Dragoman MV, Grossman D, Nguyen MH, et al. - Via performing a randomized, placebo-controlled trial in Nepal, South Africa, and Vietnam, researchers examined if in women ≤ 63 days' gestation having a mifepristone-misoprostol medical abortion, lower maximal pain is observed with providing either prophylactic tramadol 50 mg or ibuprofen 400 mg/metoclopramide 10 mg compared with placebo. A total of 563 patients were enrolled between June 2016 and October 2017. Although not clinically significant, lower mean maximum pain scores were achieved in correlation with tramadol or ibuprofen/metoclopramide co-administered with misoprostol and repeated 4 h later compared with placebo. Least likelihood to using additional analgesia was observed among women who received ibuprofen/metoclopramide along with fewer side effects.