MIFE / MISO is highly effective. The risk of ongoing pregnancy is 0.9% for pregnancies up to 49 days of gestation and 3.1% for pregnancies up to 70 days of gestation[10].
According to SOGC’s protocol for the provision of medication abortion via telemedicine, the patient should take a first dose of misoprostol buccally or vaginally 24-48 hours after taking mifepristone[7].
In addition, patients with gestational age 63 days or less should take the second dose of misoprostol if no bleeding occurs within the first 24 hours after the first misoprostol dose or as instructed by the clinician. Patients with a gestational age over 63 days should take a second dose of misoprostol 4 hours after the first dose[7].
Side Effects and Complications[10]:
Very common (≥ 10%): Nausea, vomiting, diarrhea, dizziness, headache, chills / fever, weakness, fatigue, gastric discomfort, abdominal pain, vaginal bleeding, spotting, uterine contractions or cramping.
Common (1-10%): Fainting, light or moderate gastrointestinal cramping, prolonged post-abortion bleeding, endometritis, breast tenderness, heavy bleeding (may or may not require surgical termination of pregnancy).
Uncommon (0.1-1%): Arrhythmia, hemorrhagic shock, salpingitis, heavy bleeding requiring IV fluids or blood transfusion, infection, hot flushes, hypotension, bronchospasm, skin rash / pruritus.
