INSTRUCTIONS

How to use the abortion kit (Mifegest) of Mifepristone 200 mg (1 tablet) + Misoprostol 800 mcg (4 tablets)

Abortion procedure

First stage: 200 mg of Mifepristone is given orally with water (not less than 150ml) in the presence of the doctor. Some women may start bleeding and feeling abdominal pain in 24-48 hours after taking the pill.
Mifepristone acts by blocking progesterone – the key hormone to maintain pregnancy. The action of Mefipristone discontniues the pregnancy development. Besides, Mefipristone increases cells sensibility to prostanglandines (in particular to Misoprostol).

Second stage: Misoprostol is given 36-48 hours after taking Mifepristone. Dosage: 4 pills 200mcg/pill. It is recommended to take pills sublingually with the following interval: the second, third and fourth pills should be taken in 30 minutes after taking the first pill. Misoprostole stimulates uterine contractility, that is accompanied with cramping pain and bleeding, thus the uterus gets rid of the ovum. Side effects of Misoprostol: dizziness, nausea, vomiting and diarrhea.

Pain management

For pain management use Ibuprofen or Paracetomol.

After taking Mifepristone vaginal bleeding will start in the following 3-5 days. It may last for 12-14 days.

Ultrasound should be made in 7-10 days after taking of Misoprostol.

Possible complications

1. Dizziness, headache, nausea, vomiting, discomfort, weeknes, fever, diarrea. If you vomited during 1 hour after taking Mifepristone or Misoprostol, you should take the same dose of the pill.

If a woman suffers from the early toxicosis, she should be injected Cerucal 2ml intramuscular and eat after 30 minutes. After that she should take a pill.

2. In case of severe abdominal pain a patient should take any spasmolytic, such is Nospa. Taking of non-steroid anti-inflammatory medications is prohibited.

3. Bleeding after medical abortion is usually heavier than a normal menstruation, that do not demand additional treatment.

4. Incomplete abortion. If taking Mifepristone and Misoprostol will not terminate the pregnancy, vacuum aspiration is administered to remove the residues of ovum.

Сontraindications

– chronic obstructive pulmonary disease
– asthma
– chronic heart disease
– kidney and liver failure
– smoking women older than 35 years who smokes more than 10 cigarettes per day, refers to the relatively limited group
– pathological processes in the blood coagulation system, which may occur as a result of a long and intense bleeding
– severe hypertension is a contraindication for the use of misoprostol.
– nursing mothers need to stop breast-feeding for 7 days from the date of receiving mifepristone.
– spontaneous abortion (miscarriage) during the course is not a contraindication to the complex Mifepristone + Misoprostol. The complex will provide rapid release of the ovum with a decrease in the probability of incomplete abortion.

Rehabilitation after medical abortion

To prevent hormonal imbalance after medical abortion it is recommended to take monophasic oral contraceptives (such as Marvelon) during the next menstrual cycles. Contraceptives should be taken on the 5th day of the bleeding during medical abortion.

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