Misoprostol is a medication that is frequently used with mifeprex, another medication, to terminate pregnancies up to 70 days after the first day of a person’s last menstrual cycle. However, misoprostol has many uses including inducing labor, treating postpartum hemorrhages, preventing blood loss in surgeries for uterine fibroids, birth control placements, completing miscarriages if the body is unable to expel a fetus or embryo on its own, in biopsies, and other applications.

The formulations of the misoprostol indicated for treating/preventing ulcers and the misoprostol used in the FDA approved regime for medication abortion are basically the same. 

Misoprostol is still frequently used around the world alone (i.e. not with mifeprex) for abortions and is the same ingredient as in pills used for treating and preventing ulcers, albeit under different trade names. The key component is the misoprostol itself which must be taken in much higher dosages when terminating pregnancies than when taken routinely for other purposes, including the treatment of ulcers. 

Misoprostol can be taken orally, vaginally, buccally (placing a drug between your gums and cheek to dissolve and absorb), or sublingually (placing a drug under your tongue to dissolve and absorb). 

Studies show that combining mifepristone and misoprostol typically have higher rates of successful abortion and satisfaction compared to taking misoprostol alone. However, studies show that taking misoprostol alone is still associated with a high rate of first trimester abortion, at around 80%. 

Research also shows that a higher dose of misoprostol (800 micrograms) is typically more effective than a lower dose (400 micrograms), and that the most common and likely safest and most effective route of administration was vaginal. The rate of serious adverse outcomes of misoprostol alone at any dose and administration route of misoprostol alone and with mifepristone is generally low. 

Pfizer, the maker of Cytotec, which is the brand name for their misoprostol, notes that "The recommended adult oral dose of Cytotec for reducing the risk of NSAID-induced gastric ulcers is 200 mcg four times daily with food. If this dose cannot be tolerated, a dose of 100 mcg can be used."

For pregnancy termination, the World Health Organization (WHO) notes that "For pregnancies of 12 weeks of pregnancy (84 days): The recommended method of medical abortion is 800 μg (micrograms) of misoprostol administered by vaginal or sublingual routes. Up to three repeat doses of 800 μg can be administered at intervals of at least 3 hours, but for no longer than 12 hours. For pregnancies of gestational age over 12 weeks (84 days): The recommended method of medical abortion is 400 μg of misoprostol administered vaginally or sublingually, repeated every 3 hours for up to five doses." 

Cytotec (misoprostol) can be taken on its own for "at home" abortions following the WHO protocols outlined above. However, we strongly recommend that any pregnant person seeking an abortion speak to a medical provider about obtaining a prescription for medication abortion to ensure a safe and effective protocol as well as quality assured and non-counterfeit pills. Misoprostol works best for abortion within the first 12 weeks of pregnancy. Following that window of time, the risk of complications and need for medical intervention increases. 

We should also note that not all health bodies agree on the exact doses of misopristol for abortion and not all agree on the use of misopristol after 12 weeks of pregnancy. Some international health organizations suggest only taking up to two (instead of three) repeat doses of 800 μg of misoprostol for pregnancies of gestational age up to 12 weeks. And some international health bodies do not recommend misoprostol after 12-13 weeks because of studies that suggest decreased efficacy and an increased chance of complications, and recommend instead a different type of abortion depending on gestational age.

An ultrasound is also recommended, when available, to confirm pregnancy and gestational age and rule out complications before taking misoprostol. 

Misinformation about misoprostol and medication abortion in general has been increasing in the wake of the leaked draft of the U.S. Supreme Court opinion on Roe. v Wade, which upholds abortion rights in the U.S. 

One of the misinformation narratives being spread about misoprostol has been falsely comparing misoprostol to drug ivermectin. 

Ivermectin is a drug typically used as an anti-parasitic that has been tested as a treatment for COVID-19 and shown to be ineffective and, at high doses, dangerous. Some individuals, especially online, encouraged individuals to purchase ivermectin despite lacking evidence from veterinary sources, particularly large agricultural sources that treat big animals like horses. 

This drug is being compared to misoprostol because some individuals and sources, also especially online, are encouraging individuals to purchase misoprostol from veterinary sources where the drug is used primarily to treat ulcers in animals – the same types of sources that were encouraged with ivermectin. 

While neither medication should be acquired outside of medical guidance for appropriate use, the difference between these two drugs is that there is strong data that misoprostol is effective at ending pregnancy and approved for this use by health bodies such as the U.S. Food and Drug Administration, whereas there is strong data showing that ivermectin is not effective at treating COVID-19, and is not approved by health bodies for this use.