If you vomit after taking misoprostol, it is understandable to wonder whether the abortion pill will still work. The answer depends largely on how you took misoprostol and how soon you vomited.
Misoprostol is commonly used as the second medication in a medication abortion. When taken in the cheek pouch (buccally) or under the tongue, the tablets are allowed to dissolve for about 30 minutes so the medication can be absorbed through the tissues in your mouth. If you vomit after the tablets have been in your mouth for about 30 minutes, the medication has likely already been absorbed, and vomiting usually does not mean the abortion will fail.
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If you vomit before 30 minutes, however, you should contact your abortion provider for individualized instructions. You may need to discuss whether another dose is necessary. Do not automatically repeat the medication unless your clinician or the instructions provided with your treatment tell you to do so.
If you are in California, medication abortion remains legal and available, including through telehealth in appropriate circumstances. The California Department of Public Health states that patients may be able to receive abortion medication by mail following a telehealth visit with a qualified provider.
Misoprostol is a medication that causes the uterus to contract and helps the body pass a pregnancy during a medication abortion.
Medication abortion commonly uses two medications: mifepristone, which blocks progesterone, a hormone needed to maintain pregnancy, and misoprostol, which causes uterine contractions and helps empty the uterus. Our guides on what is a medication abortion and how the abortion pill works explain this mechanism in more depth.
The FDA-approved regimen for ending an intrauterine pregnancy through 10 weeks involves mifepristone followed 24 to 48 hours later by misoprostol placed in the cheek pouch, as covered in FDA-approved abortion pills.
The exact instructions can vary depending on your pregnancy duration, medical history, the regimen prescribed by your provider, and the route of administration. Always follow the instructions given specifically for your treatment. Our guide on what to expect when you take abortion tablets walks through the standard sequence.
Medication abortion is highly effective. FDA clinical data for mifepristone followed by buccal misoprostol through 70 days showed a 97.4% complete medical abortion rate in U.S. clinical studies.
Vomiting is a known side effect of misoprostol. You may also experience nausea, diarrhea, chills, dizziness, headache, cramping, and bleeding.
The most important question is when you vomited.
If you used misoprostol between your cheek and gum or under your tongue and kept the medication in place for approximately 30 minutes before vomiting, the medicine has likely had enough time to be absorbed.
In this situation, vomiting generally does not mean that you have lost the medication or that the abortion will not work.
You should continue following your provider's instructions and monitor for expected cramping and bleeding, covered in more detail in bleeding and cramping after a medication abortion.
If you vomit while the misoprostol tablets are still dissolving in your mouth, some of the medication may not have been absorbed.
In that situation, contact your abortion provider as soon as possible. Your provider can determine whether you need additional medication based on exactly what happened, your treatment regimen, and how much medication may have been absorbed.
Do not take an extra dose on your own unless your provider or treatment instructions specifically tell you to.
Vomiting is different when misoprostol is administered vaginally.
Because the medication is absorbed through the vaginal tissues rather than the digestive system, vomiting does not remove the medication from the body in the same way it can affect medication taken by mouth.
If you vomit after using vaginal misoprostol, contact your provider if you are uncertain about whether the treatment was administered correctly or whether you need further instructions.
It is important to distinguish mifepristone from misoprostol.
Mifepristone is swallowed as a tablet, so vomiting soon after taking it can be more important than vomiting after misoprostol has already been absorbed through the mouth.
If you vomit shortly after swallowing mifepristone, contact your healthcare provider. Depending on the timing, you may need instructions about whether another dose is necessary.
The FDA-approved medication abortion regimen uses mifepristone followed by misoprostol 24 to 48 hours later, as explained in abortion pill: what to expect.
Do not assume that instructions for vomiting after misoprostol also apply to mifepristone.
Nausea and vomiting can occur around the time you take misoprostol, and gastrointestinal side effects are recognized effects of the medication.
For many people, these symptoms are temporary and improve as the medication takes effect.
Misoprostol also causes uterine contractions, which can contribute to discomfort, nausea, diarrhea, and vomiting. Some people experience stronger gastrointestinal side effects depending on how misoprostol is administered.
You may also begin experiencing abdominal cramping, vaginal bleeding, blood clots, chills, temporary fever or feeling feverish, diarrhea, nausea, and tiredness.
Cramping and bleeding are expected parts of the medication abortion process. However, symptoms should generally improve rather than become progressively worse over time. Our article on abortion pill side effects vs. complications explains where that line sits.
If you vomit after taking misoprostol, try not to panic. Instead, work through these steps.
Was it between your cheek and gum, under your tongue, vaginally, or another method specifically prescribed by your provider?
The route matters because the medication is absorbed differently.
If you used buccal or sublingual misoprostol, note whether the tablets had remained in your mouth for approximately 30 minutes.
This information is useful when speaking with your provider.
Taking additional misoprostol without instructions can expose you to unnecessary medication and side effects.
Instead, contact the clinic, telehealth provider, or medical professional who provided your abortion medication.
Expected symptoms can include bleeding and cramping. Keep track of how you feel and follow your provider's aftercare instructions. Our checklist of do's and don'ts after the abortion pill covers this stage of recovery in more detail.
If you have vomited, take small sips of water or another appropriate clear fluid when you are able to tolerate it.
If you cannot keep fluids down, contact a healthcare professional.
The important point is that vomiting by itself does not necessarily mean the medication abortion failed. Timing, administration method, bleeding, and your overall symptoms all matter.
Medication abortion is generally very safe, but serious complications can occur rarely. You should know the warning signs.
Seek urgent medical attention if you experience very heavy bleeding, particularly bleeding that rapidly soaks through multiple large pads for consecutive hours.
You should also seek medical care for symptoms such as severe or worsening abdominal pain that is not controlled with recommended pain medication, fainting or severe dizziness, significant weakness, persistent fever, severe or worsening illness, vomiting or diarrhea that continues for more than 24 hours, severe dehydration or inability to keep fluids down, and severe pain on one side of the abdomen, particularly with dizziness or fainting.
Persistent fever, vomiting, diarrhea, or feeling increasingly ill after the expected recovery period can require evaluation for infection or another complication. Our full guide on when to call a doctor after the abortion pill covers this list in more depth.
If you believe you are experiencing an emergency, do not wait for a telehealth appointment. Go to the nearest emergency department or call emergency services.
Vomiting alone cannot tell you whether a medication abortion worked.
The usual signs that misoprostol is having an effect include cramping and vaginal bleeding, which may become heavier than your normal period. You may also pass blood clots or pregnancy tissue.
The amount and timing of bleeding can vary from person to person. Some people begin bleeding relatively quickly, while others take longer. Our guide on how long it takes for the abortion pill to work covers this timeline stage by stage.
The FDA reports that most women expel the pregnancy within 2 to 24 hours of taking misoprostol, with about 90% completing expulsion within 24 hours in the studied regimen.
However, bleeding patterns are not a substitute for follow-up. Your healthcare provider may recommend a pregnancy test, blood testing, ultrasound, or another form of follow-up depending on your circumstances.
If you have no bleeding or only minimal bleeding when your provider told you to expect more, contact your provider for advice rather than taking additional medication on your own. Our guide on spotting vs. bleeding after abortion can help you tell the two apart.
Vomiting does not automatically make a medication abortion fail.
The most important factor is whether enough medication was absorbed.
For buccal or sublingual misoprostol, the tablets are designed to remain in contact with the tissues in the mouth for approximately 30 minutes. If vomiting happens after that period, the medication has likely already been absorbed.
If vomiting happens earlier, there is more uncertainty. That is why contacting your provider is important.
Medication abortion using mifepristone and misoprostol is highly effective, but no medication regimen is 100% effective. FDA clinical data show that complete abortion occurred in 97.4% of U.S. participants treated with the approved mifepristone-plus-buccal-misoprostol regimen through 70 days. If you're worried about failure more broadly, not just because of vomiting, is the abortion pill safe covers the wider safety picture.
Yes. Fertility can return quickly after an abortion, as explained in does abortion affect future pregnancies or cause infertility.
If you do not want another pregnancy, talk with a healthcare provider about contraception. Depending on your preferences and medical situation, options can include birth control pills, an implant, an IUD, an injection, a patch, a vaginal ring, condoms, or other methods.
Her Smart Choice provides educational resources about different contraception options, including its guide to birth control methods, effectiveness, safety, and side effects.
You can also learn more about birth control pills and how they work.
If you are considering contraception after a pregnancy loss or abortion, your provider can help you choose an option based on your health, preferences, and plans for future pregnancy.
Gestational age affects how the medication is dosed and what recovery typically looks like, as explained in abortion pill at 5 weeks vs. 8 weeks, medical abortion up to 10 weeks, and how far along you can take the abortion pill. If you're near the upper edge of that window, abortion at 11 weeks pregnant explains what changes once you pass it.
Breastfeeding patients and anyone unsure whether medication abortion is appropriate for their situation should review who should not take the abortion pill, abortion pill and breastfeeding safety, and is medication abortion right for me before starting treatment, since vomiting-related questions are only part of the bigger eligibility picture.
If you are in California, you may have access to medication abortion through a qualified telehealth provider.
The California Department of Public Health states that medication abortion remains available in California and that eligible patients may be able to receive abortion medication by mail after a telehealth visit with a qualified provider.
California law also protects the right to obtain abortion care before viability and allows people of any age to independently consent to abortion care, as covered in the importance of confidentiality in abortion care and how late you can have an abortion in California.
That can be especially important for someone who has questions about vomiting, medication timing, bleeding, or other symptoms but cannot easily travel to a clinic.
A telehealth consultation can allow you to speak with a qualified healthcare professional, discuss your symptoms, review the medication instructions you received, and determine whether you need additional care. See telehealth abortion safety and privacy and how telehealth abortion works in California for out-of-state patients for more on this option, and abortion care in Los Angeles, first abortion clinic visit in Huntington Park, and how much the abortion pill costs in Los Angeles if you'd rather be seen in person.
Her Smart Choice can help connect you with reproductive healthcare information and telehealth options. If you have already taken misoprostol and are concerned about vomiting, contact your abortion provider directly for individualized medical advice.
If you vomit after buccal or sublingual misoprostol has been in your mouth for about 30 minutes, the medication has likely already been absorbed. If you vomit before 30 minutes, contact your abortion provider for instructions.
Not necessarily. Vomiting after the medication has had enough time to absorb does not usually make it ineffective. Vomiting before adequate absorption may require assessment by your healthcare provider.
If you used misoprostol in your cheek or under your tongue and vomited after only 10 minutes, contact your abortion provider. Do not automatically take another dose unless you are instructed to do so.
If the tablets were held in your cheeks or under your tongue for approximately 30 minutes before you vomited, the medication has likely been absorbed. Continue following your provider's aftercare instructions.
Yes. Nausea and vomiting can occur after misoprostol. Other common effects include cramping, bleeding, diarrhea, chills, and temporary feverish feelings.
For many people, nausea and vomiting are temporary. If vomiting continues or you remain unable to keep fluids down, contact your healthcare provider. Vomiting that continues for more than 24 hours should be medically evaluated.
Vomiting alone cannot determine whether the abortion worked. Cramping and bleeding are common signs that misoprostol is taking effect, but your provider's recommended follow-up is the best way to confirm completion.
Seek medical advice if vomiting is persistent, you cannot keep fluids down, or vomiting occurs with severe pain, heavy bleeding, fainting, severe weakness, or persistent fever.
If you vomit after taking misoprostol, do not immediately assume that your medication abortion has failed.
The key question is when the vomiting happened and how you took the misoprostol. If the medication was held in your cheek or under your tongue for about 30 minutes before vomiting, it has likely had enough time to be absorbed. If you vomited sooner, contact your abortion provider for specific instructions.
Remember: vomiting can be a temporary side effect of misoprostol; vomiting after about 30 minutes of buccal or sublingual administration is generally less concerning; vomiting before 30 minutes may require guidance from your provider; do not automatically repeat a dose; monitor bleeding, cramping, fever, pain, and your overall condition; seek urgent medical care for severe bleeding, severe pain, fainting, severe weakness, persistent fever, or other serious symptoms; and if you are in California, telehealth may provide a convenient way to access medication abortion care and professional follow-up.
If you are unsure what to do after vomiting, contact the clinician or telehealth service that provided your medication rather than trying to determine the correct dose yourself.
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