How to Take Your Medication: Step-by-Step Guide
Step 1: Swallow 1 Mifepristone pill with water
Swallow one mifepristone (200 mg) pill with water.
Most people feel fine after taking this pill. You can continue all of your regular activities. You may have some vaginal bleeding but may not — either is okay.
It’s unlikely, but if you throw up within the first 30 minutes after taking it, please contact your provider. If you throw up after 30 minutes, you don’t need to contact us because the medicine has been absorbed.
Note: If you’ve been feeling nauseous with the pregnancy, you can take one ondansetron (anti-nausea) pill under your tongue and let it dissolve before starting Step 1.
Step 2 prep: Decide how you want to take the misoprostol pills
You can take the second type of pill, misoprostol, several different ways: vaginally, buccally (between your cheeks and gums), and sublingually (under your tongue). All methods of taking misoprostol are equally effective, but can cause more nausea when taken sublingually (under the tongue) and the least nausea when taken vaginally.
How to take misoprostol vaginally
This method causes the least nausea because while pretty flavorless, the pills are very chalky and can be difficult to keep in your mouth for 20+ minutes if they are already feeling queasy during the pregnancy. However, this route might not be the best option if you have started bleeding as the vagina does not absorb it as well in the presence of blood. If taking misoprostol vaginally, you can start Step 2 anywhere from 6 to 48 hours after Step 1.
How to take misoprostol buccally (between your cheeks and gums)
This method causes more nausea than the vaginal method, but less than the sublingual method. If taking misoprostol buccally, you can start Step 2 anywhere from 24 to 48 hours after Step 1.
How to take misoprostol sublingually (under the tongue)
This method can cause more intense side effects because the medication is absorbed very quickly. If taking misoprostol sublingually, you can start Step 2 anywhere from 24 to 48 hours after Step 1.
Choose a time to start Step 2 when you’ve had a good meal and plenty of rest, as bleeding and cramping usually start a few hours after Step 2. 30 minutes before taking your misoprostol pills, take 800 mg of ibuprofen (pain medicine) by swallowing with water and one ondansetron pill (anti-nausea medicine) under your tongue. The ondansetron dissolves in your mouth and does not need to be swallowed. These medicines will help decrease some of the GI side effects, like nausea, that are common with misoprostol, as well as help decrease cramping.
You must complete Step 2 even if you have started bleeding.