Here you’ll find frequently asked questions about Mariprist, how to use it for medical abortion, and what you can expect from the procedure. If you can’t find what you’re looking for here, speak to your doctor or contact us.

Taking Mariprist

• What order should I take the pills in?
• How do I take Mariprist pills?
• Should I wait 24 or 48 hours after taking the mifepristone to take the misoprostol?
• Should I take the misoprostol sublingually (under the tongue) or vaginally?
• What happens if I vomit or swallow the misoprostol tablets before 30 minutes have passed?
• How will I know the abortion is working?
• What should I expect when the medicines take effect?
• I have taken the mifepristone and misoprostol but have had no bleeding for 24 hours. Can I repeat the process and take the tablets again?
• How do I know if the abortion was unsuccessful?
• Is there a risk of birth defects in case the pregnancy is not terminated?
• I am exactly 9 weeks pregnant, can I still take Mariprist for abortion?
• Can I use Mariprist abortion pill more than once in a year?
• Can I use Mariprist if I’m still breastfeeding?
• Is there an age restriction for medical abortion?

Side effects of Mariprist

• How long do symptoms last?
• What should I do if I don’t have any bleeding?
• What can I do to ease the pain?
• How will Mariprist affect my periods?

After taking Mariprist

• How will I feel mentally after taking the abortion pill?
• Will medical abortion have long-term effects on my health?
• How soon can I have sex after taking Mariprist?
• How can I prevent future pregnancy?

Other questions about Mariprist

• How is Mariprist stored?

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What order should I take the pills in?

The Mariprist pack contains 1 mifepristone tablet and 4 misoprostol tablets. The mifepristone is taken first, followed by the misoprostol tablets 24-48 hours later.

How do I take Mariprist pills?

1. Swallow one tablet of mifepristone with water. You should wait 24 hours before moving on to step 2, but wait no longer than 48 hours.
2. Place four tablets of misoprostol under the tongue, and hold them there for 30 minutes while they dissolve. Do not eat or drink anything during these 30 minutes. After the 30 minutes has passed, swallow what is left in your mouth with water.

The misoprostol can also be placed in the vagina. However, the pills dissolve faster under the tongue.

Should I wait 24 or 48 hours after taking the mifepristone to take the misoprostol?

You should wait 24 hours before taking the misoprostol but no longer than 48 hours. Take the misoprostol when it best suits you during this time. There is no right or wrong time. Make sure you’re comfortable and have time for the process to begin.

Should I take the misoprostol sublingually (under the tongue) or vaginally?

The misoprostol will be just as effective if you put them under the tongue or in the vagina. The pills dissolve faster under the tongue and can be viewed as being more private.

You may have fewer side effects if you take the misoprostol vaginally. However, if you are experiencing any bleeding from the vagina, you should not take the tablets vaginally.

What happens if I vomit or swallow the misoprostol tablets before 30 minutes have passed?

If you vomit during the 30 minutes that the misoprostol pills are under your tongue, or swallow them before 30 minutes have passed, it is likely they will not work. In this case, it is necessary to immediately repeat the step you are on. If you vomit after the pills have been under your tongue for 30 minutes, there is no need to repeat that step, as the pills have already absorbed into your system.

How will I know the abortion is working?

Cramping and bleeding may begin as quickly as 30 minutes after taking the 4 misoprostol pills. However, bleeding usually begins within 3-4 hours of using misoprostol. The bleeding should be similar to or heavier than your normal menstrual period. These are signs the abortion is working.

What should I expect when the medicines take effect?

It’s normal to see large blood clots (up to the size of a lemon) or clumps of tissue when this is happening. It is similar to having a really heavy, crampy period, and the process is very similar to an early miscarriage. You might have chills, feel sick or experience vomiting or diarrhoea. Once the pregnancy passes, the amount of bleeding should noticeably reduce. You can read more about side effects here.

I have taken the mifepristone and misoprostol but have had no bleeding for 24 hours. Can I repeat the process and take the tablets again?

If you have had no bleeding, and if your provider or pharmacist has given you extra misoprostol pills, you can take 4 more misoprostol tablets in the same way as the others. There is no need to take the mifepristone tablet again.

If you still don’t have any bleeding 24 hours after taking the extra pills, call a healthcare provider or an MSI Reproductive Choices Contact Centre.

How do I know if the abortion was unsuccessful?

If you haven’t bled or had cramps since taking Mariprist, or you are still experiencing signs of pregnancy such as nausea, breast tenderness, etc. you may still be pregnant. A healthcare provider can perform a pelvic examination or ultrasound to be sure, or you can contact us for further advice.

Is there a risk of birth defects in case the pregnancy is not terminated?

There is a slight risk of birth defects in the event of an on-going pregnancy following misoprostol use. The risk is estimated at less than 1%.

I am exactly 9 weeks pregnant, can I still take Mariprist for abortion?

You can still take Mariprist if your last menstrual period was exactly 9 weeks ago. If it is any later than this, please contact a health professional or an MSI Reproductive Choices contact centre.

Can I use Mariprist abortion pill more than once in a year?

It is safe to use Mariprist more than once in a year. Taking Mariprist is very unlikely to affect your health, including the possibility of getting pregnant in the future.

Can I use Mariprist if I’m still breastfeeding?

Yes, if you are breastfeeding you can take mifepristone and misoprostol for medical abortion. There is no evidence to suggest that either medication is harmful to babies. Misoprostol enters breast milk soon after taken, and it is likely that mifepristone does as well. If you are worried you can breastfeed immediately before taking the Mariprist tablets or wait four to five hours after taking all of the tablets.

Is there an age restriction for medical abortion?

There is no age limit for using Mariprist, however there may be local regulations regarding the use of products for minors which should be taken into consideration.

How long do symptoms last?

The cramping and bleeding can last for several hours. Most people finish passing the pregnancy tissue in 4-5 hours, but you don’t need to worry if it happens sooner or later than this. The cramping and bleeding slows down after the pregnancy tissue comes out.

You may have cramping on and off for 1 or 2 more days. It’s normal to have some bleeding and spotting for several weeks after your abortion. Using menstrual pads can help you track how much you bleed. You can read more about side effects here.

What should I do if I don’t have any bleeding?

If you don’t have any bleeding within 24 hours after taking the second medicine (misoprostol) call your nurse, doctor or local MSI Reproductive Choices contact centre.

What can I do to ease the pain?

• Take pain medication like ibuprofen or paracetamol. Aspirin isn’t recommended because it can make your bleeding worse.
• Put a heating pad or hot water bottle on your belly.
• Take a shower.
• Sit on the toilet.
• Have someone rub your back.

How will Mariprist affect my periods?

It’s normal to bleed and spot off and on for several weeks after taking the abortion pill. Your period should go back to normal 4-8 weeks after your abortion. If you haven’t had a period 4 weeks after your treatment and are worried, you could do a pregnancy test to make sure the treatment worked.

How will I feel mentally after taking the abortion pill?

After an abortion most women feel relieved, but some also feel sad or guilty. Occasionally, although you might feel well physically, it could lead to an emotional struggle. This range of emotions is completely normal. It can help to talk to someone you trust about how you are feeling, or call an MSI Reproductive Choices contact centre.

Will medical abortion have long-term effects on my health?

There is no evidence to show any adverse long-term effects on a woman’s health due to medical abortion.

How soon can I have sex after taking Mariprist?

You can have sex as soon as the bleeding has stopped, and you feel ready. Remember that you can get pregnant again soon after an abortion, so you will need to use contraception if you want to avoid pregnancy.

How can I prevent future pregnancy?

Contraception can help you avoid unwanted pregnancies. There are a number of methods and which one is right for you will depend on your circumstances. Find out about short term, long term and permanent methods of contraception on this website.

How is Mariprist stored?

Mariprist should be stored between 50°F (10°C) – 77°F (25°C), and protected from moisture and humid conditions where possible.