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Migepristone misopristol dosage

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Migepristone misopristol dosage

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"mifepristone" AND "misoprostol"

Quick answer

Mifepristone-Misoprostol regimen for medical abortion (up to 70 days / 10 weeks gestation, per current evidence-based protocols):
Standard combined regimen:
  • Mifepristone 200 mg orally as a single dose on Day 1
  • Misoprostol 800 mcg (four 200 mcg tablets), taken:
    • Buccally, vaginally, or sublingually (buccal/vaginal preferred for better efficacy than oral)
    • 24-48 hours after mifepristone (evidence supports a range of 6-72 hours; simplified regimens allow same-day dosing in some protocols)
Some older/regional protocols (e.g., WHO-based) use misoprostol at home 24-48 hours later; efficacy is around 95% for terminating pregnancies up to 9 weeks.
Gestational age considerations:
  • Up to 10 weeks (70 days): mifepristone 200 mg + misoprostol 800 mcg as above (single misoprostol dose usually sufficient)
  • Beyond 10 weeks / second trimester (14-27 weeks, per Society of Family Planning guidance): mifepristone 200 mg followed by repeated misoprostol doses (e.g., 400 mcg every 3 hours) until expulsion, since a single dose is not adequate at later gestational ages
Alternative regimens (if mifepristone unavailable):
  • Misoprostol alone (higher doses, repeated) or methotrexate/misoprostol - both less effective and slower than the mifepristone-misoprostol combination.
Important safety notes:
  • This regimen requires prior confirmation of gestational age (ultrasound or clinical dating) and exclusion of ectopic pregnancy.
  • Follow-up is needed to confirm complete abortion (clinical exam, ultrasound, or serial hCG).
  • Contraindications include confirmed/suspected ectopic pregnancy, chronic adrenal failure, hemorrhagic disorders, or anticoagulant use, and IUD in place (must be removed first).
  • Dosing should always follow the specific protocol of the treating clinician/local guidelines, as regimens vary by country and by gestational age.
Sources: Park's Textbook of Preventive and Social Medicine; Berek & Novak's Gynecology; Pfenninger and Fowler's Procedures for Primary Care. Also consistent with the Society of Family Planning's 2024/2025 clinical recommendations on medication abortion (PMID: 37821258, 37821241) and medication management for early pregnancy loss (PMID: 39710335).
This is general medical information, not a substitute for individualized care from a qualified clinician.

Teach me basic cardiac physiology

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Cardiac physiology is a broad topic. Here's a map of what "basic cardiac physiology" covers, a short overview, and then I'll let you pick where to go deep.

Topic Breakdown

  1. Cardiac anatomy & electrical conduction system - SA node, AV node, His-Purkinje system
  2. Cardiac action potentials - pacemaker vs. contractile cell potentials, ion channels
  3. The cardiac cycle - systole/diastole, pressure-volume changes, valve opening/closing
  4. Heart sounds & their physiologic basis (S1-S4)
  5. Cardiac output & its determinants - preload, afterload, contractility, heart rate (Frank-Starling mechanism)
  6. ECG basics - correlating electrical events with the cardiac cycle
  7. Regulation of the heart - autonomic (sympathetic/parasympathetic) control, baroreceptor reflex
  8. Coronary blood flow - perfusion physiology, supply/demand balance

Brief Overview

The heart is a dual pump (right side to lungs, left side to body) driven by an intrinsic electrical system. The SA node generates spontaneous electrical impulses (pacemaker potentials) that spread through the atria, pause briefly at the AV node (allowing ventricular filling), then race down the His-Purkinje system to trigger coordinated ventricular contraction.
Each heartbeat is the cardiac cycle: diastole (ventricular filling, valves open) followed by systole (isovolumetric contraction, ejection, isovolumetric relaxation). Valve opening and closing (driven by pressure gradients between chambers) produces the classic heart sounds (S1 = mitral/tricuspid closure, S2 = aortic/pulmonic closure).
Cardiac output (CO = heart rate x stroke volume) is the key functional output, regulated by:
  • Preload (venous return, Frank-Starling law - more stretch, more force)
  • Afterload (resistance the ventricle pumps against)
  • Contractility (intrinsic strength of contraction, modulated by sympathetic tone and calcium handling)
  • Heart rate (autonomic nervous system, baroreceptor reflex)
All of this integrates with the ECG, which is the surface recording of the electrical events described above.
Which topic would you like to go deeper into first?
Asking for Preferences

Which area of cardiac physiology should we go deep on first?

Your credits are exhausted. You can purchase a top-up or subscribe to a plan to continue using Orris. If you're already subscribed, your daily credits will reset tomorrow.Mifepristone-Misoprostol regimen for medical abortion (up to 70 days / 10 weeks gestation, per current evidence-based protocols):
Standard combined regimen:
  • Mifepristone 200 mg orally as a single dose on Day 1
  • Misoprostol 800 mcg (four 200 mcg tablets), taken:
    • Buccally, vaginally, or sublingually (buccal/vaginal preferred for better efficacy than oral)
    • 24-48 hours after mifepristone (evidence supports a range of 6-72 hours; simplified regimens allow same-day dosing in some protocols)
Some older/regional protocols (e.g., WHO-based) use misoprostol at home 24-48 hours later; efficacy is around 95% for terminating pregnancies up to 9 weeks.
Gestational age considerations:
  • Up to 10 weeks (70 days): mifepristone 200 mg + misoprostol 800 mcg as above (single misoprostol dose usually sufficient)
  • Beyond 10 weeks / second trimester (14-27 weeks, per Society of Family Planning guidance): mifepristone 200 mg followed by repeated misoprostol doses (e.g., 400 mcg every 3 hours) until expulsion, since a single dose is not adequate at later gestational ages
Alternative regimens (if mifepristone unavailable):
  • Misoprostol alone (higher doses, repeated) or methotrexate/misoprostol - both less effective and slower than the mifepristone-misoprostol combination.
Important safety notes:
  • This regimen requires prior confirmation of gestational age (ultrasound or clinical dating) and exclusion of ectopic pregnancy.
  • Follow-up is needed to confirm complete abortion (clinical exam, ultrasound, or serial hCG).
  • Contraindications include confirmed/suspected ectopic pregnancy, chronic adrenal failure, hemorrhagic disorders, or anticoagulant use, and IUD in place (must be removed first).
  • Dosing should always follow the specific protocol of the treating clinician/local guidelines, as regimens vary by country and by gestational age.
Sources: Park's Textbook of Preventive and Social Medicine; Berek & Novak's Gynecology; Pfenninger and Fowler's Procedures for Primary Care. Also consistent with the Society of Family Planning's 2024/2025 clinical recommendations on medication abortion (PMID: 37821258, 37821241) and medication management for early pregnancy loss (PMID: 39710335).
This is general medical information, not a substitute for individualized care from a qualified clinician.Cardiac physiology is a broad topic. Here's a map of what "basic cardiac physiology" covers, a short overview, and then I'll let you pick where to go deep.

Topic Breakdown

  1. Cardiac anatomy & electrical conduction system - SA node, AV node, His-Purkinje system
  2. Cardiac action potentials - pacemaker vs. contractile cell potentials, ion channels
  3. The cardiac cycle - systole/diastole, pressure-volume changes, valve opening/closing
  4. Heart sounds & their physiologic basis (S1-S4)
  5. Cardiac output & its determinants - preload, afterload, contractility, heart rate (Frank-Starling mechanism)
  6. ECG basics - correlating electrical events with the cardiac cycle
  7. Regulation of the heart - autonomic (sympathetic/parasympathetic) control, baroreceptor reflex
  8. Coronary blood flow - perfusion physiology, supply/demand balance

Brief Overview

The heart is a dual pump (right side to lungs, left side to body) driven by an intrinsic electrical system. The SA node generates spontaneous electrical impulses (pacemaker potentials) that spread through the atria, pause briefly at the AV node (allowing ventricular filling), then race down the His-Purkinje system to trigger coordinated ventricular contraction.
Each heartbeat is the cardiac cycle: diastole (ventricular filling, valves open) followed by systole (isovolumetric contraction, ejection, isovolumetric relaxation). Valve opening and closing (driven by pressure gradients between chambers) produces the classic heart sounds (S1 = mitral/tricuspid closure, S2 = aortic/pulmonic closure).
Cardiac output (CO = heart rate x stroke volume) is the key functional output, regulated by:
  • Preload (venous return, Frank-Starling law - more stretch, more force)
  • Afterload (resistance the ventricle pumps against)
  • Contractility (intrinsic strength of contraction, modulated by sympathetic tone and calcium handling)
  • Heart rate (autonomic nervous system, baroreceptor reflex)
All of this integrates with the ECG, which is the surface recording of the electrical events described above.
Which topic would you like to go deeper into first?It looks like my question got interrupted. Which area of cardiac physiology would you like to start with?
  1. Electrical conduction & action potentials (SA node, AV node, pacemaker vs. contractile cells)
  2. The cardiac cycle & heart sounds (systole/diastole, valve mechanics, S1-S4)
  3. Cardiac output (Frank-Starling law, preload, afterload, contractility)
  4. ECG basics (correlating waveforms with electrical/mechanical events)
  5. Autonomic regulation & coronary blood flow (sympathetic/parasympathetic control, baroreceptor reflex, coronary perfusion)
Just tell me the number or topic, and I'll go deep on it.
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