From the Research
In India, medical abortion is permitted up to 9 weeks (63 days) of gestation as per government guidelines, and the recommended regimen involves a combination of Mifepristone followed by Misoprostol, with a high effectiveness rate of 95% as reported in the most recent study 1.
Treatment Guidelines
The treatment guidelines for medical abortion in India involve the following steps:
- First, 200 mg of Mifepristone is taken orally under medical supervision.
- Then, 24-48 hours later, 400 mcg of Misoprostol is administered, either buccally (between cheek and gums), sublingually (under the tongue), or vaginally.
- Patients should be informed about expected bleeding and cramping, which indicates the abortion process is working.
- Pain management can include NSAIDs like ibuprofen (400 mg every 4-6 hours as needed).
Pharmacy Advice
Pharmacy advice for medical abortion includes:
- Ensuring that patients understand the regimen and the potential side effects.
- Providing clear instructions on how to take the medication and what to expect.
- Advising patients to seek immediate medical attention if they experience excessive bleeding, severe abdominal pain, fever above 100.4°F, or foul-smelling vaginal discharge.
- Discussing contraception options during the follow-up visit.
Effectiveness and Safety
The effectiveness and safety of medical abortion regimens consisting of mifepristone followed by buccal misoprostol have been extensively studied, with a systematic review reporting an overall efficacy of 96.7% and a continuing pregnancy rate of 0.8% in approximately 33,000 pregnancies through 63 days of gestation 2.
Important Considerations
It is essential to note that the majority of facilities that provide medical abortion in India are in the private sector and located in urban areas, with a high proportion of facilities reporting that women typically take the medication at home 3.