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Dinoprostone Prostaglandin E2 Brand Names
Cervidil | Prepidil | Prostin E2
What is Dinoprostone Prostaglandin E2
Dinoprostone is a synthetic preparation of naturally occurring prostaglandin E2.
Dinoprostone is administered endocervically or vaginally; the drug has oxytocic actions.
Dinoprostone vaginal suppositories (Prostin E2) are used clinically to induce abortion in the second trimester of pregnancy and to evacuate the contents of the uterus following intrauterine fetal death, missed abortion, or benign hydatidiform mole and were originally approved by the FDA in 1977.
In 1992, an endocervical gel for cervical ripening (Prepidil)was FDA-approved. In 1995, the FDA approved a removable vaginal insert (Cervidil) for cervical ripening.
Use of any dosage form requires trained obstetrical personnel in a hospital setting with appropriate surgical, emergency, and obstetrical care facilities.
Indications
- cervical ripening induction
- hydatidiform mole
- intrauterine fetal death
- pregnancy termination
For evacuation of the uterine contents in the cases of missed abortion or intrauterine fetal death, second trimester pregnancy termination, or benign hydatidiform mole
Side Effects
- abdominal pain
- amniotic fluid embolism
- anaphylactoid reactions
- angioedema
- arthralgia
- back pain
- blurred vision
- bronchospasm
- cervical laceration
- chest pain (unspecified)
- chills
- cough
- diaphoresis
- diarrhea
- disseminated intravascular coagulation (DIC)
- dizziness
- dyspnea
- fever
- flushing
- headache
- hot flashes
- hypertension
- hypotension
- mastalgia
- muscle cramps
- musculoskeletal pain
- myocardial infarction
- nausea
- ocular pain
- paresthesias
- rash
- shivering
- syncope
- uterine rupture
- vaginal pain
- vomiting
- weakness
- wheezing
Monitoring Parameters
- pelvic exam
Contraindications
- amniotic fluid embolism
- anemia
- angioedema
- asthma
- bleeding
- breast-feeding
- caesarean section
- cardiac disease
- cephalopelvic disproportion
- cervicitis
- children
- diabetes mellitus
- disseminated intravascular coagulation (DIC)
- fetal distress
- fibrinolysis
- glaucoma
- hepatic disease
- herpes infection
- hypertension
- hypotension
- incomplete abortion
- increased intraocular pressure
- infants
- infection
- jaundice
- labor
- multiparity
- placenta previa
- pregnancy
- pregnancy testing
- premature rupture of membranes (PROM)
- pulmonary disease
- renal disease
- requires a specialized care setting
- requires an experienced clinician
- seizure disorder
- serious hypersensitivity reactions or anaphylaxis
- surgery
- uterine atony
- vaginal bleeding
- vaginitis
Interactions
- Articaine; Epinephrine
- Carboprost Tromethamine
- Enflurane
- Epinephrine
- Ergonovine
- Halothane
- Methylergonovine
- Oxytocin
- Prilocaine; Epinephrine
