1 May 2026Oral drugsSource update: December 2024
Misoprostol oral
Misoprostol guidance for incomplete abortion, termination of pregnancy, induction of labour, postpartum hemorrhage, and cervical dilation.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
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 reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
Rate this guide
Be the first to rate this guide.