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Read the instructions carefully before you use the medication. Keep all medications out of reach of children!
A. Content of the package
6 pills of Misoprostol (Cytotec – 200 mcg). Trade name: CYTOTEC.
Misoprostol (Cytotec-200 mcg) is used to terminate a pregnancy by inducing an abortion. It works by causing cervical contractions. Before using the medication, you should take a pregnancy test or ultrasound to know the lenght of your pregnancy, and also and to detect the presence of an ectopic pregnancy (outside the womb), in case it happens.
The medical abortion can be done up to a maximum of 12 weeks of pregnancy and has a margin of error that ranges from 5% to 15%. The risks are similar to the risks of a miscarriage.
- If you have an ectopic pregnancy (outside the womb);
- If someone is forcing you get an abortion;
- If you are not sure you really want to interrupt the pregnancy;
- If he first day of your last menstrual cycle was more than 12 weeks ago;
- If you are not able to get to an hospital or health center in less than an hour;
- If you are alone. Ask a partner, friend or someone else you trust to stay with you while you use this medication;
- If you have an intrauterine device (IUD). It must be removed before using the drug;
- If you are allergic to Misoprostol (Cytotec-200mcg), or to prostaglandins;
- If you suffer from any of these conditions: chronic adrenal failure, hemorrhagic disorders, inherited porphyria;
- If you have the inflammatory bowel disease or suffer from dehydration;
- If you have frequent diarrhea, for example, due to conditions such as Crohn’s disease, ulcerative colitis or irritable bowel syndrome;
- If you have suffered a stroke or mini-stroke.
- Set a date to do your procedure. Don’t do it without programming it;
- Relax. Too much stress can affect the process;
- Do it on a day off or weekend. It would be good for you to have time to take care of yourself;
- You should stay awake throughout the procedure. Do not do at night in order to take the pill and and then going to bed;
- It is possible to do the procedure in the morning, after waking up. That way you can take advantage of your fasting during the sleeping period;
- It is possible to use some medication for nausea (recommended by your local pharmacist) to minimize the risk of vomiting during the procedure;
- Keep IBUPROFEN close to reduce cramps. But use it just if necessary;
- Keep useful number telephones near you. For instance: emergency number, general health care, taxis and friends (for support);
- Be always accompanied by a good friend to support you.
- Be always near to a bathroom.
D. Usage Guide
Fast during 6 hours (solids and liquids) BEFORE taking Cytotec.
Place four (4) pills of Misoprostol (Cytotec – 200mcg) under the tongue, at the same time and keep them there for at least 30 minutes until the pills are completely dissolved. Do not swallow them until the 30 minutes have passed. You can swallow the saliva, but do not spit it. After those 30 minutes, you must SWALLOW the dissolved pills in your mouth.
Keep fasting solids and liquids.
4 hours after taking the first dose of Misoprostol (Cytotec – 200mcg), put the other two (2) pills under your tongue. Again, keep the pills under the tongue for 30 minutes. Do not swallow them until 30 minutes have passed. During the process is okay to swallow the saliva, but remember that you can’t spit it. After these 30 minutes, you must SWALLOW the dissolved pills that are in your mouth.
These two (2) last pills are crucial to ensure that your abortion is complete. You must take them even if you already started bleeding after the first dose.
Fast for six (6) hours (solid and liquids) AFTER taking the second dose of Cytotec.
The bleeding usually comes along with a heavy flow of clots and can last from one to two weeks. However, you may bleed for a longer or shorter period. It is intermittent, which means that can come and go. Do not use tampons, only external pads. The normal menstrual cycle usually returns after 6 weeks.
The bleeding usually starts within 4 hours. In some cases it may start a little earlier or a little later. There are cases where the wait reached 72 hours.
E. Side effects
- You may feel painful cramps;
- You will have a slightly more intense blood loss than with a regular menstrual period;
- You may experience nausea, vomiting or diarrhea;
- Pain in extremities;
- Transient fever;
- Feeling the stomach hard;
- Feeling of extreme cold.
The IBUPROFEN is the most efficient analgesic for pain or cramping.
You can also use other anti-inflammatory drugs (NSAIDs) such as Naproxen or Diclofenac. If you can’t use Ibuprofen, you can also take Tylenol (acetaminophen) or aspirin (ASA) they will help you as well.
Some women use a hot water bottle to help relieve the pain. Please, read the label of the analgesic you got and see what is the maximum dose you can take!
If you feel like the cramps you are experiencing are quite similar to what you feel during your menstrual period, or that you can endure the discomfort, then we suggest not to use any other medication or painkillers. A simple towel with hot water may be enough.
DON’T TAKE mefenamic acid (sold as Ponstan). DON’T TAKE other antispasmodics (such as Buscopan).
DON’T USE Cytotec / Misoprostol together with antacids containing magnesium because it may cause diarrhea.
F. After abortion
Bleeding and pain don’t necessarily mean that abortion was complete.
The only way to make sure you are not pregnant anymore is through an ultrasound roughly one week after taking the medication. You also have the choice of waiting 4 weeks and have a pregnancy test.
It is normal for the uterus to empty slowly for 1-3 weeks after taking the drugs. With that being said, it is okay to have light bleeding for 1 or 3 weeks.
If you have no sign of complications such as excessive bleeding, persistent pain, fever or abnormal vaginal discharge, you DON’T need a surgical intervention (such as curettage).
You can have a pregnancy test roughly four 4 weeks after the abortion. There might be a chance of getting a positive result regardless the abortion. This happens because the body still have pregnancy hormones. If this happens, you should do make an ultrasound or even repeat the test few days later.
We strongly advise you to get an ultrasound because the time you wait to make a pregnancy test may be too long if your abortion was incomplete or unsuccessful (even though it is a rare situation).
If this happens, it is important that you quickly take a second dose of Misoprostol (Cytotec-200mcg) in time so you can proceed with a medical abortion. The deadline is 12 weeks.
Symptoms: bleeding that last more than two hours and make you use more than two absorvent pads per hour. Feeling your body light or weakcan be signs of excessive blood loss. This situation is dangerous for your health and should be treated by a doctor.
Treatment: Surgical abortion (also known as vaccum aspiration). Blood transfusion is rarely required (less than 0.2% of women).
Symptoms: Intense or persistent bleeding and/or acute and persistent pain
Treatment: A surgical abortion (vaccum aspiration).
Symptoms: If you experience fever (more than 38º C) during more than 24 hours, or if the fever is higher than 39º C, then you may have an infection that requires treatment.
Treatment: Antibiotics and/or surgical abortion (vaccum aspiration)
Symptoms: a pregnancy test done 3 weeks after the abortion process that shows a positive result or a visible intact pregnancy confirmed with ultrasound 7 days after taking the pills. If the abortion failed and you decide to go on with the pregnancy, then know that there will be is a slightly increased risk of birth defects in the embryo’s hands or feet and nervous system.
Treatment: repeat the medical and/or surgical abortion.
Always seek for medical help you suspect you have suffered a complication. If there is any problem, you can always go to a hospital and say you think you had a miscarriage. The doctor will give you proper treatment.