Client Instructions
How to Take the Pills for Your Abortion and What to Expect – BUCCAL
You will take 2 sets of pills for your abortion. These pills have close to the same
name, but are different. You will take a pill at the clinic on DAY 1. You will take
other pills at home on DAY 2 or on Day 3.
 The pill you will take at the clinic (DAY 1) is called mifepristone (the “brand” name is
Mifeprex®).
 The pills you will take at home (DAY 2 or 3) are called misoprostol (the “brand”
name is Cytotec®).
DAY 1 – TODAY
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You will take a mifepristone pill at the clinic.
You will also get antibiotic pills to take. Take one pill in the morning and one pill
in the evening. Please make sure that you take ALL of the antibiotics we give
you. Make sure to take these pills with food.
We will send you home with 2 prescriptions; one to help with nausea & one to help
manage pain. You will need to fill these prescriptions at your local pharmacy.
GETTING READY FOR DAY 2 or 3
You will bleed and have cramps after you take the misoprostol pills at home. So you’ll
want to plan ahead before you take them.
 Choose a time when you can be private and rest for a while after you take them.
 Plan to have someone you trust on hand to help you out.
 Go to your local pharmacy to fill the prescriptions we gave you.
 Buy maxi pads, pain medicine, food, and anything else you will need to make
yourself relaxed.
 Have books or videos to help you pass the time.
DAY 2 or 3
How do I take the misoprostol pills?
You will take the misoprostol pills at home on Day 2 or 3 (24-48 hours after taking the
mifepristone at the clinic).
Follow these steps:
 Take 1 anti-nausea pill (the prescription we gave you). Wait 30 minutes.
 Take 2 pain pills (the prescription we gave you). Wait 30 minutes.
 Take the 4 misoprostol pills. Put 2 pills on one side of your mouth and the other 2
on the other side of your mouth. Wait 30 minutes for the pills to dissolve. After 30
minutes, swallow what is left of the pills. (see picture on next page).
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2 pills on each side
Some women will throw up shortly after swallowing the Misoprostol. This is okay, the
medicine was absorbed through your cheeks.
Take ibuprofen once cramping begins. Follow the directions on the bottle. Do NOT
take aspirin because it will make you bleed more.
DAY 2 or 3
What will happen to me after I take the misoprostol pills?
It is normal to cramp and bleed. Cramping and bleeding often start 2 to 4 hours after
you take the pills. It can last for hours. It is heaviest when the pregnancy comes out.
The pregnancy is very small. You may not see it. You might see it if you are more than
8 weeks (2 months) pregnant. At 8 weeks, the fetus is about ¼ to ½ inch. Cramping and
bleeding will slow down after it comes out.
Things to know:
 Bleeding can be heavy. You may see large blood clots the size of a lemon.
 You may feel sick to your stomach.
 You could have diarrhea.
 You could have mild fever or chills for a little while.
Your cramps may be strong. To feel better, you can:
 Take your pain pills.
 Put a hot water bottle or heating pad on your belly.
 Take a shower.
 Sit on the toilet.
 Have someone rub your back.
We recommend you use either of these two medications as your main pain medication.
Do not wait until you are in a lot of pain before taking the pain medication!

Ibuprofen 200 mg (Advil, Motrin IB, other over-the-counter products) – three
tablets (600 mg) every 6 hours or four tablets (800 mg) every 8 hours. Maximum
2400 mg (12 tablets) in 24 hours.
OR

Naproxen 220mg (Aleve) – one or two tablets every 8-12 hours. Maximum
1375mg in 24 hours. Take the maximum dose for only a short period of time (2448 hours).
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Other pain medications you can take in addition to Ibuprofen or Naproxen if you need
better pain control are:
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Acetaminophen (Tylenol and other over-the-counter products) three 325 mg
tablets or two 500 mg tablets every 4-6 hours (maximum 4000 mg in 24 hours)
OR
Acetaminophen with codeine (Tylenol #3 – one or two tablets every 4-6 hours
(maximum 12 tablets in 24 hours). Those to are unable to take Percocet may be
given a prescription for this medication to fill at a pharmacy.
OR
Oxycodone/acetaminophen (Percocet) – one tablet every 4 hours (maximum 6
tablets in 24 hours). You will be given a prescription for this medication to fill at a
pharmacy.
How will I feel after the pregnancy comes out?
Bleeding — It is normal to bleed. You may have little or no bleeding for a few days or
weeks. Bleeding may stop and then start again. You may bleed like a normal menstrual
period for 1 or 2 weeks. It should get lighter and lighter. You should have your normal
period again 4 to 8 weeks later. It is common that your first period after the abortion
will be heavier than normal and some women have an episode of heavy bleeding
and cramping 3 to 5 weeks after taking the abortion pills. Please refer to the
emergency section listed below on when to call us.
Cramping — You will cramp less and less as the hours and days go by.
Fever and chills — You may have fever and chills the day you take the misoprostol
pills. It is NOT normal to have a fever after that. Call us right away if you do. It could be
a sign that you are getting an infection.
Breast Changes — Tenderness should go away in a few days. You may leak a milky
discharge. Wear a snug-fitting bra if you do. This should stop in 1 or 2 days.
Nausea — This should go away in 1 or 2 days after you take the misoprostol pills.
Feeling Tired — You may feel tired for 1 or 2 days. You should be back to normal
soon.
Activity — You can go back to your usual activities – school, work, driving – as soon as
you feel up to it. Do NOT do hard work or heavy exercise for several days. This
includes swimming, lifting heavy things, bicycling, or jogging. You should start to feel
better each day after. Please call us if you don’t feel better.
What about other things I should know?
Should I use tampons or maxi pads?
Using maxi pads makes it easier to tell how much you are bleeding. You can use
tampons when the heavy bleeding lets up.
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When can I have sex?
You should wait a week (7 days) before having sex.
 Please note; a pregnancy test can still be positive for up to six weeks after
the abortion pill.
What should I do about birth control?
Start your birth control as you were told by the clinic staff. We can help you if you haven’t
chosen a method yet. You can get condoms, female condoms, sponges, and
spermicide at your drugstore. If you have unprotected sex or the condom breaks, you
can use emergency contraception (EC), also known as the morning-after pill. EC can
help stop you from getting pregnant if taken within 120 hours of unprotected sex. You
can get EC from the drugstore or at one of our clinics.
EMERGENCIES
Call our 24-hour emergency number at 1-888-506-9259 if ANY of these things
happen:
 A temperature of 100.4°F or higher the day after you’ve taken the misoprostol. A
fever the day you take the misoprostol can be a normal side effect.
 You soak more than 2 maxi pads an hour for more than 2 hours in a row.
 You pass “big” (larger than the size of a lemon) blood clots for more than 2 hours in a
row.
 You bleed heavily for more than 12 hours in a row
 You throw-up for more than 4 to 6 hours and/or can’t eat or drink for more than 4 to 6
hours.
 Pills, rest, a hot water bottle, or heating pads don’t help with abdominal pain or
cramps
 You are weak, feel sick to your stomach, have abdominal pain or discomfort, throwup or have diarrhea for more than 24 hours after taking misoprostol pills. All of
these could be signs of serious infection.
Call us if you have ANY of these happen to you.
Do NOT wait for your follow-up visit.
If you need to call, tell us:
1. How many maxi pads you have used in the past hour (60 minutes).
2. The phone number and name of an “open” drugstore that you can get to.
3. Your temperature (fever) in the past hour (60 minutes).
Your Follow-Up Visit
Your health is important to us. Please come back to our clinic for a follow-up visit
after your abortion. We are here to help you. We want to make sure that the
pregnancy ended and that you are well. Please call us to set up another appointment if
you are unable to keep this one.
Follow Up Visit: Date: ____/_____/____ Time: _________ Location: ______________
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