What is the difference between using misoprostol under the tongue, in the cheek, and vaginally?

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For abortion, misoprostol is best absorbed through a mucous membrane, whether it is in the mouth or in the vagina. The pills can be placed between the cheeks and gums, under the tongue or in the vagina. All of these application methods are equally effective.

For pregnancies up to 12 weeks:

Cheeks (buccal): 2 pills of misoprostol are placed on one side of the mouth, between the cheek and the gums. 2 more pills are placed on the other side of the mouth in the same way. The pills need to be kept there for 30 minutes for the misoprostol to be absorbed. The misoprostol sometimes dissolves in as little as 10-15 minutes - this will not make them less effective, and they often do not dissolve completely. What remains can be swallowed.* The pills don't have much of a taste, some people say they taste like chalk. In case of nausea, the pills can be taken out and then put back in after throwing up.

Tongue: 4 pills of misoprostol are placed under the tongue. They need to be kept there for 30 minutes. What remains of the pills after 30 minutes can be swallowed.*

Vagina: 4 pills of misoprostol are placed inside the vagina, as deep as possible, next to the cervix. It can be helpful to moisten the pills and the finger with some water before putting them in. It is best to leave inside whatever remains of the pills.

There are small differences in how quickly the medicines get absorbed. The vaginal method can be useful for people who cannot hold pills is their mouth. However, if the pills are taken vaginally, some leftover pieces of pill can remain there for up to 4-5 days and could be noticed during a medical examination, so in case of worries about medical staff knowing about the abortion, it is best to avoid vaginal use.

*If someone is using Arthrotec or another kind of pill that is misoprostol + diclofenac, it is important to spit out the remains of the pills rather than swallowing them.