Drugs Q & A

Is Brown Discharge After Taking Misoprostol Normal?

Vaginal discharge is fluid secreted from tiny glands in the vagina and cervix. This fluid leaks from the vagina each day to remove old cells and debris, keeping the vagina and reproductive tract clean and healthy.

The amount of vaginal discharge can vary significantly from person to person. The color, consistency, and amount can also change from day to day, depending on where a person is in their menstrual cycle.

It is common to wonder whether the color or consistency of vaginal discharge is normal or needs to be checked out especially when you are taking certain medications.

What is Misoprostol?

Although Misoprostol is currently only approved by the Food and Drug Administration (FDA) for the prevention and treatment of gastric ulcers resulting from chronic administration of nonsteroidal anti-inflammatory drugs (NSAIDs), it is used in conjunction with Mifepristone in the medical termination of pregnancy. Miscarriage management, induction of labor, and treatment of cervical hemorrhage are some areas where the drug is advised.

Misoprostol, a prostaglandin E1 analog, reduces the need for suction dilation and curettage (D&C) by up to 60% and shortens the time to complete compared with placebo when used off label.

Vaginal administration of misoprostol is recommended for increased efficacy. The recommended dose of misoprostol is 800 mcg (4 200-mcg tablets) inserted vaginally. Study results have demonstrated that vaginal administration is more effective than oral use of misoprostol. One dose is about 70% effective, and 2 are about 84% effective.

Is it normal to have brown discharge after taking Misoprostol?

Yes, it is completely normal and harmless to have brown discharge and clots after taking Misoprostol, and does not necessarily mean that you’re still pregnant.

For most people, the cramping and bleeding usually start 1-4 hours after taking the Misoprostol. It’s normal to see brown discharges and large blood clots (up to the size of a lemon) or clumps of tissue when this is happening. It’s kind of like having a really heavy, crampy period, and the process is very similar to an early miscarriage.

Brown discharges and blood clots usually disappear within a few days, and its most times used as an indication that the abortion was successful. You can wait 3–4 after taking the pills and take a urine pregnancy test or take a blood test sooner.

However, in some cases, brown discharge can be old blood that’s taking extra time to leave the uterus. This is especially true if you see it at the beginning or end of your menstrual period. Brown discharge at other points in your cycle may still be normal but be sure to take note of any other symptoms you experience.

What are the side effects of Misoprostol?

Medical abortion using Misoprostol normally causes side effects such as pain and cramping, as well as bleeding accompanied by the passage of blood clots and tissue. Nausea, vomiting, diarrhea, headache, dizziness, and hot flashes or fever may also occur.

A fever that starts soon after Misoprostol administration and lasts less than 24 hours and is less than 100.4 F/ 38 C is a common side effect. If the fever lasts longer than 24 hours or is greater than 100.4 F/38 C, you should seek medical attention.

An allergic reaction to the medication can cause hives (itchy welts or bumps on the skin.)

If your side effects are extreme, you may have a complication. Please refer to the question “How do you know if you have a complication and what should you do?” if you think you might be experiencing abnormal side effects.

Precautions:

o          Tell your doctor or pharmacist whether you are allergic to it, or whether you have any other allergies, before taking misoprostol

o          Tell your doctor or pharmacist your medical history before using this drug, in particular: stomach/intestinal disorder (e.g., inflammatory bowel disease).

o          Alcohol and tobacco consumption on a daily basis can increase your risk of stomach bleeding. Limit drinks made with alcohol and avoid smoking.

o          An incomplete abortion can rarely occur if you are taking this drug in conjunction with mifepristone to end a pregnancy. Being closely watched by your doctor and holding your regular appointments to track your progress is very important for you. In case of an emergency, make sure to have specific instructions from your doctor on who to contact and what to do. If you experience some unlikely symptoms, such as severe/prolonged vaginal bleeding, signs of infection (including fever, chills), or fainting, anticipate vaginal bleeding after you take the combined drug, but inform your doctor right away.

o          Owing to potential damage to an unborn infant, this medicine must not be used during pregnancy to avoid stomach ulcers. Use successful birth control measures when taking misoprostol and for at least one month or one completed menstrual cycle after you quit taking it if you are of childbearing age. Inform your doctor right away if you become pregnant or think you might be pregnant.

o          It passes into breast milk with this drug. This medication is unlikely to affect a breastfeeding child. However, before breastfeeding, consult the doctor.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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