Misoprostol Brand Name– Cytotec
What is Misoprostol
Misoprostol is a synthetic, oral prostaglandin E1 (PGE1) analog. Misoprostol is effective for prevention of gastric ulcers secondary to use of nonsteroidal antiinflammatory drugs (NSAIDs) and should be taken for the duration of NSAID therapy.
The drug may produce uterine contractions, uterine bleeding, and abortifacient effects and the products carry a boxed warning regarding the reproductive risks; adequate contraception is required in females of childbearing potential during oral use for prevention of NSAID-induced ulcers.
Due to its ability to ripen the cervix and stimulate uterine contractions, misoprostol is used widely off-label in various obstetric protocols for cervical ripening and labor induction; these uses are not FDA-approved but are recommended in obstetric guidelines and are discussed in the oral product label.
Misoprostol is a recognized component of the FDA-approved mifepristone-regimen for early pregnancy termination.
Misoprostol was initially approved by the FDA in December 1988.
Indications
- cervical ripening induction
- duodenal ulcer
- early pregnancy failure
- gastric ulcer
- intrauterine fetal death
- kidney transplant rejection prophylaxis
- labor induction
- NSAID-induced ulcer prophylaxis
- postpartum bleeding
- pregnancy termination
For NSAID-induced ulcer prophylaxis in patients receiving NSAIDs and at high risk for gastric ulceration (e.g., elderly, past history of ulcer, concomitant debilitating disease, or concomitant systemic corticosteroid use)
NOTE: Misoprostol is indicated to prevent NSAID-induced gastric ulcers but has not been shown to prevent duodenal ulcers.
Side Effects
- abdominal pain
- agitation
- anaphylactoid reactions
- breakthrough bleeding
- cervical laceration
- chest pain (unspecified)
- chills
- constipation
- diaphoresis
- diarrhea
- dysmenorrhea
- dyspepsia
- edema
- fetal bradycardia
- fetal death
- fever
- flatulence
- headache
- hypertension
- hyperthermia
- hypotension
- infection
- lethargy
- leukocytosis
- menstrual irregularity
- myocardial infarction
- nausea
- pelvic pain
- phlebitis
- pulmonary embolism
- rash
- shivering
- sinus tachycardia
- stroke
- syncope
- teratogenesis
- thrombosis
- uterine contractions
- uterine pain
- uterine rupture
- vaginal bleeding
- vertigo
- vomiting
- weakness
Monitoring Parameters
- pregnancy testing
- stool guaiac
Contraindications
- abnormal fetal position
- breast-feeding
- caesarean section
- cardiac disease
- children
- contraception requirements
- dehydration
- diarrhea
- ectopic pregnancy
- fetal distress
- fever
- herpes infection
- incomplete abortion
- infection
- infertility
- inflammatory bowel disease
- labor
- multiparity
- obstetric delivery
- placenta previa
- pregnancy
- pregnancy testing
- renal disease
- reproductive risk
- sepsis
- ulcerative colitis
- vaginal administration
- vaginal bleeding
- vasa previa
Interactions
- Aluminum Hydroxide; Magnesium Hydroxide
- Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
- Calcium Carbonate; Magnesium Hydroxide
- Magnesium Hydroxide
- Oxytocin
