Allergy to one of the medications is a contraindication. Methotrexate is administered intramuscularly in a dosage of 50 mg per m 2 of body surface. Patients are instructed to avoid taking folate-containing vitamins for a week after the methotrexate injection. The patient should lie down for 30 minutes after inserting the tablets. Protocols involving mifepristone are quite similar.
Mifepristone is taken orally on the first day.
Three to four days later, misoprostol is inserted vaginally. Women should be seen by their physician in one to two weeks so the completion of the abortion can be assessed. Women whose sonograms demonstrate embryonic cardiac activity two weeks after methotrexate administration should be offered a suction procedure. Women whose sonograms reveal a nonviable pregnancy should be offered the options of a suction procedure or further trials of misoprostol. Nonsteroidal anti-inflammatory drugs should be avoided because they reduce the synthesis of prostaglandins 7 and may be associated with increased bleeding.