Concerns About the First Dose of RU486: What to Expect?

Regarding the first dose of RU486?

Hello Doctor: My girlfriend took the first dose on May 29th at 6 PM, and she has been experiencing bleeding, which is about the same amount as the third day of a typical menstrual period.
However, the doctor who examined her at that time mentioned that the first dose should not cause significant bleeding, but it is evident that the current amount of bleeding is considerable.
Should she still take the second dose, or can we wait until her follow-up appointment for an ultrasound examination? Thank you for your response.
Kuan

Kuan, 30~39 year old female. Ask Date: 2020/05/31

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, you should finish all the medications and return for a follow-up examination as instructed by your physician.
Wishing you good health.

Reply Date: 2020/05/31

More Info

RU486, also known as Mifepristone, is a medication primarily used for medical abortion. It is important to understand its usage, potential side effects, and the necessary follow-up care to ensure safety and effectiveness.
When a patient takes RU486, the typical dosage is 600 mg, which is usually administered as three tablets. Following this, a second medication, Misoprostol (often referred to as Cytotec), is taken 24 to 48 hours later to help expel the pregnancy. It is crucial to follow the prescribed regimen closely, as taking an insufficient dose may not lead to the desired outcome.
Regarding your concern about bleeding after the first dose, it is not uncommon for women to experience some vaginal bleeding after taking RU486. This bleeding can vary in amount and may resemble a menstrual period. However, if the bleeding is significantly heavier than a normal menstrual flow, or if it is accompanied by severe pain, dizziness, or other concerning symptoms, it is essential to seek medical attention immediately.
In most cases, women do not need to be hospitalized when taking RU486, which is one of its advantages over surgical abortion methods. However, close monitoring is necessary to ensure that the abortion is complete and to manage any potential complications. If the bleeding is excessive or if there are signs of incomplete abortion (such as persistent pain or heavy bleeding), further evaluation may be required, which could include an ultrasound or additional medical intervention.

As for the second dose of medication, it is generally recommended to proceed with taking Misoprostol as directed, unless advised otherwise by a healthcare provider. The second dose is crucial for the process to be effective, and delaying it could lead to complications or an incomplete abortion. If there are concerns about the amount of bleeding or any other symptoms, it is best to consult with the healthcare provider who prescribed the medication. They can provide guidance based on the specific situation and may recommend an ultrasound to assess the status of the pregnancy.

In terms of safety, both medical and surgical abortions have their own risks and benefits. Medical abortion with RU486 is generally considered safe when performed under the supervision of a qualified healthcare provider. However, it is essential to ensure that the pregnancy is intrauterine and that there are no contraindications to using RU486, such as certain medical conditions or medications that could interact negatively.

In summary, if your girlfriend has experienced heavier bleeding than expected after taking RU486, it is advisable to consult with her healthcare provider. They can assess her condition and determine whether she should proceed with the second dose of medication or if further evaluation is necessary. Always prioritize safety and follow medical advice closely when undergoing any form of abortion.

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