WHO Guideline (2022)[1] | FIGO Guideline (2023)[2] | SFP Guidelines (2024)[3,4] | |||
Gestational age | Misoprostol dosing | Gestational age | Misoprostol dosing | Gestational age | Misoprostol dosing |
<12 weeks | Buccal, intravaginal*, sublingual: 800 mcg¶ | <12 weeks | Buccal, sublingual, intravaginal*: 800 mcg every 3 hours until expulsionΔ◊ | ≤12 weeks | Sublingual, intravaginal: 800 mcg every 3 hours for 3 to 4 doses until expulsion |
≥12 weeks | Buccal, intravaginal*, sublingual: 400 mcg every 3 hoursΔ | 13 to 24 weeks | Buccal, sublingual, intravaginal*: 400 mcg every 3 hours until expulsionΔ§ | 14 0/7 to 23 6/7 weeks | Buccal, sublingual, intravaginal: 400 mcg every 3 hours until expulsionΔ |
25 to 27 weeks | Buccal, sublingual, intravaginal*: 200 mcg every 4 hours until expulsionΔ¥‡ | 24 0/7 to 27 6/7 weeks | Buccal, intravaginal: 200 mcg every 3 hours until expulsionΔ | ||
≥28 weeks | Intravaginal*: 25 to 50 mcg every 4 hours‡ or Oral: 50 to 100 mcg every 2 hours‡† |
FIGO: International Federation of Gynecology and Obstetrics; SFP: Society of Family Planning; WHO: World Health Organization.
* Avoid intravaginal administration if bleeding and/or signs of infection.
¶ Repeat doses can be used when needed; this guideline does not provide a dosing interval or maximum number of doses.
Δ Repeat doses can be used when needed; this guideline does not provide a maximum number of doses.
◊ Can be self-managed at home.
§ An additional dose should be provided to the patient to use as needed.
¥ Dosing based on Society of Family Planning Guidelines (20111, 20133): A comprehensive systematic review and meta-analysis, published 2020.
‡ Induced fetal demise should be considered for such patients.
† Dosing based on Cochrane Database Systematic Review (CD014484), published 2021.