In your case since you haven't bled even once chances are high like to the tune of 70-80% that you're don't bleed only and might need another dose soon.
All the best.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Jain (5 hours later)

That was not my question. My question was what are the chances the 2nd dose won't cause bleeding either?

Answered by Dr. Manisha Jain (6 hours later)

Brief Answer:
Very less chances

Detailed Answer:
Very very less chances to the tune of less than 5% and also if it happens then surgical evacuation is the only option and a proper ultrasound evaluation is a must.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Jain (14 hours later)

Will the side effects be the same, worse, or less? How long should the process take this time since its the 2nd cyle?

Answered by Dr. Manisha Jain (54 minutes later)

Brief Answer:
Starts and culminates early

Detailed Answer:
Usually second cycles starts early because uterus has already been sensitised but still nothing conclusive can be said and it can take 24-36 hours also.
Time consumed is not the issue but the process should be complete.
Since you had full rest of 48 hours Therd are not much added risks of second cycle.
But in case it fails too then surgical evecuation is the only option left.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar