A: A few hours after misoprostol administration, the person should expect bleeding heavier than a regular period with clots for 2-4 hours. If the pregnancy is less than 56 days gestation, they may pass tissue but not an obvious fetus. After 56 days, when the tissue is passed, fetal tissue may dissemble. Cramping and pain will occur before and at the time of expulsion^[16]. Misoprostol can cause diarrhea, chills and fever, nausea, vomiting, headache and dizziness^[17-20].

A: The person under 18 more frequently report pain as compared to adults when using MIFE200 / MISO8005. Higher doses of misoprostol and older gestational age are also associated with more pain^[21]. Less pain is reported by person with previous deliveries^[21].

A: NSAIDs for pain control can be used in most instances, such as ibuprofen 200-400 mg every 8 hours or naproxen 225-500 mg every 12 hours on an as-needed basis^[21]. A mild opioid analgesic (e.g., codeine or oxycodone) prescription can also be offered as need to treat significant cramping or severe pain^[21]. Dimenhydrinate, ondansetron, or diclectin can be offered to manage nausea.

A: If, after the abortion, for more than 2 consecutive hours the person is soaking 2 maxi pads per hour and / or if they are experiencing dizziness, light-headedness or a racing heart rate, this is "too much bleeding"^[16]. You should provide the person with access to emergency medical care directly or via telephone^[22].

A: Misoprostol is rapidly absorbed when administered buccally. Consensus suggests that most prescribers would evaluate the effect of the absorbed misoprostol over the first 48 hours. Should the pharmacist be certain that the dose was vomited in less than 30 minutes, they could follow-up directly with the prescribing healthcare prescriber to advise them of the situation.

In the CAPS Pharmacist Resource Guide for Dispensing Mifegymiso, it states:

• If vomiting occurs during buccal absorption of MISO, contact prescriber for assessment. If there is not any bleeding within 48 hours of MISO administration, another dose may be required.
• After swallowing MISO fragments 30 minutes after buccal administration: no action required; medication has already been absorbed.

A: Symptoms are vague and include general malaise with nausea, vomiting, and diarrhea, weakness, absence of fever (or mild fever), minimal abdominal pain, flu-like symptoms, hypotension, tachycardia, edema, high hemoglobin level (hemoconcentration) and a high white blood cell count^[23-25].