Misoprostol is the second medicine taken for a medication abortion. When used in combination with mifepristone, it’s 98% effective in ending a pregnancy in the first trimester.

Misoprostol, also called Cytotec, has been used as an abortion medication since the late 1980’s and early 1990's. At that time, misoprostol was approved only to treat peptic ulcers, but women in areas with restrictions to abortion access discovered the side effect of uterine cramping and vaginal bleeding. In the United States, misoprostol was FDA-approved for medication abortion treatment in 1996.

How does misoprostol work?

Misoprostol causes the uterus (or womb) to contract, causing cramping and bleeding to empty the contents of the uterus, thus ending a pregnancy. When taken with the other medication often used for medication abortion treatment, mifepristone, it’s 98% effective in ending pregnancy in the first trimester. 

To use misoprostol, we recommend meeting with an abortion provider who can prescribe the medications and ensure the process is completed safely. In 24-48 hours after taking 200mg mifepristone, the medication which ends the pregnancy, you’ll take four 200mcg tablets of misoprostol. Misoprostol causes uterine cramping and bleeding. Generally, you’ll experience vaginal bleeding within about 6-24 hours after taking the misoprostol, and heavy bleeding can last for a few hours.

Vaginal bleeding and cramping are expected. They mean the treatment is working. 

Misoprostol can also cause other side effects for about 24 hours after taking it. None of these side effects are dangerous, but they can be uncomfortable. 

What are the side effects of misoprostol?

Misoprostol side effects include:

• Nausea
• Diarrhea
• Vomiting
• Upset stomach and abdominal pain 
• Vaginal bleeding or spotting
• Heavy, menstrual-like cramps
• Fever
• Chills/shivering
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Side effects from misoprostol can happen, but they should go away in a few days. Over-the-counter pain medication, heating pads, and other comfort measures can help manage these symptoms if you do end up experiencing them. Let your provider know if your fever lasts more than 24 hours after taking misoprostol.

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Most common 

The most common side effects of misoprostol are gastrointestinal, mainly diarrhea and abdominal pain. In clinical trials, about 13% of people who took misoprostol (Cytotec) experienced diarrhea and 7% of people had abdominal pain. If you have an underlying inflammatory bowel disease, this might be something to watch out for. 

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Helpful tip: You can reduce your chance of getting diarrhea by taking misoprostol after meals, at bedtime, and by stopping any magnesium-based antacids, like Maalox and Mylanta, while taking this medication.

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Gynecological 

Some people have also experienced vaginla bleeding, spotting, and menstrual-like cramping after taking misoprostol. It’s fine to use period products if you’re experiencing any spotting or bleeding.

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Less common side effects

There are a few other side effects that may be causally related to misoprostol, including nausea, flatulence, headache, indigestion, vomiting and constipation. During clinical trials, only 3.2% -1.1% of people reported these side effects, so they aren’t that common. The studies also found no significant difference between how often these symptoms occurred for people taking misoprostol vs. the placebo. 

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Persistent symptoms 

If any of these symptoms persist after about a week or increase in intensity, contact your healthcare provider or seek emergency care. 

Studies show that people are able to safely manage medication abortion treatment at home without a clinic visit, but your provider may request you follow up in-person based on their clinic policies and your health history.

How do I get misoprostol?

Misoprostol should only be taken when prescribed by a medical provider. To buy misoprostol online, use a professional telehealth abortion provider. This will ensure your process is safe and effectively ends your pregnancy. You can also meet with an abortion provider in a clinic where they can administer the medications during the visit or give them to you to take at home.  

How to get an abortion at home

Laws around abortion telehealth services change frequently and differ state to state. To find options available to you, check here. 

Hey Jane provides telehealth medication abortion sevices and abortion pills online for adults that are less than 10 weeks along in their pregnancy. Check that you are eligible for services here and speak with one of our licensed medical providers. If approved, we’ll send your medications to the address of your choice (as long it’s in one of the states where we’re operating) to you in an unmarked box to protect your privacy. They should arrive on your doorstep in about 1 to 5 days.

For more information, read reviews from past patients, and check out our Resources page, as well as our Frequently Asked Questions page for answers to common questions.

Why Hey Jane cares

Hey Jane supports those seeking options for their pregnancy and aims to make patients feel informed about their choices. We offer loads of resources and provide accurate information about abortion and the process.

By offering telehealth abortion services and abortion pills online, we eliminate the need to find an in-person clinic—which can be difficult, especially as the number of abortion clinics declines and wait times increase. 

We also offer financial assistance to those who can’t afford our abortion services, through our abortion fund partner program. Plus, all Hey Jane patients have an automatic support network through The Lounge, our private peer-to-peer community forum available to patients past and present.

If you have any questions about Hey Jane—or finding the best option for you—feel free to text us directly at (405) 643-7957.