How To Use Abortion Pills

Medication abortion uses mifepristone and misoprostol to end an early pregnancy.

For the FDA-approved U.S. regimen, the medicines are used to end an intrauterine pregnancy through 10 weeks (70 days), counted from the first day of the last menstrual period.

Before You Take the Pills

Medication abortion is not appropriate for everyone. Before starting, a licensed healthcare professional should review your pregnancy history, health conditions, medicines, and other relevant factors.

Do not take mifepristone with misoprostol for medication abortion if you:

• Have or may have an ectopic pregnancy
• Have certain adrenal gland problems
• Take long-term corticosteroids
• Have a bleeding disorder or take blood-thinning medicines
• Have inherited porphyria
• Have had an allergic reaction to mifepristone, misoprostol, or similar medicines
• Have an IUD in place; it must be removed before taking mifepristone
• Are more than 70 days from the first day of your last menstrual period for the FDA-approved U.S. regimen

What to Have Ready

Before starting the process, make sure you have:

• Your prescribed mifepristone
• Your prescribed misoprostol
• Instructions from your healthcare professional
• A way to contact your healthcare professional if you have questions or concerns
• Access to emergency medical care if needed
• Sanitary pads to monitor bleeding

Keep your medication instructions available throughout the process.

How to Take Abortion Pills

Step 1: Take Mifepristone

Day 1: Take 200 mg of mifepristone by mouth as directed by your healthcare professional.

Mifepristone blocks progesterone, a hormone needed to maintain pregnancy.

Step 2: Take Misoprostol

24–48 hours after mifepristone: Take 800 mcg of misoprostol according to the regimen and instructions provided to you.

For the FDA-approved U.S. regimen, misoprostol is taken buccally, meaning the tablets are placed between the cheek and gum.

Misoprostol Administration Routes

Depending on the medical regimen being used, misoprostol may be administered by buccal, sublingual, or vaginal routes. WHO recognizes all three routes for early medical abortion and notes that route choice may take patient and provider preference into account.

1. Buccal — Between the cheek and gum

• Place the prescribed misoprostol tablets between your cheek and gum.
• Keep them there for 20–30 minutes.
• Swallow any remaining tablet fragments afterward.

FDA-approved U.S. regimen: 800 mcg buccally, 24–48 hours after mifepristone.

2. Sublingual — Under the tongue

• Place the prescribed misoprostol tablets under your tongue.
• Keep them there for about 30 minutes.
• Swallow any remaining tablet fragments afterward.

3. Vaginal — Inside the vagina

• Place the prescribed misoprostol tablets inside the vagina, as instructed by your healthcare professional.
• WHO guidance describes placing the tablets high in the vagina and remaining lying down for about 30 minutes.

Which Route Should You Use?

Do not switch between routes on your own.

The appropriate route depends on the medication-abortion regimen being used. If your healthcare professional has provided a specific route, follow those instructions.

For the FDA-approved U.S. mifepristone regimen, the specified route is buccal. Other routes are recognized in WHO guidance for appropriate early medical-abortion regimens.

Step 3: Expect Cramping and Bleeding

Cramping and vaginal bleeding are expected parts of the medication-abortion process.

You may also experience:

• Blood clots
• Nausea
• Vomiting
• Diarrhea
• Headache
• Chills
• Fever
• Dizziness
• Tiredness

The amount of bleeding and the intensity of cramping can vary.

When to Get Medical Help

Seek urgent medical attention for heavy bleeding

Contact your healthcare professional immediately if you soak through 2 thick full-size sanitary pads per hour for 2 consecutive hours.

Get medical help promptly if you have:

• Severe or worsening abdominal pain
• Fainting or significant weakness
• Abdominal pain, weakness, nausea, vomiting, or diarrhea occurring more than 24 hours after misoprostol
• A fever of 100.4°F (38°C) or higher lasting more than 4 hours
• Prolonged or very heavy bleeding
• Other symptoms that make you feel seriously unwell

If you cannot reach your healthcare professional during an emergency, go to the nearest emergency department.

Important: Ectopic Pregnancy

Mifepristone with misoprostol does not treat an ectopic pregnancy.

An ectopic pregnancy develops outside the uterus and can become life-threatening if it ruptures. Confirmed or suspected ectopic pregnancy is a contraindication to the FDA-approved mifepristone regimen.

Seek urgent medical care for concerning symptoms such as severe abdominal or pelvic pain, fainting, or significant weakness.

Step 4: Follow Up

Follow the follow-up instructions provided by your healthcare professional.

For the FDA-approved U.S. regimen, follow-up with a healthcare provider is recommended approximately 7–14 days after taking mifepristone.

Bleeding does not by itself confirm that the abortion is complete.

Follow-up may be needed to confirm that the pregnancy has ended and determine whether additional care is necessary.

Important Precautions

• Take the medicines according to your prescribed regimen.
• Do not change the dose, timing, or route on your own.
• Do not take additional misoprostol unless your healthcare professional or the regimen instructions tell you to do so.
• Keep your healthcare professional's contact information available.
• Know where to obtain emergency medical care before starting.
• Keep your medication guide and treatment instructions available.
• Tell emergency medical staff that you have taken mifepristone and misoprostol if you need emergency care.

Quick Summary

Day 1:
Mifepristone 200 mg by mouth

24–48 hours later:
Misoprostol 800 mcg according to your prescribed regimen and route.

After misoprostol:
Expect cramping and bleeding. Monitor for warning signs.

About 7–14 days later:
Complete the recommended follow-up.

Medical Information

This page provides general information about medication abortion and does not replace individualized medical advice, diagnosis, or treatment.

A licensed healthcare professional should determine whether medication abortion is appropriate for you and provide instructions for your specific treatment.