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It’s not uncommon to throw up when taking abortion pills (and definitely not pleasant). Nausea and vomiting are pregnancy symptoms after all.. but we hear a lot of people worry that the pills won’t work if they puke, so we talked with doctors and doulas to answer your questions on when not to stress, when to consider taking more, and how to avoid puking in the first place.

What if I throw up after taking mifepristone?

We know that as long as mifepristone stays in your body for 60 minutes you get most of the medication and do not need another tablet. But if you throw up before 60 minutes or see the pill when you vomit, you’ll need to take more Mifepristone or you can switch to the misoprostol only protocol (which requires more misoprostol). Keep in mind, it may take time to request more mifepristone from the provider.

Note: Mifepristone by itself will not be enough to have an abortion—it must be taken with misoprostol. But, people still successfully and safely have an abortion with only misoprostol, it just requires more of the tablets.

Review how to take abortion pills here.

What if I throw up after taking misoprostol?

As long as the misoprostol has been sitting in your cheek for 20 minutes, it will work. Some people know they’re about to throw up, so they take the tablets out, throw up, and then put them back in. It’s harder to do than it sounds, but it's something to keep in mind. If you throw up before 20 minutes you might need to take more misoprostol. If the misoprostol is thrown up 20 minutes after it has been in the mouth or after it is swallowed it is working and that dose does not need to be repeated.

How can I avoid throwing up while taking the misoprostol?

Let’s start by explaining how misoprostol is taken. It is not swallowed immediately, instead it’s taken buccally which means the tablets are placed in between the cheek and the gum to dissolve. Not only is this way more effective for the abortion but it also makes taking the misoprostol easier on your stomach. Some of the side effects of the medication are nausea and vomiting. So by taking the misoprostol in between the cheek and the gum allows it to be absorbed into the bloodstream instead of through the stomach lining. You’ll likely still feel nauseous though.

When prescribed misoprostol, many health care professionals will also prescribe ondansetron (Zofran) which is an anti-nausea medication. If that isn’t offered to you, you can always ask! Or you can pick up dimenhydrinate (Dramamine) or diphenhydramine (Benadryl) at your pharmacy—no prescription needed. It’s helpful to pre-treat the symptoms of the misoprostol so you’re not playing catch up with the symptoms of the medication. In other words, misoprostol causes cramping and nausea so you want to take the pain relievers and anti-nausea medication before taking the misoprostol. And then continue to take as directed.

Step 1: Eat something light

Step 2: Take a pain reliever
This can be 800mg of ibuprofen (Motrin/Advil) and/or 1000mg of acetaminophen (Tylenol). If you are prescribed stronger pain relievers by the doctor, follow those directions.

Step 3: Wait 30 minutes

Step 4: Take the anti-nausea medication

Step 5: Wait 30 minutes

Step 6: Place the misoprostol tablets in between the cheek and the gum.

Abortion pills can be taken on an empty stomach and anti-nausea medications can be taken before or after the Mifepristone or misoprostol. The suggested steps above may not make the nausea or vomiting go away completely but it may help! Make sure to follow the directions of the pain relievers and anti-nausea medication and take as needed.

What are other ways to prevent or treat nausea and vomiting after taking abortion pills?

• Drinking ginger tea or chewing on ginger candies
• Other teas that can help with nausea: peppermint, chamomile and lavender
• Smoking weed can prevent nausea
• If you’re usually nauseous and throwing up in the morning from the pregnancy, try taking the Mifepristone in the evening instead.
• Sniffing an alcohol wipe or peppermint oil
• Placing an ice pack to the back of the neck