Misoprostol Uses and Dosage in Management of Pregnancy Complications

IndicationDosageNotes
Induced abortion
(0-8 weeks)
Misoprostol 800 microgram vaginally or orally or sublingually 3-12 hourly (max. 3 dosesIdeally used 24-48 hours after Mifepristone, oral, 200 mg.
Induced abortion
(9-12 weeks)
Misoprostol 800 microgram vaginally followed by
Misoprostol 400 microgram
vaginally or sublingually
every 3 hours hourly (max.
3 doses
Ideally used 24-48 hours after Mifepristone, oral, 200 mg
Missed abortion
(0-12 weeks)
Misoprostol 800 microgram vaginally if needed repeat dose in 24 to 72 hours

OR

Misoprostol 600 microgram
sublingually followed by two
additional doses if needed 3 hourly
Give 2 doses and leave to work
for 1-2 days (unless heavy
bleeding or infection)
Incomplete abortion
(0-12 weeks)
600 microgram orally statLeave to work for 2 days (unless
heavy bleeding or infection)
Induced abortion
(13-24 weeks)
400 microgram vaginally 3-4
hourly (max. 5 doses
Ideally used 48 hours after
Mifepristone, oral, 200 mg.

A lower Misoprostol dose of
<200 microgram may be used
with caution in women with
caesarean scar only under specialist supervision
Intrauterine foetal
death (<28 weeks)
13-17 weeks: Misoprostol
200 microgram 6hourly
Misoprostol should be used
with caution in women with
caesarean scar and only under
specialist supervision
Intrauterine foetal
death (>28 weeks)
18-28 weeks:
Misoprostol
100 microgram 6hourly
Do not administer to women with previous caesarean section
or other uterine scar
Induction of labour
(live fetus > 28
weeks)
25 microgram vaginally 4 hourly Or 50 microgram orally 4 hourly
Or 20 microgram oral solution 2 hourly
Do not use if previous caesarean section
PPH treatment600 microgram orally or sublingually stat.Use as second line drug if
oxytocin is not available or is
ineffective.
Cervical
ripening prior to
instrumentation
400 microgram vaginally 3
hours before procedure
Use for insertion of intrauterine
device, surgical termination
of pregnancy, dilatation and
curettage, hysteroscopy

 

  • Stat = single dose taken immediately,
  • PPH = postpartum haemorrhage

Note:

Misoprostol is associated with an increase in shivering, diarrhoea, and temperature higher than 38°C.