Misoprostol is the go-to pill for many women seeking to safely terminate their pregnancies.
According to research, misoprostol is remarkably safer and more effective than many abortion pills. The drug is generally recommended for women seeking to end their pregnancies in the first trimester.
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But like most abortion pills, misoprostol isn’t without risks. Understanding the drug’s potential adverse events is critical in managing your expectations.
In this post, we examine some of the common and rare side effects to expect when using misoprostol for abortion.
Unpacking Misoprostol
Misoprostol is a synthetic prostaglandin medication commonly used to induce abortion. It’s widely considered one of the safest abortion pills around.
However, there are misoprostol side effects to be aware of. These adverse events can range from mild episodes of diarrhea to severe abdominal cramping.
In rare cases, misoprostol may cause severe hypersensitivity and dermatological and cardiovascular reactions.
How Did Misoprostol Become So Popular?
Although misoprostol is widely used to terminate pregnancies, the drug was originally developed in 1973 as a treatment for gastric ulcers. It was first associated with abortion in Latin America in the ‘80s due to widespread miscarriage reports among female users.
Many contemporary pharmacies still prescribe misoprostol for treating gastric ulcers.
Other popular therapeutic applications include relieving duodenal ulcers, inducing labor, and managing postpartum bleeding.
How Does Misoprostol Work?
Misoprostol is a synthetic prostaglandin.
Prostaglandin is a hormone-like substance involved in various reproductive processes in women. It notably plays a critical role in labor and abortion, although it’s also involved in menstruation, ovulation, and pregnancy.
One study found that prostaglandin suppositories can induce labor and abortion by encouraging uterine evacuation. The hormone’s role as an active contractile agent enables it to safely expel fetal remains during abortions or stillbirths.
As a synthetic prostaglandin, misoprostol displays the same biological mechanism as the natural hormone. The pill activates prostaglandin activity by impacting the body’s signaling of prostaglandin (EP2, EP3, and EP4) receptors.
Some research suggests that misoprostol induces myometrial contractions by binding to myometrial cells, effectively expelling fetal tissues.
Further, the pill dilates and softens the cervix. This mechanism minimizes contraction pain as the fetal remains are ejected from the body.
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Popular Delivery Methods
Misoprostol is commonly administered orally. You can either consume the pills sublingually (slipping them underneath your tongue) or buccally (putting them inside your cheeks). Both delivery methods are remarkably effective due to their high bioavailability (absorption rate).
To unlock misoprostol’s potent effects, place two pills under your tongue and hold them for up to 30 minutes. The active ingredients will enter your bloodstream almost immediately via the sublingual glands.
Besides oral consumption, you may also administer misoprostol vaginally or rectally. The latter route is commonly recommended for treating postpartum bleeding.
You could also consider swallowing misoprostol pills. However, this delivery method is the least effective due to its lower bioavailability.
Sublingual, buccal, and vaginal routes produce greater efficacy when taking misoprostol for abortion.
Common Misoprostol Side Effects
As misoprostol is commonly administered orally (be it sublingually, buccally, or by swallowing), it’s unsurprising that the most common side effects are gastrointestinal. Most users report diarrhea.
Taking misoprostol by mouth may also induce vomiting, abdominal cramping, and diarrhea. Besides, some users experience dyspepsia and headaches.
Note that the adverse effects from oral misoprostol typically set faster if the pill is sublingually administered. That’s because much of the drug enters your system and fast.
Other common side effects of misoprostol include vaginal bleeding and uterine cramping. The bleeding and cramping tend to be more severe than those experienced during regular menstruation.
Rare Misoprostol Side Effects
Gastrointestinal Side Effects
- Gastrointestinal bleeding
- Gastrointestinal infection and/or inflammation
- Severe diarrhea
- Rectal disorder
- Reflux
- Dysphagia
- Gingivitis
Dermatological Side Effects
- Increased sweating
- Alopecia
- Dermatitis
Allergic Reactions
- Persistent itching due to skin rashes, particularly hives
- Fever
- Breathing problems, such as wheezing
- Dizziness or lightheadedness
- Trouble swallowing due to throat tightness
- Swollen lymph nodes
- Swollen face, lips, tongue, or throat
- Muscle cramps
- Joint pain
Cardiovascular Side Effects
- Elevated heart rate
- High or low blood pressure
- Chest pain
- Arrhythmias
- Coronary artery spasms
- Arterial thrombosis
- Amniotic fluid embolism
- Heart attack
Nervous System Side Effects
- Abnormal taste
- Neuropathy
- Drowsiness
Mortality
Misoprostol may cause uterine rupture in sporadic cases, resulting in fatal bleeding.
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Complications
Misoprostol complications are extremely rare but not entirely nonexistent.
Multiple studies have shown that about 12% of all pregnancies following misoprostol-induced abortions may result in birth defects. Various anecdotal reports also associate the pill with ectopic pregnancy, although most of these claims are yet to be scientifically proven.
Moreover, there have been maternal deaths related to misoprostol overdose.
Tips for Managing Misoprostol Side Effects
1. Stick to the Recommended Doses
Most misoprostol adverse events result from overdose. Therefore, following proper dosage guidelines is the best way to avoid these unpleasant reactions.
A single dose is safe for vaginally, buccally, or sublingually administered misoprostol. The pill is commonly available in 100 mcg or 200 mcg oral doses.
2. Pick a Suitable Delivery Method
Orally administered misoprostol causes the most side effects. These range from gastrointestinal reactions to nervous system issues and even cardiovascular problems.
To lower the risks of adverse events, consider taking misoprostol rectally. However, the rectal route is generally effective for postpartum bleeding but not very reliable at inducing complete abortion.
3. Take Misoprostol Alone
Although misoprostol is commonly co-administered with mifepristone or methotrexate, the drug is still potent if used alone. Besides, taking misoprostol by itself presents fewer risks of side effects.
Note that both mifepristone and methotrexate may produce their distinct adverse events. Mifepristone is associated with fever, chills, muscle pain, and sore throat, whereas methotrexate can induce abdominal cramps, vaginal itchiness, and headaches.
4. Take Misoprostol Alongside Meals
While misoprostol is safer when administered alone than alongside other abortion pills, don’t take the drug on an empty stomach. The idea is to lessen the intensity of abdominal cramping, which tends to be more severe on an empty stomach.
However, choose your foods wisely. Prioritize fiber-rich diets to combat misoprostol-induced diarrhea and constipation.
5. Cut Back On Exercise
It’s best to limit physical activity while on a misoprostol prescription.
Not only can excessive exercise worsen abdominal discomfort during abortion. It could also exacerbate bleeding.
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The Bottom Line
Misoprostol is considerably safer and more effective than many abortion pills. Even if adverse events occur, they’re usually mild.
However, misoprostol may trigger specific life-threatening reactions in rare cases.
The best way to minimize the drug side effects is to consult a board-certified clinician before administering it. It’s also prudent to follow misoprostol’s dosage recommendations.
Besides, take the drug alongside a meal and cut back on physical activity during the period to minimize abdominal cramps.
