Misoprostol Dosage: Practical Guide to Common Doses

Misoprostol is used for different things: medical abortion, preventing or treating postpartum hemorrhage (PPH), inducing labor, and protecting the stomach from ulcers when taking NSAIDs. The dose and route change a lot depending on use. Below you’ll find common, real-world dosing patterns, how to take the tablets, and clear safety tips. Don’t use this as a prescription—talk to a clinician before taking misoprostol.

Common dosing regimens

Medical abortion (most common modern approach): the typical regimen is mifepristone 200 mg orally followed 24–48 hours later by misoprostol 800 mcg. Misoprostol can be given buccal, sublingual, or vaginal for this purpose. If only misoprostol is available, many protocols use 800 mcg buccal or sublingual, repeated every 3 hours for up to three doses, or 800 mcg vaginal every 6–12 hours up to three doses. One 200 mcg tablet is the usual unit size, so 800 mcg = four 200 mcg tablets.

Postpartum hemorrhage (PPH): when oxytocin is not available, WHO-style guidance commonly uses 600 mcg orally once to prevent PPH after delivery. For treating severe bleeding when injectable uterotonics aren’t available, a single 800 mcg sublingual dose is often used because it acts quickly.

Gastric protection / ulcer prevention (off-label use of Cytotec): typical clinic dosing for NSAID-related gastric protection is 200 mcg two to four times daily (often 200 mcg QID). This is different from reproductive uses and should be supervised by a doctor.

Labor induction / cervical ripening: low doses are used because the uterus is sensitive—commonly 25 mcg vaginally every 4–6 hours. This must be done in a monitored setting because higher doses can cause strong contractions and risk uterine rupture in certain patients.

How to take it and safety tips

Tablets are usually 200 mcg. Routes change how fast the drug works: sublingual and buccal act faster and give higher peak levels; vaginal absorbs slower but stays steady; rectal can be used when vomiting or to reduce fever/diarrhea. For many regimens, four 200 mcg tablets = 800 mcg.

Common side effects: cramping, heavy bleeding (in abortion uses), fever, chills, nausea, vomiting, and diarrhea. Seek urgent care for very heavy bleeding (soaking more than two pads per hour for multiple hours), fainting, severe abdominal pain, or signs of infection (high fever, bad-smelling discharge).

Warnings: don’t use misoprostol if you have an untreated ectopic pregnancy. Women with prior uterine surgery need special evaluation before induction. Always confirm pregnancy location and talk to a healthcare professional about risks and proper follow-up.

Storage and practical notes: keep tablets dry and at room temperature; protect from moisture. Because dosing varies widely by use and route, avoid self-prescribing. If you’re considering misoprostol for any reason, contact a licensed clinician or local health service for the correct regimen and safe supervision.