Typically, there will be no symptoms after taking the medication in the office. However, less than 1% of patients will cramp, bleed, or even pass the pregnancy after the first pill. It is important that the 4 tablets of misoprostol are taken in 24-48 hours after the first dose, even if there is bleeding prior to this scheduled dosing. The misoprostol taken at home can have side effects including nausea, vomiting, diarrhea, shaking chills and a fever. These symptoms only occur in 10% of patients and should not persist over 24 hours.

Rarely, patients will have cramping and bleeding after taking the Mifeprex, the medicine taken in the office. Typically, the bleeding will start 1-4 hours after taking the 4 misoprostol pills taken at home. The bleeding is commonly described as heavy, initially, by patients. This bleeding should not exceed 3 saturated pads an hour for over 3 hours. After 3 hours, the bleeding should become lighter. The irregular light bleeding may persist for 6 weeks. Frequently, a completely normal menstrual period takes 3 months. If you have received a prescription for oral contraceptives, it is recommended that you begin these in 2 weeks. This will assist in regulating your cycle as well as prevent pregnancy. If the bleeding exceeds 3 pads/hour for over 3 hours, contact the office immediately.

The cramping pain is like a menstrual period. This is your uterus contracting to expel the pregnancy tissue. It will be most intense when you are at home, approximately 1-4 hours after the 4 misoprostol tablets are taken at home. After the tissue has passed, the cramping should improve. Ibuprofen 800 mg every 8 hours is recommended. Over the counter Motrin/Ibuprofen comes in 200 mg tablets. You should take 4 (total 800 mg) every 8 hours beginning an hour prior to taking the medication at home. Take the first dose one-hour prior to taking the misoprostol..

Some patients suffer from severe nausea due to pregnancy and others may develop nausea from the 4 misoprostol tablets taken at home. A prescription for Zofran will be provided at your visit. It is recommended that one tablet be placed sublingual (under the tongue) to dissolve one hour prior to taking the medication at home and every 12 hours as needed following this dose. If the nausea is severe, the 4 misoprostol tablets can be placed vaginally. These should be placed after emptying the bladder and be placed as high in the vagina as possible. Also, you should lie down for about 30 minutes after this has been placed.

If you suffer from any of the symptoms relating to pregnancy (such as breast tenderness, nausea, heightened sense of smell etc.), it can take up to 2 weeks for these to resolve. After 2 weeks, if the pregnancy symptoms do not resolve or there is NO bleeding, please call and come into the office for an evaluation. It is always recommended that you bring a driver with you in the event a procedure (D and C) is recommended. This is not mandatory, but IV sedation will not be administered without a driver. The procedure is well tolerated using local anesthesia, which numbs the cervix (mouth to the uterus) as well as the lower 2/3 of the uterus.

It is imperative that a pregnancy test be performed on FIRST MORNING urine after 4 weeks. If this is positive, you will need to call the office to schedule an appointment for an evaluation. Again, it is recommended that you bring a driver in the event a procedure Is recommended. This is not mandatory.