Today, _______________________, you took a pill called Mifepristone (also called RU-486 or Mifeprex) to end your pregnancy. You took 200 milligrams of Mifepristone at ___________ AM/PM.

You will probably not feel any different after taking this pill. (You may have some vaginal bleeding.) You can continue all of your regular activities.

On,_____/_______/_____, after _____AM/PM, you will put 4 pills of another medicine, Misoprostol (also called Cytotec), inside your cheek, 2 on each side, as I have shown you. Each Misoprostol pill is 200 micrograms. You must use these pills even if you have already started to bleed

After putting these pills in your cheek, you should let them melt for 20- 30 minutes. This lets the medicine get absorbed into your body. After 20-30 minutes, if any of the pills are left in your mouth, you can swallow them with water or juice. I suggest that you put on a maxi pad in case you start bleeding heavily.

Symptoms to Expect:
Misoprostol (the second medicine) causes cramping and bleeding, often with clots. The cramps and bleeding may be much more than you get with a period. The clots may be bigger than with your period. The cramps usually start 2 to 4 hours after you insert the pills, and may last for 3 to 5 hours. Although you may have a lot of bleeding, it is usually not dangerous; this means that the treatment is working. The bleeding is usually heavy for the first few hours, but may continue for 2 weeks. During this time, the bleeding is usually lighter and may stop and start several times.

I have given you prescriptions for Ibuprofen 400 mg and Vicodin (5 mg hydrocodone/500 mg APAP). You can swallow 1 or 2 hydrocodone/APAP before you put the misoprostol inside your cheek, to prevent strong cramps. If you continue to have a lot of pain or cramps you can use the ibuprofen or more of the vicodin, or both.

You can also use a heating pad, or drink some warm tea, or soup, to relieve the pain.

Some women get nausea or diarrhea right after the second medicine. This does not mean anything is wrong.

If you have questions or concerns:
You can call [Your telephone or pager number here] If you don’t bleed at all after several hours, if you are soaking more than 2 maxi pads an hour for 2 hours, or if your pain isn’t helped by the medicine, please be sure to call. If you have a fever over 100.40F (380 C), or if you get strong stomach pain or “feel sick” more than 24 hours after using the second medicine, call right away. If you have other questions, think something is going wrong, or think you have an emergency, you should page us. Please be sure to turn off call blocking on your phone, so we can call you back.

You have an appointment to come back to [Your health center name here] on _____________________ at ______ AM/PM. At this visit I will make sure that the abortion is complete. If you want to use Depo-Provera (the shot), or an IUD, or a diaphragm, I will give it to you that day.

Birth Control Pills, Patch, or Ring:If you want to use birth control pills, the patch, or the ring, I have given you a prescription. You should start these on Sunday ___________________________, even if you are still bleeding.

Emergency Contraception (EC): I have given you a prescription for EC---PlanB--- in case you have sex without protection and do not want to get pregnant.

If you go to the Emergency Room, please take this paper and show it to the doctors there.