Misoprostol Oral: Uses, Dosing, and Precautions
Misoprostol guidance for incomplete abortion, termination of pregnancy, induction of labour, postpartum hemorrhage, and cervical dilation.
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Source reviewed
December 2024
Guide category
Oral drugs
Safety boundary
Prescription medicine information for clinician-guided use.
Kenza Health Hub presents this medicine page as structured health education. Check dose, route, interactions, pregnancy or breast-feeding considerations, and local protocol with a qualified clinician or pharmacist. Read our medical editorial policy.
Therapeutic action
Oxytocic drug, prostaglandin analogue.
Indications
- Incomplete abortion.
- Termination of intra-uterine pregnancy, preferably in combination with mifepristone.
- Induction of labour.
- Treatment of post-partum haemorrhage due to uterine atony when injectable oxytocics are not available or ineffective.
- Cervical dilation before aspiration or curettage.
Forms and strengths
- 25 micrograms and 200 micrograms tablets.
Dose and duration
Incomplete abortion
- Up to 13 weeks since the last menstrual period: 400 micrograms single dose sublingually or 600 micrograms single dose orally.
- From 13 to 22 weeks since the last menstrual period: 400 micrograms sublingually every 3 hours.
Termination of pregnancy
- Up to 13 weeks since the last menstrual period: 800 micrograms single dose sublingually or vaginally. If expulsion has not occurred within 24 hours administer a 2nd dose of 800 micrograms.
- From 13 to 22 weeks since the last menstrual period: 400 micrograms single dose sublingually or vaginally every 3 hours.
Induction of labour
- 25 micrograms orally every 2 hours, or if not possible vaginally every 6 hours, until labour starts, maximum 200 micrograms per 24 hours.
Treatment of post-partum haemorrhage
- 800 micrograms single dose sublingually.
Cervical dilation before aspiration or curettage
- 400 micrograms single dose sublingually 1 to 3 hours before the procedure or vaginally 3 hours before the procedure.
Contra-indications, adverse effects, precautions
- For induction of labour if the foetus is viable, do not administer in the event of previous caesarean section.
- Administer with caution in grand multiparity or overdistention of the uterus because of the risk of uterine rupture.
- Monitor contractions and foetal heart rate after administration.
- Do not administer simultaneously with oxytocin. At least 4 hours must have elapsed since the last administration of misoprostol before oxytocin can be given.
- For incomplete abortion or termination of pregnancy after 13 weeks, reduce the dose by half in the event of 2 or more previous caesarean sections.
- May cause dose-dependent diarrhoea, vomiting, uterine hypertony, headache, fever, chills, foetal heart rhythm disorders, and foetal distress.
- Breast-feeding: no contra-indication.
- Do not use misoprostol in ectopic or molar pregnancy.
Source
MSF Essential drugs practical guidelines (January 2026)
This page combines source-derived medicine reference sections with Kenza editorial context, while leaving out the Storage and Remarks sections from the source batch.
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