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MISOPROSTOL-ONLY
RECOMMENDED REGIMENS 2017
<13 weeks’ 13–26 weeks’ >26 weeks’ Postpartum
gestation gestation gestation8 use

Pregnancy termination1 Pregnancy termination1,5,6 Pregnancy Postpartum

800μg sl every 3 hours 13–24 weeks: 400μg pv*/sl/ termination1,5,9 hemorrhage (PPH)
or pv*/bucc every bucc every 3 hours 27–28 weeks: 200μg prophylaxis 2,10
3–12 hours (2–3 doses) 25–26 weeks: 200μg pv*/sl/ pv*/sl/bucc every 600μg po (x1)
bucc every 4 hours 4 hours or PPH secondary
Missed abortion2 >28 weeks: 100μg pv*/ prevention 11
800μg pv* every 3 hours (x2) Fetal death1,5,6 sl/bucc every 6 hours (approx. ≥350ml
or 600μg sl every 3 hours (x2) 200μg pv*/sl/bucc blood loss) 800μg
every 4–6 hours Fetal death 2,9 sl (x1)
Incomplete abortion2,3,4 27–28 weeks:
Inevitable abortion 2,3,5,6,7 100μg pv*/sl/bucc PPH treatment 2,10
600μg po (x1)
200μg pv* every 4 hours 800μg sl (x1)
or 400μg sl (x1) /sl/bucc >28 weeks: 25μg pv*
or 400–800μg pv* (x1) every 6 hours every 6 hours
or 25μg po every
Cervical preparation Cervical preparation 2 hours
for surgical abortion for surgical abortion
400μg sl 1 hour 13–19 weeks: 400μg pv 3–4 Induction of labor 2,9
before procedure hours before procedure
25μg pv* every 6 hours
or pv* 3 hours >19 weeks: needs to be
combined with other modalities or 25μg po every 2 hours
before procedure

1 If mifepristone is available (preferable), 5 An additional dose can be offered if 9 If only 200μg tablets are
Notes

follow the regimen prescribed for
mifepristone + misoprostol
2 Included in the WHO Model List of
Essential Medicines
3 For incomplete/inevitable abortion
women should be treated based on
their uterine size rather than last
menstrual period (LMP) dating
4 Leave to take effect over
1–2 weeks unless excessive
bleeding or infection
the placenta has not been expelled 30 available, smaller doses can be
minutes after fetal expulsion made by dissolving in water
6 Several studies limited dosing to 5 (see www.misoprostol.org)
times; most women have complete 10 Where oxytocin is not
expulsion before use of 5 doses, but available or storage
other studies continued beyond 5 and
conditions are
achieved a higher total success rate inadequate
with no safety issues
7 Including ruptured membranes where 11 Option for
delivery indicated community
based
8 Follow local protocol if previous
programs
cesarean or transmural uterine scar

For full references see

figo.org
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