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Aims: To investigate misoprostol use as a self-administered medical abortifacient and to explore the knowledge and availability of misoprostol and attitudes towards it among Saudi women.

Methods: A questionnaire-based cross-sectional study was conducted in obstetric and gynecological outpatient clinics at private and teaching institutions between January 1 and June 29, 2012.

Results: Of the 678 respondents, 40% (271/678) were aware of misoprostol use as an abortifacient and 7.4% (50/678) reported personal use of it as an abortifacient. Misoprostol users were more likely to have had previous abortions (96%, 48/50; p < 0.01), had a relative/friend working in the medical field (70%, 35/50; p < 0.01) and known someone else who had used the drug (82%, 41/50; p < 0.01). The majority responded incorrectly that higher misoprostol doses are required with more advanced gestational age (96%, 48/50) and that misoprostol use confers no fetal risks (100%, 50/50).

Conclusion: The proportion that reported personal use of misoprostol in the current study (7.4%) exceeded that in similar samples in Brazil (2.2%) and the USA (5%). One concerning finding was the users' poor knowledge about misoprostol. Increased awareness about the inherent risks associated with unsupervised misoprostol use as an abortifacient is needed.

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MeSH terms

Abortifacient Agents, Nonsteroidal*

Abortion, Induced / methods*

Adolescent

Adult

Cross-Sectional Studies

Female

Gestational Age

Health Education

Health Knowledge, Attitudes, Practice

Humans

Middle Aged

Misoprostol / administration & dosage*

Pregnancy

Saudi Arabia

Self Medication* / adverse effects

Surveys and Questionnaires

Young Adult

Substances

Abortifacient Agents, Nonsteroidal

Misoprostol

Related information

PubChem Compound (MeSH Keyword)

LinkOut - more resources

Full Text Sources

S. Karger AG, Basel, Switzerland

Other Literature Sources

scite Smart Citations

Miscellaneous

NCI CPTAC Assay Portal

Uses

This medication is used to prevent stomach ulcers while you take NSAIDs (e.g., aspirin, ibuprofen, naproxen), especially if you are at risk for developing ulcers or have a history of ulcers. Misoprostol helps to decrease your risk of serious ulcer complications such as bleeding. This medication protects your stomach lining by lowering the amount of acid that comes in contact with it.This medication is also used in combination with another drug (mifepristone) to end a pregnancy (abortion).

How to use Misoprostol

This medicine comes with a patient information leaflet. Read it carefully. If you have any questions about this drug, ask your doctor, nurse, or pharmacist.

Dosage is based on your medical condition and response to therapy.

If you are taking this drug to prevent stomach ulcers, take it by mouth usually four times a day, after meals and at bedtime to minimize diarrhea, or as directed by your doctor.

If you are taking this medication for abortion, take it by mouth exactly as directed by your doctor.

If you are using this medication to start labor, your healthcare professional will insert it into your vagina.

Avoid taking antacids that contain magnesium while using misoprostol because they may make the diarrhea it causes worse. If you need an antacid, consult your doctor or pharmacist to help you choose a product.

For ulcer prevention, continue to take this drug for as long as you take NSAIDs. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same times each day.

Inform your doctor if your condition persists or worsens.

How does the abortion pill work?

In This Section

The Abortion Pill

How does the abortion pill work?

What can I expect after I take the abortion pill?

How safe is the abortion pill?

How do I get the abortion pill?

The abortion pill causes cramping and bleeding that can last several hours or more. You can be at home, or wherever is comfortable for you. Plan on taking it easy for the day.

Thinking about getting the abortion pill?

FIND A HEALTH CENTER

What do I need to do before I take the abortion pill?

Before you take the abortion pill, you’ll meet with your nurse, doctor, or health center staff to talk about whether abortion is the right decision for you, and what your abortion options are. You’ll get an exam and lab tests, and you may get an ultrasound to figure out how far into your pregnancy you are.

Your nurse or doctor will let you know if there’s anything else you need to do to prepare for your abortion. They’ll give you written instructions on how to take your pills. You will have access to a caring professional through the process — you’ll get a number you can call 24/7 if you have any questions or concerns.

You’ll have a lot of bleeding and cramping after you take the second medicine, so plan ahead to make the process more comfortable. You can be at home, or wherever is comfortable for you to rest. You may also want to have someone you trust with you (or nearby) that you can call for support if you need anything.

Stock up on maxi pads, food, books, movies, or whatever you like to help pass the time, and a heating pad for cramps. Make sure you have some pain medicine — but don’t take aspirin because it can make you bleed more.

What happens during a medication abortion?

The abortion pill process has several steps and includes two different medicines.

First, you take a pill called mifepristone. This medicine stops the pregnancy from growing. Some people feel nauseous or start bleeding after taking mifepristone, but it’s not common. Your doctor or nurse may also give you antibiotics to take to prevent infection.

The second medicine is called misoprostol. You’ll either take the misoprostol right away, or up to 48 hours after you take the first pill — your doctor or nurse will let you know how and when to take it. This medicine causes cramping and bleeding to empty your uterus.

For most people, the cramping and bleeding usually starts 1-4 hours after taking the misoprostol. It’s normal to see large blood clots (up to the size of a lemon) or clumps of tissue when this is happening. It’s kind of like having a really heavy, crampy period, and the process is very similar to an early miscarriage. (If you don’t have any bleeding within 24 hours after taking the second medicine, misoprostol, call your nurse or doctor.)

The cramping and bleeding can last for several hours. Most people finish passing the pregnancy tissue in 4-5 hours, but it may take longer. The cramping and bleeding slows down after the pregnancy tissue comes out. You may have cramping on and off for 1 or 2 more days.

You can take pain medicine like ibuprofen about 30 minutes before you take the second medicine, misoprostol, to help with cramps. You can also take anti-nausea medicine if your doctor or nurse gives it to you. Don’t take aspirin, because it can make you bleed more.

It’s normal to have some bleeding and spotting for several weeks after your abortion. You can use pads, tampons, or a menstrual cup — whatever's the most comfortable for you. But your nurse or doctor may recommend you use pads for the first few days after the abortion so you can track how much you're bleeding.

The last step is a follow up with your nurse or doctor. You may go back into the health center for an ultrasound or blood test. Or you’ll get a pregnancy test to take at home, followed by a phone call with your nurse or doctor. These tests will make sure the abortion worked and that you’re healthy.

In the unlikely case that the abortion doesn't work and you're still pregnant, your doctor or nurse will discuss your options with you. You may need another dose of medication or to have an in-clinic procedure to complete the abortion.

How does a medication abortion feel?

For most people, medication abortion feels like having an early miscarriage. You might have:

lots of cramping and aches in your belly

very heavy bleeding with large clots (If you don’t have any bleeding within 24 hours after taking the second medicine, misoprostol, call your nurse or doctor.)

an upset stomach and vomiting (Your doctor or nurse may give you medicine to help with nausea.)

diarrhea

dizziness

tiredness

mild fever (99-100° F) or chills on the day you take the misoprostol (If you have a fever after the day you take the misoprostol pills, call your doctor or health center right away.)

To help ease pain and make you more comfortable, you can:

Take pain medication like ibuprofen (Advil or Motrin). Don’t take aspirin because it can make your bleeding worse.

Put a heating pad or hot water bottle on your belly.

Take a shower.

Sit on the toilet.

Have someone rub your back.

Misoprostol

Generic name: misoprostol (mye so PRAH stole)

Brand name: Cytotec

Dosage forms: oral tablet (100 mcg; 200 mcg)

Drug class: Miscellaneous GI agents

Medically reviewed by Drugs.com on Jun 30, 2021. Written by Cerner Multum.

Uses

Warnings

Dosage

What to avoid

Side effects

Interactions

What is misoprostol?

Misoprostol reduces stomach acid and helps protect the stomach from damage that can be caused by taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

Misoprostol is used to prevent stomach ulcers during treatment with aspirin or an NSAID.

Misoprostol may also be used for purposes not listed in this medication guide.

Warnings

Misoprostol can cause birth defects, premature birth, uterine rupture, miscarriage, or incomplete miscarriage and dangerous uterine bleeding. Do not use misoprostol if you are pregnant.

If you are able to become pregnant, you will need to have a negative pregnancy test before starting this treatment. You will also need to use effective birth control to prevent pregnancy during treatment.

Before taking this medicine

You should not use misoprostol if you are allergic to misoprostol or other prostaglandins, or if you are pregnant.

To make sure misoprostol is safe for you, tell your doctor if you have:

inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), or other intestinal problems;

heart disease; or

if you are dehydrated.

FDA pregnancy category X. Misoprostol can cause birth defects, premature birth, uterine rupture, miscarriage, or incomplete miscarriage and dangerous uterine bleeding. Do not use misoprostol if you are pregnant. Use effective birth control to prevent pregnancy while you are using this medicine, and for at least 1 month after your treatment ends.

If you are able to become pregnant, you will need to have a negative pregnancy test before you start taking misoprostol. Treatment with this medicine should begin on the second or third day of your menstrual period.

Stop taking this medicine and tell your doctor right away if you become pregnant during treatment.

It is not known whether misoprostol passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take misoprostol?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Do not share this medicine with another person.

Misoprostol is usually taken with meals and at bedtime. Follow your doctor's instructions.

You may have nausea, stomach cramps, or diarrhea while taking this medicine, especially during the first few weeks after you start taking misoprostol. These symptoms usually last for about a week.

Call your doctor if you have severe nausea, stomach pain, or diarrhea lasting longer than 8 days.

Read all medication guides or patient instructions provided with this medicine each time your receive a new supply.

Store at room temperature away from moisture and heat.

Detailed Misoprostol dosage information

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking misoprostol?

Ask your doctor before using an antacid, and use only the type your doctor recommends. Some antacids can increase your risk of diarrhea while you are taking misoprostol.

Misoprostol side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

severe ongoing stomach discomfort or diarrhea; or

dehydration symptoms--feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin.

Common side effects may include:

diarrhea;

stomach pain, nausea, upset stomach, gas;

vaginal bleeding or spotting, heavy menstrual flow; or

menstrual cramps.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Misoprostol side effects (more detail)

What other drugs will affect misoprostol?

Other drugs may interact with misoprostol, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Misoprostol drug interactions (more detail)

Does Misoprostol interact with my other drugs?

Enter other medications to view a detailed report.

Drug name

Misoprostol

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En Español

552 Reviews

Drug class: miscellaneous GI agents

Patient resources

Advanced Reading

Other brands

Cytotec

Professional resources

Prescribing Information

Related treatment guides

Abortion

Cervical Ripening

Duodenal Ulcer

Gynecological Conditions

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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DRUG STATUS

Availability

Prescription only

Pregnancy & Lactation

Risk data available

CSA Schedule*

Not a controlled drug

N/A

Approval History

Drug history at FDA

User Reviews & Ratings

7.8 / 10

552 Reviews

Related Drugs

omeprazole, famotidine, pantoprazole, Protonix, Pepcid, ranitidine, lansoprazole, Prevacid, oxytocin, Cytotec

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Misoprostol systemic 100 mcg (Logo 100 4430)

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