Medication Abortion: Dosage Concerns and Effectiveness

Pregnancy termination

Hello, doctor.
I would like to ask about my situation.
I am approximately 4 weeks pregnant and went to the obstetrics and gynecology department for a medical abortion using Mifepristone (also known as RU-486).
However, the doctor only prescribed one tablet for the first dose, and for the second dose two days later, I was given only two tablets.
This is different from the information I found, which states that the first dose should be three tablets.
I would like to know if taking only one tablet for the first dose will be effective in stopping the embryo from developing, or if it could lead to incomplete abortion requiring further surgical intervention.

ww, 30~39 year old female. Ask Date: 2023/04/13

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Hello, online information may not always be accurate.
Please trust your attending physician.
If you have any concerns, it is recommended to return for a consultation.
Thank you.

Reply Date: 2023/04/13

More Info

Medication abortion, also known as medical abortion, is a safe and effective method for terminating a pregnancy, especially within the first 10 weeks. The process typically involves the use of two medications: mifepristone (often referred to as "the abortion pill") and misoprostol. Mifepristone is taken first, followed by misoprostol a few days later. The dosages and administration can vary based on clinical guidelines, the healthcare provider's judgment, and the specific circumstances of the patient.

In your case, you mentioned that you were prescribed one tablet of mifepristone followed by two tablets of misoprostol. The standard regimen for mifepristone is usually 200 mg taken orally, while misoprostol is often administered as 800 mcg (four 200 mcg tablets) taken buccally (between the gums and cheek) or vaginally. However, variations in dosing can occur based on individual health considerations, provider practices, or local guidelines.

Regarding your concern about the effectiveness of the abortion with the lower dosage of mifepristone, research indicates that mifepristone is effective in terminating a pregnancy when taken as directed. The effectiveness of the medication can be influenced by several factors, including the timing of the abortion (how far along you are in your pregnancy), the specific dosages used, and individual health factors. While the standard dosage is typically more effective, a single tablet of mifepristone can still be effective, but it may not be as reliable as the recommended dosage.

If the first dose of mifepristone was lower than expected, it is essential to follow up with your healthcare provider. They can assess whether the abortion was successful through follow-up appointments, which may include an ultrasound or blood tests to check hormone levels. If the abortion is incomplete, there may be a need for additional medical intervention, which could include further medication or a surgical procedure.

It is also important to note that the risk of complications from medication abortion is low, but they can occur. Symptoms such as heavy bleeding, severe pain, or signs of infection should be reported to a healthcare provider immediately.
In summary, while the dosage you received may differ from the standard regimen, it does not necessarily mean that the abortion will be ineffective. However, it is crucial to have follow-up care to ensure that the process is complete and to address any concerns you may have. Always consult with your healthcare provider for personalized advice and guidance based on your specific situation.

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