Misoprostol
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Drug Status
Government Approvals
US(FDA)
WHO Essential Medicine
YES
Known Teratogen
Definite
Pharmaceutical Class
Prostaglandin E1 Analog
Controlled Drug Substance
NO
Misoprostol
Summary
Misoprostol is used to prevent stomach ulcers, particularly those caused by long-term use of NSAIDs like ibuprofen or aspirin. It's also used in gynecology to induce labor, manage postpartum bleeding, and assist in medical abortions. Additionally, it can treat missed or incomplete miscarriages.
Misoprostol is a synthetic prostaglandin that mimics natural hormones. It protects the stomach lining from acid damage and stimulates uterine contractions. In terms of ulcer prevention, it reduces gastric acid secretion and increases mucus production.
For ulcer prevention, the typical dose is 200 mcg four times a day. For medical abortion, it's often used with mifepristone, with a dose of 800 mcg. It can be taken orally, sublingually, or vaginally as directed by a doctor.
Common side effects include diarrhea, nausea, abdominal pain, vomiting, and fever. Serious risks include uterine rupture, severe dehydration from prolonged diarrhea, heavy bleeding, or infection in abortion cases.
Misoprostol should not be taken by pregnant women unless prescribed for specific cases. It should also be avoided by people allergic to prostaglandins, those with inflammatory bowel disease, or a history of cesarean delivery. People with severe heart, kidney, or liver conditions should consult a doctor before use.
Indications and Purpose
How does Misoprostol work?
Misoprostol stimulates prostaglandin receptors, which causes uterine contractions and reduces gastric acid secretion. It protects the stomach lining from ulcers by increasing mucus production and reducing stomach acid. In pregnancy-related uses, it softens the cervix and induces contractions, making it effective for abortion, labor induction, and postpartum bleeding control.
Is Misoprostol effective?
Yes, misoprostol is highly effective. Studies show 80-90% success in medical abortions, especially when used with mifepristone. It is widely used for labor induction and postpartum bleeding and has been proven to reduce maternal mortality. For ulcer prevention, it provides significant protection against NSAID-related gastric damage when taken correctly. Its effectiveness is well-documented, making it a preferred option in many medical protocols.
What is Misoprostol?
Misoprostol is a medication used to prevent stomach ulcers, induce labor, and assist in medical abortions. It works by protecting the stomach lining from acid damage and stimulating uterine contractions. It is a synthetic prostaglandin that mimics natural hormones to help the body respond effectively in various conditions. It is commonly prescribed for individuals at risk of gastric ulcers due to NSAIDs and for gynecological uses such as abortion or postpartum bleeding control.
Directions for Use
For how long do I take Misoprostol?
For ulcer prevention, treatment typically lasts 4 to 8 weeks, depending on the severity of the condition. In the case of medical abortion, it is usually taken as a single or short-term regimen. For labor induction, the duration depends on the individual’s response, and a doctor will monitor progress closely. For postpartum bleeding, it is used as a one-time dose.
How do I take Misoprostol?
For ulcer prevention, take with food to minimize stomach irritation. Do not take with magnesium-containing antacids, as they can worsen diarrhea. For medical abortion or labor induction, it may be taken orally, sublingually, or vaginally as directed by a doctor. Misoprostol should always be used under medical supervision when taken for reproductive health purposes. Avoid alcohol and caffeine while using this medication.
How long does it take for Misoprostol to start working?
For ulcer prevention, it starts working within 30 to 60 minutes by reducing stomach acid. For abortion or labor induction, it usually begins to work within 1 to 4 hours, causing uterine contractions. When used for postpartum hemorrhage, effects typically appear within minutes to an hour after administration. The duration and effectiveness depend on the condition being treated and the method of administration.
How should I store Misoprostol?
Store at 15-30°C, away from heat, moisture, and direct sunlight. Keep it in an airtight container and out of children’s reach.
What is the usual dose of Misoprostol?
The usual dose for ulcer prevention is 200 mcg, four times a day. If not tolerated, the dose may be reduced to 100 mcg. For medical abortion, it is often used in combination with mifepristone, with a dose of 800 mcg buccally, sublingually, or vaginally. For labor induction, doses vary and should be strictly followed as prescribed by a healthcare provider.
Warnings and Precautions
Can I take Misoprostol with other prescription drugs?
Avoid NSAIDs like ibuprofen, as they can reduce its effectiveness for ulcers. Be cautious when combining it with blood thinners or oxytocin, as it may increase bleeding risks. Always inform your doctor about any medications you are taking.
Can Misoprostol be taken safely while breastfeeding?
Yes, but it may cause mild diarrhea in the baby. Misoprostol is considered relatively safe while breastfeeding when taken in low doses.
Can Misoprostol be taken safely while pregnant?
No, unless prescribed for abortion or labor induction, as it can cause birth defects, miscarriage, or preterm labor. Pregnant women should never use it for ulcer prevention.
Is it safe to drink alcohol while taking Misoprostol?
Most people tolerate this medicine well and occasional alcoholic drinks should not affect the way this medicine works. However, everybody can respond differently to medicines. Always track any changes you notice and let your doctor know when new symptoms are concerning - this will help make sure this medicine is right for you.
Is it safe to exercise while taking Misoprostol?
Yes, but if experiencing diarrhea, dizziness, or weakness, avoid intense physical activity.
Is Misoprostol safe for the elderly?
Yes, but elderly patients are at higher risk of dehydration due to diarrhea. Dose adjustments may be necessary, and fluid intake should be maintained.
Who should avoid taking Misoprostol?
Pregnant women should not take it unless prescribed for abortion, labor induction, or postpartum bleeding. People allergic to prostaglandins, those with inflammatory bowel disease, or those with a history of cesarean delivery should avoid it due to potential complications. It should not be taken by individuals with severe heart, kidney, or liver conditions without a doctor’s advice.
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