letrozole + misoprostol

A combination regimen consisting of letrozole, an aromatase inhibitor, and misoprostol, a prostaglandin analog. This combination is primarily used for pregnancy termination (medical abortion) and management of early miscarriage. Letrozole works by inhibiting the aromatase enzyme, reducing estrogen production. Misoprostol causes uterine contractions. Together, they facilitate the expulsion of pregnancy tissue. The standard protocol recommended by the WHO involves letrozole 10 mg orally daily for 3 days followed by misoprostol 800 μg sublingually on the fourth day. This regimen has shown higher complete abortion rates compared to misoprostol alone and may be used as an alternative when mifepristone is unavailable or expensive. It is considered suitable for pregnancies up to 12 weeks gestation. Side effects may include nausea, diarrhea, and chills.