Orders:
- •Mifepristone 200 mg in clinic
- •Phenergan 12.5 Q6 × 12
- •Ibuprofen 800 mg Q6 × 30
- •Miso 200 mcg × 4 (= 800 mcg total) vaginal or buccal
Miso dose count by GA: >9 wks = 2 doses; >11 wks = 3 doses (don’t recommend); 12w0d hard cutoff — beyond that = surgical only.
Counseling (also .fppreopmisoinstructions for patient instructions):
- •Do not send miso to Walmart! They won’t fill.
- •Sign two forms, then have attending sign third form.
- •Mife: stops pregnancy, primes body for miso.
- •800 mcg Miso 24h after first pill — wait for it to dissolve 30 min.
- ◦Buccal — 2 pills each cheek, after 30 min, swallow with water. Only say this if more than 1 dose.
- ◦Vaginal — place as far up as you can, allow 30 minutes. Less nausea.
- •Should bleed in next 1–24 hours. Call if no bleeding in 24 hours — not working.
- •Bleeding, cramping normal — will send ibuprofen and nausea meds. Should improve over time.
- •Abnormal: multiple pads in an hour, fever, chills → call this number on sheet.