Answer the side-effect intent for abortion pill without diagnosing; distinguish common from serious reactions and give safe next-step/reporting guidance.
Sources
This page covers medical abortion — a group of products, not a single one. Each statement below is taken from the SAHPRA-approved patient information leaflet named beside it:
Retrieved 2026-09-03. Your own medicine’s leaflet is the one that applies to you, and where it differs from this page the leaflet is correct.
What is abortion pill?
Medical abortion covers several products registered in South Africa, not one. They work in a similar way, and their approved leaflets do not list identical side effects.
The medicines covered here, and the leaflet used for each:
- misoprostol — ACEMISO, Ruby Pharmaceuticals (Pty) Ltd (Tablet)
- mifepristone — MEDIPRIST, Adcock Ingram Limited (Tablets)
Check your own pack
Two medicines in the same group can differ in their approved uses, their cautions and their side effects. The leaflet inside your pack is the one that applies to you.
Common side effects of abortion pill
Each medicine in this group has its own approved leaflet, and the effects below are the ones that leaflet lists. They are shown separately rather than combined, because the leaflets do not agree on what to list or how to word it.
Misoprostol (ACEMISO)
- skin rashes
- diarrhoea
- dizziness
- headache
- stomach pain
- constipation
- wind
- indigestion
- feeling or being sick
- Birth defects (foetal malformations)
- fever
- irregular periods
The leaflet lists 15 more. Read the full leaflet.
Mifepristone (MEDIPRIST)
- headache, dizziness
- vaginal bleeding
- effects related to prostaglandin use such nausea, vomiting, diarrhoea, dizziness, abdominal discomfort, abdominal pain, uterine spasm, fatigue and chill/fever
- prolonged bleeding after the abortion
- spotting
- severe bleeding
- endometritis (inflammation of the womb)
- breast tenderness
- uterine contractions or cramping
- fainting
- vagal symptoms (hot flushes, skin rashes/itching)
- salpingitis (infection in the fallopian tubes)
The leaflet lists 26 more. Read the full leaflet.
Serious side effects and warning signs
None of the leaflets reviewed set out a separate serious-effects list.
General warning signs that apply to any medicine
Call for emergency help now if any of these happen
- Difficulty breathing, wheezing, or tightness in the throat or chest
- Swelling of the face, lips, tongue or throat
- A widespread rash with blistering or peeling skin, or sores in the mouth, eyes or genitals
- Fainting, collapse, or a sudden severe drop in alertness
- Chest pain, or sudden weakness or numbness on one side of the body
- A fit (seizure), or confusion that comes on suddenly
In South Africa call 10177 for an ambulance, or 112 from a mobile phone. Go to your nearest emergency department if it is faster. Do not wait to see whether the symptom settles.
How long can side effects last?
How long a side effect lasts depends on the effect, the product, how long it has been used, and the person. Some effects ease within days as the body adjusts. Others continue for as long as the product is used. A few can persist after stopping, and some need review rather than waiting.
- Settling effects — mild effects that ease over the first days or weeks of use
- Ongoing effects — effects that continue while the product is being used and improve after stopping
- Persistent effects — effects that continue after stopping and need medical review
- Delayed effects — effects that appear after weeks or months rather than immediately
Which of these applies to a particular effect is a clinical question. If a side effect is not settling, is getting worse, or is affecting your daily life, that is worth a conversation with a pharmacist or doctor regardless of how long it has been going on.
Evidence required before publish — source the following for abortion pill from the SAHPRA-approved patient information leaflet or professional information, and cite what you actually used.
- Anything the approved information for abortion pill says about how long specific effects last
- Whether the source describes any effect as usually temporary, or as needing review if it persists
- Whether any effect is described as continuing after the product is stopped
Factors that may affect side effects
Cautions from each medicine’s approved leaflet.
Misoprostol (ACEMISO)
Do not use it at all if:
- if you are allergic to misoprostol or any of the other ingredients of ACEMISO (listed in section 6), or other prostaglandin medicines
- If you are a woman of childbearing age and you are not using an effective contraceptive method to avoid becoming pregnant
- if you are pregnant or trying to become pregnant or do not have a negative pregnancy test because it may cause a miscarriage, premature birth or birth defects
- if you are breastfeeding (as this may give your baby diarrhoea)
- If you have kidney disease or impaired renal function
Use with care, and tell your doctor, if:
- if you are pregnant or plan to become pregnant. Due to the risk for the foetus, your treatment with ACEMISO must be discontinued immediately
- if you are a woman of childbearing age. Due to the risk for the foetus, it is important to use effective contraception while you are taking ACEMISO
- heart disease
- low or high blood pressure, or any disease of the blood vessels
- inflammatory bowel disease
- prone to dehydration. If you are a younger woman who has not yet gone through the menopause, your doctor will have only prescribed ACEMISO if he is satisfied you are at high risk of developing ulcers from your NSAID medicine. Children: Do not give ACEMISO to children under the age of 18 years because it is unlikely to be safe
Mifepristone (MEDIPRIST)
Do not use it at all if:
- if you are hypersensitive (allergic) to mifepristone or any of the other ingredients of MEDIPRIST 200 mg (listed in section 6)
- if you suffer from chronic adrenal failure
- if you suffer from severe asthmatic disease where it is necessary to take steroids (e.g. asthma uncontrolled by treatment) or chronic obstructive airways disease
- if you have hereditary porphyria
- if your pregnancy has not been confirmed by a biological test or an ultrasound scan
- if the first day of your last period was more than 63 days (9 weeks) ago
Use with care, and tell your doctor, if:
- if you suffer from chest pain or have a prosthetic heart valve
- if you have risk factors for heart diseases, such as high blood pressure or high blood cholesterol levels (increased fat content in your blood)
- if you suffer from asthma
- if you suffer from an illness that may affect the clotting of your blood or anaemia
- if you have liver or kidney disease
- if you are malnourished
What to do if you experience side effects
If you think you are having a side effect, the response depends on how severe it is. Use the warning signs above first — if any of those apply, treat it as urgent.
If the symptom is severe or frightening
Get medical help immediately. Call 10177 for an ambulance, or 112 from a mobile phone, or go to the nearest emergency department. Take the product and its packaging with you if you can.
If the symptom is mild but bothering you
- Write down what the symptom is, when it started, and how it relates to when you take the product
- Check the leaflet that came with the product to see whether the symptom is listed
- Speak to your pharmacist — for many questions this is the fastest route to a useful answer
- Contact the prescriber if the symptom is affecting your daily life or is not settling
Do not stop a prescribed treatment on your own
Stopping some treatments suddenly causes its own problems, and the condition being treated may get worse. If you want to stop, ask a pharmacist or doctor how to do it safely — they can usually offer an alternative.
You can also report a suspected side effect in South Africa. Reporting does not replace getting medical advice, and you do not need to be certain the product was the cause.
When to seek urgent medical help
Some symptoms need medical attention straight away rather than an appointment in a few days. Do not wait to see whether they settle.
Call for emergency help now if any of these happen
- Difficulty breathing, wheezing, or tightness in the throat or chest
- Swelling of the face, lips, tongue or throat
- A widespread rash with blistering or peeling skin, or sores in the mouth, eyes or genitals
- Fainting, collapse, or a sudden severe drop in alertness
- Chest pain, or sudden weakness or numbness on one side of the body
- A fit (seizure), or confusion that comes on suddenly
In South Africa call 10177 for an ambulance, or 112 from a mobile phone. Go to your nearest emergency department if it is faster. Do not wait to see whether the symptom settles.
Get same-day medical advice if you have
- A high fever, or a rash together with feeling generally unwell
- Yellowing of the eyes or skin, or unusually dark urine
- Unusual bruising or bleeding that you cannot explain
- Severe or persistent vomiting or diarrhoea, especially if you cannot keep fluids down
- A sudden change in mood, or thoughts of harming yourself
- Any symptom that is rapidly getting worse
If you are having thoughts of harming yourself
Help is available in South Africa. The SADAG helpline is 0800 567 567, or you can go to your nearest emergency department. You do not have to wait until it feels like an emergency.
How to report a suspected side effect in South Africa
South Africa has an official system for reporting suspected side effects, run by the South African Health Products Regulatory Authority (SAHPRA). Reports from the public and from healthcare professionals are how safety signals get detected after a product is already in use.
Who can report
Anyone can report — you do not have to be a healthcare professional, and you do not need to prove that the product caused the problem. A suspicion is enough. Patients, caregivers and family members can all submit a report.
What to have ready
- The name of the product, its strength and form, and the batch number if you have it
- Why it was being used, and when it was started and stopped
- What the suspected reaction was, when it began, and how long it lasted
- Any other medicines, supplements or remedies being used at the same time
- Basic details about the person affected — age and sex are usually enough
How to report
SAHPRA accepts adverse reaction reports through its e-Services reporting system and through the Med Safety mobile app. Healthcare professionals can also report through the same routes. Current forms and access points are published on the SAHPRA site.
- SAHPRA Health Products Vigilance — the main vigilance and reporting hub
- SAHPRA e-Services — current adverse reaction reporting access
Reporting is not a substitute for medical care
If someone is unwell now, get medical help first and report afterwards. Urgent symptoms always take precedence over paperwork.
For a fuller walkthrough see how to report an adverse drug reaction.
Related pages
← Back to more medicine side effects.
← Back to more contraception side effects.
Report a side effect
If you think you have had a side effect, you can report a suspected side effect in South Africa. Report a suspected side effect through the appropriate SAHPRA pathway where relevant.
Information only
This page gives general medicine-safety information for people in South Africa. It is not a diagnosis and not personalised medical advice. It cannot tell you whether a symptom you are having is caused by a particular product. Speak to a pharmacist or doctor about your own situation, and do not stop or change a prescribed treatment on the basis of a web page.
Editorial status: draft — not for publication
Brief SE-00210 · build rank 210 · Phase 2 · Tier 2. Every evidence slot on this page must be completed from the SAHPRA-approved source and the page signed off by a qualified clinical or pharmacy reviewer before it is published. Target length 1,300–2,000 words.