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Millions of women worldwide have safely terminated their pregnancies with medication since mifepristone—or RU 486—was first introduced in the late 1980s. Research in the past two decades has identified several highly effective regimens for early medical abortion with a success rate of 95 to 98 percent, consisting of 200 mg of mifepristone followed by 400 or 800 mcg of misoprostol.1 Whether taken in a health center or at home by women themselves, the regimen using pills offers an option that many women prefer to surgical procedures such as manual vacuum aspiration or dilation and curettage (D&C).

Because mifepristone is a registered abortion drug, its sale and use are not permitted in most countries with restrictive abortion laws. In contrast, misoprostol is an anti-ulcer medication that is registered under various trade names in more than 85 countries.2, 3 Research has found that misoprostol used alone is about 85 percent successful in inducing abortion when used as recommended. Although less effective alone than when combined with mifepristone, misoprostol offers a safe and accessible alternative for women who have no other option.

UIDELINES FOR USING MISOPROSTOL TO INDUCE ABORTION

Misoprostol is typically sold in pharmacies in tablets of 200 mcg. Four tablets are recommended to initiate an early abortion, and four (or, rarely, eight) more may be required for its completion. It is best to use misoprostol within nine weeks since the last menstruation; that is, fewer than 63 days counting from the first day of the last regular period. The earlier in the pregnancy it is administered the better, because it is safer,more effective and less painful. Misoprostol can be used later in pregnancy but the risks of complications are higher (see below). Women with an intrauterine contraceptive device (IUD) in place should have it removed before using misoprostol.