Expected effects after taking misoprostol

Central lower abdominal cramping usually begins within 2 hours of taking misoprostol, and almost always begins within 4 hours. The pain is usually more severe than dysmenorrhoea; the median pain score is 6 out of 10 on a visual analogue scale. It generally decreases once the products of conception are passed (usually within 4 hours of taking misoprostol) but can persist for several days. If pain persists or worsens a week or more after taking misoprostol, consider the possibility of infection.

Bleeding usually starts after cramping. It is expected to be heavier than the regular menstrual period, and clots are typically passed. The gestational sac is not usually observed, but is more likely with later gestations; this can be distressing. Bleeding decreases after the products of conception are passed, but can continue similar to heavy days of the regular menstrual period for 5 to 7 days. Bleeding usually stops by day 14, although it can persist for 4 to 5 weeks. Atypical bleeding may indicate a complication of medical abortion.