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Misoprostol Dosages For Reproductive Health

This document outlines recommended dosages of misoprostol for various reproductive health indications. It provides dosages for induced abortion in the first trimester using misoprostol alone or with mifepristone, as well as for missed or incomplete abortion. It also lists dosages for cervical ripening, induced abortion in the second trimester, intrauterine fetal death in the second trimester, induction of labor in the third trimester, prevention of postpartum hemorrhage, and treatment of postpartum hemorrhage. Notes provide context on when dosages are most effective and safety considerations around previous c-sections and overdose.

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226 views1 page

Misoprostol Dosages For Reproductive Health

This document outlines recommended dosages of misoprostol for various reproductive health indications. It provides dosages for induced abortion in the first trimester using misoprostol alone or with mifepristone, as well as for missed or incomplete abortion. It also lists dosages for cervical ripening, induced abortion in the second trimester, intrauterine fetal death in the second trimester, induction of labor in the third trimester, prevention of postpartum hemorrhage, and treatment of postpartum hemorrhage. Notes provide context on when dosages are most effective and safety considerations around previous c-sections and overdose.

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Anonymous b6xAEr
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Misoprostol Dosages for Reproductive Health

INDICATION DOSAGE NOTES


Induced abortion 1 800mcg vaginally or sublingually 3-hrly Ideally used 48h after mifepristone 200mg
(1st Trimester) (max x3 within 12 hrs)a

Missed abortion 800mcg vaginally 3-hrly (max x2) or Give 2 doses and leave to work for
(1st Trimester) 600mcg sublingually 3-hourly (max x2)b 1-2 weeks (unless heavy bleeding or
infection)

Incomplete abortion 600mcg orally single dosea or 400mcg Leave to work for 2 weeks (unless heavy
2,3
(1st Trimester) sublingually single dosea bleeding or infection)

Cervical ripening 400mcg vaginally 3-hrs or sublingually 2-3 Use for insertion of intrauterine device,
pre-instrumentation hrs before procedurea surgical termination of pregnancy,
(1st Trimester) dilatation and curettage, hysteroscopy

Induced abortion 400mcg vaginally or sublingually 3-hrly Most effective when used 48h after
1,4
/Interruption of (max x5)a mifepristone 200mg.
pregnancy
(2nd Trimester)

Intrauterine foetal 13-17 wks: 200mcg vaginally Reduce doses in women with previous
death 4 6-hrly (max x4)c caesarean section.
(2nd Trimester) 18-26 wks: 100mcg vaginally
6-hrly (max x4)c

Induction of labour 25mcg vaginally 6-hrly or 25 mcg orally Do not use if previous caesarean section.
2,5 2-hrlyd
(3rd Trimester)

PPH prophylaxis 2 600mcg orally single dosee Not as effective as oxytocin.


(Post-Partum) Exclude second twin before
administration.

PPH treatment 800mcg sublingually single dosef

PPH = postpartum haemorrhage

Notes References
1 Only use where legal and with mifepristone, where available a) WHO/RHR. Safe abortion: technical and policy guidance for health
2 Included in the WHO Model List of Essential Medicines systems (2nd edition), 2012
3 Leave to work for 1-2 weeks unless excessive bleeding or infection b) Gemzell-Danielsson et al. IJGO, 2007
4 Halve dose if previous caesarean section or uterine scar c) Gmez Ponce de Len et al. IJGO, 2007
5 Make sure you use the correct dosage - overdose can lead to d) WHO recommendations for induction of labour, 2011
complications. Do not use if previous caesarean section e) FIGO Guidelines: Prevention of PPH with misoprostol, 2012
f) FIGO Guidelines: Treatment of PPH with misoprostol, 2012

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