Methotrexate and Misoprostol for Abortion

Methotrexate and misoprostol use is a two-step method.

• First, methotrexate tablets are taken by mouth or an injection of methotrexate is given by your doctor. Methotrexate interferes with the growth of the Reference placenta Opens New Window, which allows it to separate from the Reference endometrium Opens New Window. This is an Reference unlabeled use Opens New Window of methotrexate. For reference, see a picture of the Reference reproductive organs Opens New Window Reference Opens New Window.
• Second, tablets of misoprostol are taken by mouth or inserted vaginally, usually 5 to 7 days later. Some doctors may give misoprostol buccally (dissolved between the gums and cheek). This medicine causes uterine contractions so that your body passes the uterine contents. The pregnancy usually ends at home within a day or two when the tissue from the uterus is passed.

A medical abortion usually requires at least two visits to your doctor over several weeks. For the first visit, one medicine is taken during the visit and a second medicine is given to be taken at home. The second visit is a follow-up appointment and is usually scheduled about 2 weeks after the first visit to make sure the abortion is complete and no complications are present. If a medical abortion is unsuccessful, a surgical abortion must be done to complete the process. (A fetus may not develop normally after exposure to methotrexate or misoprostol.)

You may also take pain medicine by mouth for this procedure.

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