Should i take second dose of misoprostol

No women were included in the study who had had prior cesareans. I was 7 weeks 3 days pregnant i had a medical abortion last evening at 6:05 by keeping 4 tablets of Misoprostol (800mcg) I experienced headache and drowsiness and shiver around 9:30 I throw up everything I eat in lunch and 9:45 I got my bleeding but slow the cramps were mild I had my dinner n at 10:40 again took second Should not urine after taking misoprostol All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. 1 Study results have demonstrated that vaginal administration is more effective than oral use of misoprostol. Tablets should be taken orally, regardless of meal intake. Perioperative oral doxycycline given up to 12 h before a surgical abortion appears to effectively reduce infectious risk. What the side effects are. I had a little cramping but no bleeding. If you take a second dose of misoprostol, you should have a follow-up visit 7 days later. We wish to examine of repeated doses of 400mcg misoprostol  1 Oct 2019 This medicine should come with a Medication Guide. Your doctor may give you medicine to treat or prevent these side effects. I tried to completely follow the  The termination of second-trimester pregnancies requires lower doses of Women should not take misoprostol if they have a known allergy to misoprostol. You should follow the same instructions as with the first dose. 12,13 The 50-µg dose was chosen because it is the dose most commonly used orally and vaginally in various studies reported in the literature. In repressively methotrexate price the second phase, a marked exudate protruding through an area of mucosal ulceration represents the classic volcano lesion ( Fig! Even in patients with chronic pain without a personal history of depression, misoprostol buy significantly higher rates of depression have been found in family members ( Magni et al 1987)! La compressa deve essere deglutita con un bicchiere d'acqua, misoprostol buy un'ora prima di avere rapporti sessuali in questione! Women must be evaluated clinically for potential contraindications to medical abortion, including ectopic pregnancy, severe anaemia, cervicitis or upper genital tract infection, presence of an intrauterine device, or any contraindication to use of the specific medication. Women should not take their first dose until after the second or third day of their period to rule out or confirm pregnancy. • Diarrhea is usually dose-related and develops within the first 2 weeks of therapy. I took the first dose and started bleeding and cramping but I'm pretty sure its not all out because I didn't see anything too big pass and because i feel the same as I did before. This medication causes contractions, which helps the woman deliver the fetus. 23 Jun 2019 ever, they might not have great u lity, and dosing should con nue un routes for taking misoprostol; in most cases . After 24 hours you will start with the misoprostol dose. 10 May 2017 The ideal dose and medication interval of misoprostol however Sign up to take part. It could be given by oral, sublingual or vaginal, while the doses . Two days later at the second visit, you will be given four tablets of another medicine called misoprostol. Mifepristone causes the placenta to separate from the endometrium. Because of the teratogenic risk posed by the medical abortion regimen, aspiration curettage would be indicated. After taking misoprostol, you must plan to stay home for up to 24 hours while the abortion process pregnancy and may need another dose of misoprostol . Ninety-six percent of women had a successful medical abortion after the first or second dose of misoprostol. However some studies reported converse opinion, by pointing out that a lower dose or different routes of misoprostol may be equally effective 21, 22. However it can also be used earlier or later, from 12 hours to 72 hours after swallowing Mifepristone. Based on these data, the most evidence based dose of miso for second trimester induction is 400 mcg q6h vaginally. You can take tablets of misoprostol by mouth, usually within 48 hours of mifepristone. Women who received misoprostol before IUD insertion were more likely to experience cramping after taking misoprostol but not at 24 hours after insertion. i highly advise taking the pain meds BEFORE you start the misoprostol, Therapy should be started on the second or third day of the next normal menstrual cycle. If after 24 hours the woman has no bleeding, and she is sure that she is pregnant AND that the pregnancy develops in the uterus she can repeat the misoprostol dose of 4 tablets. Patient counseling is important for appropriate administration. Shivering (37 percent compared to 15 percent) We classified whole trials according to interaction tests as described by Deeks et al. For example, in one large study, 71 percent of women had a complete miscarriage within three days of taking misoprostol. Patients became more anxious and the worry of treatment failure grew if they were not responding after `repeated medication'. I hold them in my mouth for Then I took the second dose of Misoprostol, about 4 hours later. Second Trimester Abortion Pill Procedures Failed. No accumulation of misoprostol acid was found in multiple-dose studies, and plasma steady state was achieved within 2 days. The doctor again recommended I take misoprostol, in part because they would not be able to schedule a d&c before Monday anyways. It has been demonstrated that by adding water to misoprostol, the success rate rose to 92%. If the process is not yet finished and as long as the woman is clinically stable, she may be offered a choice between expectant management or a repeat dose of misoprostol at the follow-up visit (18). And, also, the buy cytotec misoprostol tablets chapter is need catching up with the children who take it to end their bacteria. Each of the women in the study had premature rupture of membranes beyond 36 weeks’ gestation. Ready access to emergency care in a medical facility is essential, and women should not attempt an abortion alone. You will be given some antibiotics to take, pain medicine with instructions for use and advice on how to care for yourself. You should use the misoprostol even if you have had bleeding after taking mifepristone in our office. If you do not start bleeding within 48 hours of taking the misoprostol please contact EPAGU. This medicine causes cramping and bleeding to empty your uterus. At 27 acne should be a rare outbreak not a constant problem? Some time i have lower back pain my doctor did test on me for my diabeties and for that my calcium level is high now i have to take some more test but in my family most of them died from kidney failure or some type bleeding of the liver or kidney so i'm at a lost! Although many studies have been published on the use of sublingual misoprostol for medical abortion in the first and second trimesters, 7-11, only two studies (by the same group) have compared sublingual to oral misoprostol, in different doses. 23 Mar 2019 FRIDAY, March 30 (HealthDay News) -- Women can take the two components of And a second study found the drug is safe for late first-trimester abortions. Stopping Post-Birth Bleeding: Misoprostol Tablets Can Be Used As An Alternative To Intravenous Oxytocin. More scientific information: Research has shown that for women with pregnancies of 8 weeks or less, Misoprostol works with the same efficacy whether it is taken at 12 hours, 24 hours, 48 hours, or as much as 72 hours after Mifepristone. If your body has not completely passed the pregnancy, you may be given another dose of misoprostol. Take two misoprostol pills and keep it in your cheek pouch after 3 hours take another 2 misoprostol pills and keep it in your cheek pouch again give a gap of 3 hours and keep 2 misoprostol pills from the 2nd MTP kit in your cheek pouch and lastly after 3 hours keep the remaining 2 misoprostol pills in your cheek pouch. to 84% by Day 8 after a second dose of 800 µg of vaginal misoprostol was administered, if needed. You will take the second medication (misoprostol) 1 to 2 days later at home or in another place you choose (that is, not in the clinic or your health care provider's office). I did not take the second dose of pills yet (Misoprostol). Rarely does a second Trimester Abortion Procedure not work. For women who strongly desire to avoid a surgical procedure, a second dose of misoprostol is an important option for consideration. However, for women who strongly desire to avoid surgery, there is evidence to support a second dose of misoprostol, with 36% of women with persistent gestational cardiac activity expelling the pregnancy. I'm supposed to wait and take another dose of the medicine tomorrow if it this dose doesn't work, but I can't just sit around waiting forever, especially if it's not going to work. Misoprostol reduces stomach acid and helps protect the stomach from damage that can be caused by taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others. Two days or so and the medication should be completely out of your body. DOSAGE AND ADMINISTRATION. Most common adverse effects of misoprostol after oral administration are nausea vomiting diarrhoea, abdominal cramps and fever which are dose dependent. this point should be considered when assessing adaptations of the existing regimen. This medication dose shall be determined by the attending health provider based on the diagnosis and the severity of the health disorder. He doesn't give the option of trying more misoprostol although I've read online that many women need to take more than one set to complete the procedure. If you are taking this drug to prevent stomach ulcers, take it by mouth usually four times a day, after meals and at bedtime to minimize diarrhea, or as directed by your doctor. 3,14 To the best of our knowledge, no study comparing sublingual to vaginal misoprostol for labor induction at linear relationship with dose of misoprostol over the range of 200 to 400 mcg. Dosage is based on your medical condition and response to therapy. The risk of infection with a medication abortion is very low but not totally impossible. Stop taking this medicine and tell your doctor right away if you become pregnant during treatment. The treatment was considered a failure if the woman was still bleeding or cramping and the uterus was not empty; at this time, manual vacuum aspiration was performed unless the woman was stable and opted for a second 800 mcg dose of misoprostol. How long does Misoprostol stay in your system. The misoprostol advantage: is one (1) 800mg tab, followed by a second (1) 800mg tab in 24 hours - lightly moistened with 2 or 3 drops of clean water - placed vaginally causing the cervix to become Women of childbearing age potential must receive written and oral warnings about the hazards of misoprostol, be able to adhere to effective contraceptive measures, and have had a negative serum pregnancy test result in the 2 weeks before administering therapy. But a progesteron went by, and far another. for girls at 49–63 days of gestation, if abortion has not occurred four hours when administration of misoprostol, a second dose of misoprostol If you are able to become pregnant, you will need to have a negative pregnancy test before you start taking misoprostol. Misoprostol is given 36-48 hours after taking Mifepristone. More than 99% of patients complete the delivery process in less than 24 hours. I wonder if I should contact a different Dr. Misoprostol for Treatment of Early Pregnancy Loss. 45 – 48 As a substitute for laminaria, misoprostol does not achieve the same degree of preoperative cervical dilation and frequently additional mechanical At the second visit (Day 7 to 14 after you took Mifeprex), your doctor will check your uterus to make sure the pregnancy has completely ended. I am just wondering if I should skip it and request a D & C. A: Give Shingrix in a two-dose series, regardless of a whether a patient has had shingles or received Zostavax (zoster vaccine live) in the past. Renal impairment Adjustment of the dosing schedule in renally impaired patients is not routinely needed, but dosage can be reduced if the 200-mcg dose is not tolerated. The misoprostol could also be administered by a clinician or self-administered by the girl. And Misoprostol Tablets should be taken with a meal and the last dose of the day should be at bedtime. Rarely does a second Trimester Abortion Procedure Fail. The first received 50 micrograms of misoprostol orally and the second received the same dose sublingually. Women should be asked about symptoms of ectopic, given ectopic For the second dose of cytotec on the next day, I took the percocet right away and it made all the difference in the world. 25 Mar 2014 Costs may vary over time, and trusts and units should take this into prostaglandin E2 tablets or gel: 1 dose, followed by a second dose after 6  The second pill, misoprostol, is taken later on while at home. When used alone, the successful complete abortion rate dropped to ~60%. This is a hormonal treatment that causes uterine contractions and thinning of the uterine lining, which interferes with the pregnancy. The first medicine (mifepristone) is given at a health center or your health care provider’s office. This was probably related to the relatively long treatment protocol. I was given 2 doses of misoprostol to be taken vaginally, I was told that if bleeding doesn't start within 24 hours, take the second dose. Medical Abortion :: Took Second Dose Of Misoprostol (cytotec) Feb 23, 2016. You should follow the instructions on your prescription label carefully when taking this medicine. If after 24 hours you haven’t bled, and you’re sure you’re pregnant and that the pregnancy is developing in your uterus, you can repeat the misoprostol dose of 4 tablets. How to use Misoprostol. It's used off-label as a cervical dilator because by crazy random happenstance it does that too. On the second day, after taking the misoprostol, I got an upset stomach from that and the ibuprofen, and cramps intensified, but not to a level near what I’d heard online or from the staff at CDC recommends two doses of Shingrix, with the second dose given 2-6 months after the first. However, I took it again and absolutely nothing happened. Same day to 72 hrs later, take 2nd pills – Misoprostol at home My pregnancy test was positive and I'm not sure what to do. ): You may take 800mg of ibuprofen (four over-the-counter tablets) every six to eight hours. They should have told you in the clinic about taking pain medication before actually taking the pill. abortion, treatment-dose antibiotics may lower the risk of serious infection. After getting the Misoprostol pills, uterine contractions usually start within 4 to 6 efforts and genital blood vessels loss begins soon thereafter. A urine pregnancy test  19 Oct 2010 If this first dosage fails to induce a miscarriage, please call the clinic to receive Upon taking the second medication misoprostol tablet, cramping, bleeding, Vaginal bleeding with medical abortion could be extremely heavy. So she can put another 4 misoprostol buccally The second medicine is called misoprostol. • You may repeat the ibuprofen dose every 8 hours to control pain, if pain becomes very strong you can also take Vicodin 5/500mg 1-2 tablets, Do not drive while taking Vicodin. Step 4: Place 4 Misoprostol pills under your tongue (sublingual). Diarrhea. i highly advise taking the pain meds BEFORE you start the misoprostol, After taking the pill I felt a lot of regret and have decided that, if there is a chance, I would like to keep my baby. 56 a Doses taken from the summaries of product characteristics and recommendations in the NICE clinical guideline on induction of labour . I know this post was from ages ago, but I wanted to sar my story so others can be informed. Misoprostol is best effective if it is used 48 hours after taking mifepristone. . The aim of our study is to compare the efficacy of a 50-µg sublingual dose of misoprostol administered at 4-hour intervals with an equivalent dose regimen administered vaginally in women admitted for induction of labor for a medical or obstetric indication at term. This process is typically complete within 24-48 hours after the second pills are ingested. You should also avoid taking any antacids containing magnesium within an hour before or two hours after taking Misoprostol. I had mixed emotions. Yes, you must take the next doses, despite the blood loss. One group of women was treated with a single oral dose of 600 mg of mifepristone, followed 48 hours later by a 400 mcg oral dose of the prostaglandin misoprostol. The recommended regimen is a single dose of 600 mcg oral misoprostol for women with a uterine size equivalent to 12 weeks or less. The second is Cervidil, which contains 10 mg of dinoprostone embedded in a mesh and is placed in the posterior fornix of the vagina. If abortion has not occurred, a further dose of misoprostol 400 micrograms after 3 hours can be administered. Prostaglandin E1 analog (misoprostol) use was described recently in a series of articles. Misoprostol Tablets should be taken with a meal, and the last dose of the day should be at bedtime. The pills keep working for a few days after you take them believe it or not. One dose is about 70% effective, and 2 is about 84% effective. The article is talking about kind of a small study. Pharmacists should educate patients about the proper administration of the tablets. What do comparisons of this and the standard mifepristone/misoprostol  4 Dec 2018 Women should either get an ultrasound after the medical abortion or take a pregnancy test 3 weeks after the abortion. WHO guidelines recommend for pregnancies up to 12 weeks to use 12 tablets of 200 mcg (micrograms). Misoprostol where to buy misoprostol tabletkasi haqida malumot When discreetly tobramycin eye drops price I was in practice my training was in large hospitals and we saw a lot of stuff! 1991-92: zyrtec price cvs aloofly Paul Sorvino plays his replacement, nice-guy Phil Cerretta. Efficacy and safe use in children have not been established. Overdoses at this stage of pregnancy are dangerous. What to expect after the misoprostol Misoprostol and mifepristone have been shown to be effective for medical abortion up to 9 weeks of gestation. What to Expect When You’re taking Misoprostol for a Miscarriage WARNING: I’m not writing this blog for regular TKC readers. Side Effects : 1. misoprostol venta sin receta; jual misoprostol di medan; misoprostol uses side effects In addition, misoprostol with alcohol simvastatin can also lower triglyceride levels and slightly raise HDL levels! This, dosis de misoprostol para abortar de 6 semanas you should swallow the tablets with a large drink of water! You can take tablets of misoprostol by mouth, usually within 48 hours of mifepristone. The first pill mifepristone will work up to 72 hours. This can be done through obtaining a history and clinical examination (4, 11). Women who got misoprostol and didn’t have a contraction pattern of more than 3 contractions in a 10minute period within 6 hours received a second dose, for a maximum of 50 micrograms. The mortality and morbidity of the second trimester is greater than that of the first trimester termination. The heaviest bleeding typically occurs 4-8 hours after using the first dose of misoprostol and usually slows within 24 hours. The information contained within this site is meant to supplement the information given to you by your own physician but is not to be used in place of your physician's medical advice. Misoprostol is used to prevent stomach ulcers Yes it is normal to feel this way after taking Misoprostol you'll face bleeding for around 7-10 days, if you have excessive bleeding which lasts more than 10 days then you should visit the gynecologist. I took my first dose 30 hours ago and very little has happened so my doctor wants me to take a second dose to see if that will do it. The abortion pill, i took the first when do I take the second? I took the first one yesterday at 3 and then my doctor told me I can take the other four today anytime after 3, she wasn't really specific so I can I wait until tomorrow morning to take it I read online up to 48 hours. A miscarriage or Sometimes, a second dose is needed if the Do not take Misoprostol at night. At the second visit (Day 7 to 14 after you took Mifeprex), your doctor will check your uterus to make sure the pregnancy has completely ended. Misoprostol alone may be more effective in earlier gestation. The conventional timing of misoprostol administration after mifepristone for second-trimester medical abortion is 36–48 hours. It is not known whether misoprostol passes into breast milk or if it could harm a nursing baby. was below 8 weeks while in the second we excluded another study in . Misoprostol has been used for TOP in different ways, vaginal, oral, and in combination of the two routes in the first and second trimester [8]. Disclaimer: We are not medical professionals. Treatment with this medicine should begin on the second or third day of your menstrual period. 1 dose, followed by a second dose after 6 hours if labour is not established (up to a maximum of 2 doses) £13. Keep them there for at least 30 minutes. Misoprostol should not be used for reducing the risk of NSAID-induced ulcers in women of childbearing potential unless the patient is at high risk of developing gastric ulcers or complications. If an ultrasound wasn’t performed prior to the medication abortion or an intrauterine pregnancy wasn’t seen on the ultrasound, then ectopic pregnancy should be considered. The nurse told me to take pain medication at least a half hour before. You’ll either take the misoprostol right away, or up to 48 hours after you take the first pill — your doctor or nurse will let you know how and when to take it. If the second dose is given less than 4 weeks after the first dose, the second dose should be considered invalid. for girls at 49–63 days of gestation, if abortion has not occurred four hours when administration of misoprostol, a second dose of misoprostol could also be administered vaginally or orally (depending upon preference and quantity of bleeding). Do not rush into taking a second dose of pills immediately. 600 mcg of oral misoprostol in one dose, or; 400 mcg of sublingual misoprostol in one dose. You will take the second medicine, misoprostol either at home or in the clinic 1 or 2 days later. If you are taking this medication for abortion, take it by mouth exactly as  Misoprostol, sold under the brandname Cytotec among others, is a medication used to prevent Misoprostol-induced diarrhea and the need for multiple daily doses (typically four) are the main issues impairing compliance She should wait 3 hours and repeat with 4 pills under the tongue or in the vagina for 30 minutes. If you have no response to the misoprostol after 2 doses, call your provider who will then schedule an evacuation procedure. . This morning, still nothing, and the cramps are just about gone. In addition to the cramping and bleeding, you may also experience any of the following after taking the second dose of the How do I know if the abortion pill is right for me? 21 Jun 2018 take the second dose of tablets (this dose contains the drug misoprostol, You should take care of yourself in the 48 hours after having the  Cytotec should not be used for reducing the risk of NSAID-induced ulcers in women of will begin Cytotec only on the second or third day of the next normal menstrual After a single oral dose of misoprostol to nursing mothers, misoprostol acid while taking an NSAID compared the ability of 200 mcg of Cytotec, 100 mcg  10 Jan 2019 Her doctor prescribed a medication called misoprostol, which helps the miscarriage to pass. In the second year, misoprostol price an open-label design was used and patients could select either suppressive or episodic therapy or discontinue treatment and participation? Acheter Amoxil 250 mgOnline Pharmacy Cheapest Amoxil Online Fast. The second is misoprostol (also known as Cytotec). The second step of medical abortion involves taking a different medication, called misoprostol, or Cytotec, about two days later. 10 Apr 2017 However, the impact of repeat doses of misoprostol is not clear. Ulcer Therapy: Requires written and oral patient counseling. Dose 1 gave me cramps from hell. The woman should put 4 tablets of misoprostol under the tongue or far up the vagina and let them dissolve for 30 minutes. Misoprostol is a medication used to start labor, induce abortions, prevent and treat stomach ulcers, and treat postpartum bleeding due to insufficient contraction of the uterus. Ibuprofen usually does not cause side effects such as sleepiness, nausea, or dizziness. 8 Jun 2012 The routine medical treatment is 800mcg of misoprostol administered vaginally. Instructions for Using Vaginal Misoprostol in Medical Abortion Some women bleed after taking mifepristone. Additional blood loss of 300 mL or greater after treatment was similar for the two groups and occurred for 34 percent of women receiving misoprostol and 31 percent receiving oxytocin. For most people, the cramping and bleeding usually starts 1-4 hours after taking the misoprostol. I bled enough to replace around 4 pads total, not totally soaked through, and only the one large clot. 8 Dec 2017 The recommended dose of misoprostol is 800 mcgs (4 200-mcg tablets) Administration should take place in the morning or early afternoon. However, in almost all cases you must use the second medication, called misoprostol, to complete the abortion. Women in the second group received 200 mg of mifepristone, also followed by 400 mcg of misoprostol. Wednesday, September 19, 2007. 8% with 600 mcg sublingual misoprostol every 24 h for two days but had a very long induction evacuation interval. The rest took a second dose, which brought the overall success rate to 84 percent by the eighth day. A pill can be taken today and abortion happens a couple of days later. Antacids may be taken with diclofenac and misoprostol combination, if needed, to help relieve stomach pain, unless you are otherwise directed by your doctor. All the women who withdrew from the study did so after the second dose of misoprostol. Second, you take tablets of misoprostol by mouth or insert them Mifepristone should not be used for women who have any of the following conditions:. I went back 2 weeks later for my follow up appt only to find the baby was still growing!!! Constipation is a side effect of the use of aluminum products, but the client should not take a laxative with each dose. All men: black, white, asian and so dangerous as you think people should make sure you take out, or goes to work the private noel extended-release tablets - concerta mirtazapine - remeron misoprostol - should be eyeless to that with foggy misoprostol dysfunctional on detailed pharmokinetic and frisky centerpiece. " Up to two additional doses of misoprostol were administered orally or  Early medical abortion Second trimester medical abortion. Misoprostol pills (4 pills each of 200mcg) can help women to eliminate the embryo from the body. It's been a day and I have yet to start feeling any symptoms such as nausea, bleeding, cramps etc. Seven days after receiving the first dose of misoprostol, patients were offered a second dose if there was evidence of a persistent gestational sac. 26 and carried out the following subgroup analyses: (i) misoprostol versus placebo and versus other uterotonics; (ii) misoprostol to prevent or treat postpartum haemorrhage; and (iii) misoprostol at a dose of ≥ 600 µg or more; 400 to 600 µg;="" or="">> You usually take the first medication (mifepristone) at the clinic or medical office. 3–7 Recent proposals include vaginal administration of misoprostol for prevention of postpartum hemorrhage as The dose is usually 2 mg per kg of body weight per day, taken as a single dose. not sure of the dosages tho. The misoprostol may be administered by a clinician or self-administered by the woman. Misoprostol is in the FDA pregnancy category X. But the misoprostol didn't work right away, and Herbst needed to take many women are forced to return to their doctors for a second dose or to . 2 days. Evidence Rating Level: 2 (Good) Study Rundown: This study found that vaginal administration of a 400μg misoprostol tablet four hours before IUD insertion reduces the difficulty of and pain These authors did not address the topic in detail (just one paragraph within the “outcome measures” section) but make two main points; first they argue that the efficacy of a second dose of misoprostol should not be estimated from those who fail with the first dose and go for the second dose, because of the (obvious) attrition bias that would render inappropriate any comparisons between success rates of the second versus the first dose. If you have no response to the Misoprostol is given 36-48 hours after taking Mifepristone. For women at 49 - 63 days of gestation, if abortion has not occurred 4 hours after administration of misoprostol, a second dose of misoprostol 400 mcg (2 tablets of 200 mcg) may be administered vaginally or orally (depending upon preference and amount of bleeding). You should never buy them online or on the black market. The serum protein binding of misoprostol acid is less than 90% and is concentration-independent in the therapeutic range. The first dose of 50 mg of misoprostol was inserted into the posterior fornix. Of course, you all are more than welcome to read about my miscarriage (which I’m sure this is the first you’re hearing of), but I warn you that this is a graphic post. More than 99% of patients complete the medical induction procedure in 24 hours or less. Also, the number of doses you take each day, the time allowed  Conclusion(s): Single dose of vaginal misoprostol alone has a success rate comparable with surgical method for termination . Although the success of the second dose may be lower when GCA is present, a substantial percentage of women still avoided uterine aspiration. I felt prepared for the bleeding part of the processes but I was completely unprepared for the amount of pain that was involved with this medication. This time you will have to place, at the same time, the 2 pills under your tongue. (12) Increased age of women may be associated with higher failure rates. Post-Abortion Ultrasound 4 Leave to take effect over 1–2 weeks unless excessive bleeding or infection 5 An additional dose can be offered if the placenta has not been expelled 30 minutes after fetal expulsion 6 Several studies limited dosing to 5 times; most women have complete expulsion before use of 5 doses, but other studies After taking the pill I felt a lot of regret and have decided that, if there is a chance, I would like to keep my baby. Misoprostol is taken as a single 400 microgram oral dose 36 to 48 hours after taking a single 600 mg oral dose of mifepristone. cramping started after about 9 hours. Begin therapy only on second or third day of the next normal menstrual period. linear relationship with dose of misoprostol over the range of 200 to 400 mcg. In Burkina Faso and Vietnam: 1. Some women may pass clots days or even weeks later. Many women experience some nausea or vomiting. Misoprostol Dosage. Ibuprofen will reduce the intensity of the cramps and help you manage the possible side effects of Misoprostol such as headache, fever and chills. Any remaining pill remnants are washed down with water after this period. 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 5 An additional dose can be offered if the placenta has not been expelled 30 minutes after fetal expulsion If after 24 hours you haven’t bled, and you’re sure you’re pregnant and that the pregnancy is developing in your uterus, you can repeat the misoprostol dose of 4 tablets. This is common and is not dangerous, if there are no symptoms of complication . (This means no sex or tampons, until you stop bleeding which may take 2 weeks or more. If you are still pregnant, you will be given a second medication—misoprostol—in the form of two pills to be taken orally or as a vaginal suppository. But just to let you know these pills are more effective than surgical abortion. Outcomes assessed included difficulty of IUD placement; cervical dilatation; pain at insertion; the woman’s subjective experience of placement; and side effects during insertion and at several time points afterward (immediate, 24 hours, 30 days). Common side effects include diarrhea and abdominal pain. Though this is correct, we have not seen any 800 micrograms for 1 dose, dose to be given 36–48 hours after mifepristone, followed by (by vagina or by mouth) 400 micrograms every 3 hours if required for a maximum of 4 doses, if abortion has not occurred 3 hours after the last dose of misoprostol, a further dose of mifepristone may be given, and misoprostol may be recommenced 12 hours later. Cytotec (Misoprostol) Dosage. Women should be evaluated 1-2 weeks after misoprostol administration in order to ensure complete abortion. Place under your tongue and at the same time 4 pills of Misoprostol (Cytotec – 200mcg). administration of misoprostol. Proper Use TOP. for the second dose of abortion medication, choosing instead to take  Patients who did not abort within a week received a second dose of misoprostol. These doses will help make sure the process is complete and make it less likely that you will need any sort of medical attention. On completion of 14 days of the medication, you will be required to take an ultrasound to see if there's any remnant products within. If using oral misoprostol, the evidence suggests that the dose should be 20 to 25 mcg in solution. Administration should take place in the morning or early afternoon. Scientific research has proven that the advised dose increases the effectiveness of the treatment and reduces the number of incomplete abortions (i. mifepristone PO: 200 mg single dose Then 1 to 2 days later: misoprostol sublingually or vaginally: 800 micrograms 1. After a total of 18 h had elapsed, non-responders were given a third dose of prostaglandin. Misoprostol works by causing the uterus to There are two different methods of medical abortion available: mifepristone followed by misoprostol, and methotrexate followed by misoprostol. 28 to £26. Misoprostol should never be used during pregnancy since it can cause abortion, premature birth, or birth defects. The dose is abortion-inducing drug two hundred mg orally followed 1–3 days later by misoprostol vaginally. Therapy should be started on the second or third day of the next normal menstrual cycle. This independent site has been set up to distribute dosage guidlines for the use of misoprostol in obstetrics and gynaecology. It is not known whether the drug enters breast milk; thus, its use by nursing mothers is not recommended. It is important to drink a lot of fluids and eat lightly. Depending on the gestational period, a patient will take the second medication, misoprostol, between 6 to 48 hours after taking the dose of mifepristone. No accumulation of . This is common and is not dangerous, if there are no symptoms of complication. tissue remains in the uterus), which means that no follow-up treatment is necessary. It is recommended to take pills sublingually with the following interval: the second and the third pills should be taken in 30 minutes after taking the first pill. In 24 to 48 hours, you will take 4 misoprostol tablets at one time. Good morning 3hours After taking first dose of misoprostol bleeding is starting. In the second trimester 200µcg 12 hourly is a common dose, whilst beyond 24 weeks 25µcg 6 hourly is usually used. 400 mcg of sublingual misoprostol in one dose. ) If you have no response to the initial dose of misoprostol, you may repeat it 24 hours after your initial dose. If mifepristone is not available or contra-indicated: If you have no response to the initial dose of misoprostol, you may repeat it 24 hours after your initial dose. 31 Aug 2012 First, your doctor gives you a dose of mifepristone tablets by mouth. What should I do? How would I know if I am still pregnant? My doc gave me misoprostol to take orally (2 x 800mg doses 24 hrs apart). There is no clinical reason to withhold misoprostol for the treatment of missed abortion in women with previous caesarean section. Misoprostol is a drug with many uses; for one, it is given to people who are taking certain anti-inflammatory drugs in order to prevent stomach ulcers. Depending on the dose, this could be as soon as 6 hours after the mifepristone. My cramps have increased and are slightly greater than my regular full flow period cramps…but no flow yet still just spotting…in fact I’m spotting less than I was Step 3: Take 800 mg of Ibuprofen 1 hour before using Misoprostol. So you can put another 4 misoprostol between the gum and the cheek, and let it dissolve for at least 30 minutes. Where misoprostol remains unlicensed for the induction of labour, many practitioners will prefer to use a licensed product like dinoprostone. Do not take Misoprostol at night. each woman will react differently to the misoprostol; for example, some women experience bleeding within 20 minutes. A valid second dose should be administered 2 months after the invalid dose (minimum acceptable interval is 4 weeks following invalid dose). However, the number-needed-to-treat is high. After taking mifepristone, you take a second medication (misoprostol) at home 6-48 hours later. control failure; 4) start taking misoprostol only on the second or third day of the next normal Dosage is based on your medical condition and response to therapy. Women were randomized to misoprostol (n=86) or placebo (n=93) and had two 200μg misoprostol tablets or two placebo tablets placed in the posterior vaginal fornix. The effects of misoprostol on the reproductive tract are increased and gastrointestinal side effects are decreased if the tablets are administered vaginally. Do not take misoprostol with antacids that contain magnesium. Source: associatedcontent. for me, after the first vaginal dose, the bleeding started in about 5 hours. If it has not ended, there is a chance there may be birth defects. per protocol, a second dose of misoprostol was not adminis- tered. After taking your first dose at carafem, you can proceed with normal activities until you take the 2nd medication. or methotrexate. The average time of delivery after taking the first dose of Misoprostol is 6 to 18 hours. Misoprostol must be readily available especially for women who do not mcg sublingually; may be repeated every 3 hours for two additional doses (18, 19). The recommended dose of misoprostol is 800 mcgs (4 200-mcg tablets) inserted vaginally. Tell your doctor if you are breast-feeding a baby. The regimens studied for second-trimester D&E vary widely and include 400 µg of vaginal misoprostol for 3 to 4 hours, 400 µg and 600 µg of buccal misoprostol for at least 90 minutes, 600 µg of buccal misoprostol for 2 to 4 hours, and 800 µg of buccal misoprostol for at least 20 minutes but not more than 90 minutes preoperatively. If you are still pregnant, your provider will talk with you about the other choices you have, Sublingual Versus Vaginal Misoprostol for Labor Induction at Term. Most women will pass the pregnancy within 2 to 24 hours after taking the tablets. This, however, should not affect the primary outcome. The methods are similar, but have some important differences. 2 The rectal administration of misoprostol at doses up to 1,000 µg has not been as extensively examined but seems to be proliferating widely around the world as evidenced in the literature. For treatment to be effective, you must take misoprostol 24 to 48 hours after you took Mifeprex. It can be minimized by administering the drug after meals and at bedtime, and by avoiding magnesium-containing antacids. So be prepared with big pads. paracetamol and diclofenac should be fine. You should give the second dose of Shingrix 2 to 6 months after you gave the first dose. Repeat doses of buccal misoprostol to treat ongoing pregnancy have not been studied. If you are able to become pregnant, you will need to have a negative pregnancy test before you start taking misoprostol. If gestational cardiac activity persists at follow-up after a second dose of misoprostol, uterine aspiration should be performed. With the vaginal application, you place four of the pills in your vagina and lie down for 30 minutes while the medication is absorbed. If the woman vomits within one Do not take a double dose to make up for a missed dose. Patients should be advised that they may (rarely) experience a second episode of heavy bleeding several weeks after initiating medical abortion. People are given a second drugs, Cytotec (Misoprostol), which is a drugs that causes the womb to agreement that is taken 24 to 96 time after making the workplace. Ngoc NT et al (5) (2004) used 800mcg vaginal Misoprostol only single dose and mean induction abortion interval was high-21hrs. Children up to 8 years of age—Use is not recommended. f. Second trimester termination of pregnancy (TOP, induced 5 MISOPROSTOL USE IN PREGNANCIES WITH PREVIOUS CESAREAN OR TRANSMURAL UTERINE SCAR. Because it can also cause uterine contractions, it has become a second component of medical abortion along with either methotrexate or mifepristone. You doctor can prescribe antibiotics if you have an infection. This causes cramping and bleeding and empties your uterus. Posted 8 years ago. Some women may require a second dose of misoprostol and we can provide this for you. 19 The single dose should be given between 1 and 2 weeks to work. Li et al [34], [35] had reported their simultaneous use of mifepristone and misoprostol for early pregnancy termination with a better result. What should I do? How would I know if I am still pregnant? Lactation: Drug is rapidly metabolized in mother to misoprostol acid, which is biologically active and is excreted in breast milk; although no published reports of adverse effects of misoprostol in breast-feeding infants exist, caution should be exercised when misoprostol is administered to breastfeeding women. First Dose. (3) Some women should not take mifepristone. Although misoprostol alone can also be used for second-trimester abortions, the chances of serious complications such as uterine rupture or hemorrhage rise as pregnancy advances. 41. Barcelo F et al (6) had a success of 87. You should take the first dose 1 or 2 days before traveling to an area where malaria may occur, and continue taking the medicine every day throughout travel and for 4 weeks after you leave the malarious area. I vomited and couldn't get off the floor but no blood. In the latter case she received a second dose of misoprostol and an . Sometimes it works a few days later. of surgical abortion, we found a high rate (94. I'm wondering if I should take the second dose as I'm worried I didn't pass everything. Thanks, everyone. combine with co-codamol or paracetomol but NOT at the same time as this reduces the effectiveness. -Early Pregnancy Loss: 800 mcg intravaginally once; a second dose may be given if there is no response to the first dose no sooner than 3 hours after the first dose, and usually within 7 days-Incomplete Abortion: 600 mcg orally once I was wondering if anyone had to take a second dose of misprostol (abortion pill)? I was wondering was am I suppose to expect as for symthoms??? I took them last night and I'm not bleeding, or having cramps like the first dose??? Yes, you must take the next doses, despite the blood loss. Ask your doctor for advice on what antacid to take. One day bleeding after taking misoprostol. The results of the second case series (Vayrynen et al. Will taking the second dose cause any harm or undue complications if I already passed everything? Thanks for the help. You should give the process a couple of days. e. Sources: Pharmacokinetics of repeated doses of misoprostol. how that could create repercussions for the hospital," Brandi says. 24 to 48 hours after taking Mifepristone: Take 2 Misoprostol tablets buccally (hold pills in buccal area in the cheek to diffuse through the oral mucosa (tissues which line the mouth) and enter directly into the bloodstream). At 27 acne should be a rare outbreak not a constant problem? Some time i have lower back pain my doctor did test on me for my diabeties and for that my calcium level is high now i have to take some more test but in my family most of them died from kidney failure or some type bleeding of the liver or kidney so i'm at a lost! Some women find that it may take a few hours for bleeding to begin, even if they are already experiencing pain. It will be right to take next dose or not? Plz suggest Misoprostol alone may be more effective in earlier gestation. Women must have a negative serum pregnancy test within 2 weeks prior to beginning therapy, use effective contraceptive measures, and initiate therapy only on the second or third day of the next normal menstrual period. We hypothesize that treatment of incomplete abortion with either 400 mcg sublingual misoprostol, 600 mcg oral misoprostol or MVA are equally effective in evacuating the uterus. misoprostol acid was found in multiple-dose studies, and plasma steady state was achieved within . This allows for controlled release of dinoprostone over 12 hours, after which it is removed. For the first trimester 800µcg 24 hourly can be safely used. If you are taking this medication for abortion, Seven days after receiving the first dose of misoprostol, patients were offered a second dose if there was evidence of a persistent gestational sac. The vaginal administration of misoprostol up to a dose of 800 µg for medical induction of abortion and cervical priming before surgical abortion is now recommended in the published guidelines. Misoprostol can cause cramps, nausea, diarrhea, and other side effects. When in doubt, always seek a second opinion by another medical professional. (12) Second Trimester Abortion Method Failed. It's typically taken four times a day, after meals and at bedtime with food. However, do not take magnesium-containing antacids, since they may cause diarrhea or worsen the diarrhea that is sometimes caused by this medicine. If the cervix was still unfavorable, a second dose of misoprostol or dinoprostone was given and the same evaluation steps as described above were followed. 1 3. If you do become pregnant during treatment with misoprostol, stop taking the medication and contact your doctor immediately. personally and on the (unofficial) recommendation of my doctor i take 100mg first dose then 50mg 3 times a day. It is important to take metoprolol exactly as prescribed by your doctor to decrease the chance of this happening! Although food and water precautions continue to be recommended, misoprostol where to buy travelers may not always be able to adhere to the advice. 4 hours after the first dose, you must take a second dose of Misoprostol (Cytotec – 200mcg). Misoprostol should be used with caution in patients in whom dehydration would be dangerous. If you have a fever higher than that, or the day after you take the misoprostol, you should call your doctor immediately. You may. How will I feel after the second medication (misoprostol or Cytotec)? The misoprostol can take between 12 and 24 hours or more to begin bleeding and cramping. Misoprostol tablets What is this medicine? MISOPROSTOL (mye soe PROST ole) helps to prevent stomach ulcers in patients who take medicines like ibuprofen and aspirin and who are at high risk of complications from ulcers. There is less than a 1% chance of developing complications or side effects. 25 Aug 2018 The government is moving to allow women to take misoprostol at home . This would promote laxative abuse and should be avoided if less habit-forming means can be used. Uterine rupture has been reported when misoprostol was administered to pregnant women to induce labor or to induce abortion beyond the eighth week of pregnancy. Your dose of misoprostol may need to be reduced. [ 3 , 4 ] The effectiveness of only one dose has not been studied, so to get full protection, patients This speed is buy cytotec misoprostol tablets helping the drug rarity problems to foreign to receive inessential dreambox types from systemic weeks. One or both methods might be available in your area. It doesn't mean they need to do it this way, but it opens up a time window. They gave me Tylenol with Codeine for the pain. 3%) of accept- ability to both methods should be made available to the patient. Doses were given at 4 hours intervals to a maximum of 5 doses. Dosage and Administration. For women at 49–63 days of fertilization, if abortion has not occurred 4 hours after administration of misoprostol, a second dose of misoprostol 400 mcg (2 tablets of 200 mcg) may be administered vaginally or orally (depending upon preference and amount of bleeding). If you're planning to buy misoprostol online, please remember that this drug has a black box warning regarding its abortifacient properties. There is insufficient evidence available to recommend a regimen of misoprostol for use at more than 26 weeks’ gestation in women who have had a previous cesarean or transmural uterine scar. I feel like it's generally a good idea to ask doctors what the purpose of a medication is, rather than just assume. Misoprostol works by causing the uterus to It is important to use the second and third doses of misoprostol even if you are already bleeding and think the abortion already occurred. Your provider will check whether your pregnancy has completely ended. Misoprostol is actually used to prevent stomach ulcers. The patient may be administered a second dose of misoprostol where: Less than half (50%) of women with a persistent GS will fail to expel their pregnancy. Yes it is normal to feel this way after taking Misoprostol you'll face bleeding for around 7-10 days, if you have excessive bleeding which lasts more than 10 days then you should visit the gynecologist. How should I use this medicine? Take this medicine by mouth with a full glass of water. Dosage: 3 pills 200mcg/pill. Is that normal? it successful or did you take another dose. A second dose of misoprostol may be required if the first round of medications has not been successful. This step is not required, but we highly recommend it. These doses can be administered buccally (between the cheek and the gum), sublingually (under the tongue), or vaginally with equal efficacy. 2007, n=130) suggest that oral mifepristone followed by a low dose of vaginal misoprostol (median total dose 100 micrograms) is similarly effective to a higher dose of vaginal misoprostol used on its own without mifepristone (median total dose 200 micrograms). The optimal regimen for pregnancies through nine weeks’ gestation is 800 micrograms of misoprostol followed 3-12 hours later with a second 800 microgram dose of misoprostol followed 3-12 hours later by a third 800 microgram dose (3 doses x 800 micrograms). I just experienced mild cramps all day. The first dose of MTP kit for abortion should be Mifepristone (1 tablet of 200mg) and after the first dose, the second dose is to be administrated after 24-48 hours. 9. The age of the pregnancy, the medication doses and administration, and whether or not a woman has About 24 to 48 hours after you take the first pill, you will take misoprostol, which causes the uterus to  insertion of the second dose of misoprostol was not of much use in bringing about expulsion in cases administration could be dosed at longer intervals than. All women should be given the choice between surgical, expectant or medical management. The termination of second-trimester pregnancies requires lower doses of misoprostol because the uterus is, at this point of pregnancy, more sensitive to the drug. Misoprostol has recently been added to the WHO model essential drugs list for this indication. woman call back if she still hasn’t bled or dispensing a second dose of misoprostol right away. Mifepristone, then misoprostol best in early pregnancy loss If gestational cardiac activity persists at follow-up after a second dose of misoprostol, uterine aspiration should be performed. You should not drink alcohol or smoke once the Mifegyne® has been taken and for at least After being given the second Cytotec® tablets, bleeding should start within the next The dose, frequency and method of delivery of the drugs varies from clinic to clinic. The misoprostol group received treatment on day 1, a second dose on day 3 if expulsion was incomplete, and vacuum aspiration on day 8 if expulsion was still incomplete. I took first Misorprostol pills exactly 24 hours after taking Mifepristone. Bleeding is usually heavier than a period and often accompanied by clots. i finished mifepristone last wed and took the misoprostol 24 hours after. A lower dose of vaginal or oral misprostol (50–100 μg) is used in most studies on labour induction when compared with first or second trimester medical abortion (Afirevic, 2001; Hofmeyr and Gulmezoglu, 2001). The recommended adult oral Breeky Tablets dose of misoprostol for risk of NSAIDs induced gastric ulcer is 200 mg four time daily with food. (12) Two-thirds (66%) of women who have a persistent GS with cardiac activity will fail to expel their pregnancy. 2. After those 30 minutes, you must swallow the pills that are dissolved. 4 Jan 2007 Early research assessing the use of two doses of misoprostol significant adverse effects after taking the second misoprostol dose. Hope you have taken the total dose prescribed by your In 24 to 48 hours, you will take 4 misoprostol tablets at one time. The final dose of the day should always be administered before retiring for the night. It helps to eat a small meal before using the misoprostol. • It will take about 4-16 hours to pass the tissue. The blood indicated the process was starting and the Misoprostol was working, but at the same time I had the realization (once again) that I was losing my baby. Justgottaloveit, theres something whitish that comes out after I used misoprostol, it looks soft and around 7 cm long and a little thick, like blood clot but I noticed its clear/whitish, and the red color of the blood covers it. The misoprostol is administered as four 200 microgram pills inserted between the cheek and gum -- 2 on each side of the mouth -- for 30 minutes. My cramps are increasing in intensity but so far there’s not much else to report…light spotting and that’s it. But misoprostol (Cytotec) alone for women with a closed cervical os can require a second dose or intervention. Ibuprofen (Motrin, Advil, etc. Other misoprostol side effects: Wednesday, September 19, 2007. You may take the first dose of pills as soon as you feel you need something for the pain. A second dose of 50 mg of misoprostol was inserted. Don't take more or less of the drug than your doctor prescribes. Recommended Dosages: A second ultrasound after 1-2 weeks may be needed to confirm the diagnosis. If expulsion has not occurred within 24 hours, give a second dose of 800 micrograms of misoprostol. The medical abortion pill didn't make me bleed with the first dose, but I bled a little after the second dose. A single dose of 800 micrograms of misoprostol is taken 24 to 48 hours after taking mifepristone. 19 Sep 2017 If you're under ten weeks pregnant and take the second pill on the same day, nausea and period-type cramping, but basically, you should be fine to time, you may also be given extra doses of Misoprostol every few hours,  WARNING: Do not take this medication if you think that you may be pregnant. The results of clinical studies indicate that Cytotec does not produce hypotension at dosages effective in promoting the healing of gastric and duodenal ulcers. The downside to misoprostol is that, like expectant management, it doesn’t always work. 3. Recommended doses of Misoprostol (Cytotec®) are provided in this site along (2nd/3rd Trimester), 13-24 wks: 400mcg vaginally/sublingually/buccal 3-hrly For incomplete/inevitable abortion women should be treated based on their uterine Leave to take effect over 1–2 weeks unless excessive bleeding or infection  How did you do the abortion? with medicines. The biggest clots came out about 2 days after taking the 2nd dose. study is its confirmation that misoprostol should not be used to treat incomplete abortion  Find patient medical information for Misoprostol Oral on WebMD including its uses, side This medication is also used in combination with another drug ( mifepristone) to end a Dosage is based on your medical condition and response to therapy. Misoprostol comes as a tablet to take by mouth. am clear not pregnant or do i have to take second dose You may be advised to take ibuprofen an hour before the misoprostol in order to reduce cramps. If you are taking the pills by mouth, they should be taken with food but not with antacids or calcium. Do not take misoprostol for the prevention of stomach ulcers if you are pregnant or if you might become pregnant during treatment. I am going to get the heating pad to help with the cramps though…I have another hour until my next dose of Misoprostol and Percocet…I can tell the Percocet is wearing off! 4:00pm– Taking the second dose. These patients should be monitored carefully. It's a "one shot" thing with him. Providers should consider providing this to women, especially those for whom travel to the clinic is difficult Mifepristone should be taken in the approved hospital or clinic. successful, you will experience less cramps and pain than after the first time you used Misoprostol. Outside the hospital, for a missed abortion not greater than 8 weeks of pregnancy 600 micrograms of cytotec ( misoprostol ) swallowed by mouth should accomplish products of conception to pass within 3 - 6 hrs. Sometimes, a second dose is needed if the tissue is not passed within 24 hours. As I administered the third dose, I could feel that one of the pills from the second had not yet dissolved. Misoprostol 200 MCG should be taken for the duration of NSAIDs therapy as prescribed by the physician. Eight hours later, her cervix was 2 cm dilated, uneffaced and anterior. Should I take the plan B? Is it necessary to take misoprostol after taking mifeprestone even if one is bleeding a lot? Hello Dr. Information on the posology of mifepristone can be found in the product information of mifepristone. Given the current data on the pharmacokinetics of oral, vaginal and sublingual misoprostol, the dose of sublingual misoprostol may need to be further reduced. ity of one dose or schedule of misoprostol over another for use in . Consequently, the balance of risk and benefits warrants further investigation. If diarrhea persists for more than a week, contact your doctor. Because its job is to cause the uterine lining to shed, misoprostol should cause a lot of bleeding and cramping within one to four hours of taking the first dose. Additionally, elderly patients may not be able to tolerate the usual dose. Local and national regulations should be followed, such as special consent forms or other information that must be provided to patients. Pregnant patients • Pregnant women shouldn’t take misoprostol to reduce the risk of ulcers induced by NSAIDs. Second Dose. I'm miserable and I don't know Female patients must meet the following four requirements in order to use this drug: 1) test negative for pregnancy within two weeks before starting treatment; 2) use effective birth control to prevent pregnancy; 3) receive oral and written warnings on the dangers of using misoprostol while of childbearing age and the risks of possible birth control failure; 4) start taking misoprostol only on the second or third day of the next normal menstrual period. A single dose of 800 micrograms of misoprostol by vaginal or oral for missed abortion was recommended by National Institute for Health and Care Excellence (NICE) 20. tomorrow and explain what's going on and see if he'll give me the extra misoprostol I need to move this along. Wait three hours before taking another dose. Thanks carifairy for your reply on my pm. should i take second dose of misoprostol

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