Premedication and supportive treatment in medical abortion

Premedication and supportive treatment are prescribed by providers of medical abortion to minimise the expected pain and nausea after taking mifepristone and misoprostol.

Most individuals undergoing medical abortion experience pain, so analgesia is usually required. Evidence is insufficient to support choice of one analgesic regimen over another; consider patient preference and previous experience with pain. A nonsteroidal anti-inflammatory drug (eg ibuprofen) is usually given before misoprostol (unless contraindicated). An oral opioid should be discussed with all individuals undergoing medical abortion. Consider giving prophylactically 30 to 60 minutes before misoprostol. For analgesic dosages, see Oral drugs for moderate acute nociceptive pain in adults.

Offer an antiemetic (eg ondansetron, metoclopramide) before both mifepristone and misoprostol, especially if pregnancy-induced nausea or vomiting is present; see Antiemetic drugs for dosages.