Side effects & warning signs

Explain to your clients that after taking Misoclear it is normal to experience moderate to heavy vaginal bleeding and abdominal cramps that decrease after the pregnancy is expelled.

Women using Misoclear should expect to experience strong cramps one to three hours after taking Misoclear. This will diminish as the abortion happens. Pain killers should be provided. 

  • Women using Misoclear for medical abortion should expect vaginal bleeding that is a little heavier than an average menstrual period 
  • On average, bleeding usually continues up to 9 days, but may in rare cases continue up to 45 days. This bleeding is not heavy 
  • Women should expect to see the products of conception/clots 
  • Women might experience shivering, fever, vomiting or diarrhoea
  • The average time for expulsion of pregnancy is 7-8 hours after the first misoprostol dose

Side effects

Possible side effects and their management include:

Low grade fever - provide paracetamol and observe 

Headache - provide pain killers and observe 

Dizziness - recommend rest and an increase in fluid intake 

Nausea/vomiting - provide an anti-emetic and recommend rest 

Diarrhoea - provide an anti-diarrhoeal

Pain and cramping - provide an NSAID such as ibuprofen or paracetamol, suggest heat pack

Pain management

Most women will experience some stomach cramps and abdominal pain during a medical abortion because uterine contractions are needed to expel or push out the pregnancy.

Most of the time this pain can be managed at home. You can get painkillers from your local clinic or over the counter from your local pharmacy to help manage your pain. 

Some options they may suggest include:

Paracetamol 500mg tablets - take 1 or 2 tablets every four to six hours when required. Do not take more than 8 tablets in a 24hour period

Ibuprofen 200mg tablets - take 1 or 2 tablets every six to eight hours with food when required

Applying a heat pack or hot water bottle to below the stomach may help to ease the pain. As much as possible, you should make sure you are in a relaxed environment with supportive people there to assist you.

If you experience severe or persistent pain, you should go to your medical clinic immediately. 

Warning signs

Complications are rare with Misoclear but it is important that your clients understand that if they experience any of the following, they need to quickly seek medical help.

It is important that women know that they should seek medical help immediately if they have any of these symptoms:

  • heavy bleeding continues 
  • high fever 
  • foul smelling vaginal discharge
  • excess cramping/abdominal pain
  • excess vomiting or diarrhoea
Warning sign Management
Heavy vaginal bleeding 1. Assess for signs of low blood volume/hypovolemic.
2. If no hypervolemia, assure client, advise her to take ibuprofen, plenty of oral fluids, rest and check back if symptoms worsen.
3. If client is showing signs of hypovolemia, replace fluids and perform surgical evacuation of uterus.
4. Blood transfusion may be required in rare cases.
High fever (>100.4°F or 38°C) or more after taking misoprostol or fever that lasts more than a day This suggests infection.Treat infection with broad-spectrum antibiotic treatment and perform surgical aspiration. In the extremely rare case of severe infection or sepsis, the woman should be hospitalised for treatment.
Foul smelling vaginal discharge This suggests infection. Treat infection with broad-spectrum antibiotic treatment and perform surgical aspiration. In the extremely rare case of severe infection or sepsis, the woman should be hospitalised for treatment.
NO bleeding after 24 hours of taking misoprostol Examine clinically to rule out ectopic pregnancy and decide: a. to wait for a few more days; OR b. to give additional misoprostol; OR c. to perform vacuum aspiration.

How Misoclear can help

Do you have questions about Misoclear or its treatments?
Use the website to learn about Misoclear or get in touch with our international teams to learn more.

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