Misoprostol (Cytotec): General Information, Uses, How to take , Misoprostol and other medications, Contraindications, Side effects, Special Notes, Analogues, FAQs
- General Information
- Misoprostol uses
- How to take Misoprostol pills
- Misoprostol and other medications
- Side Effects of Misoprostol
- Special Notes
- Misoprostol Analogues
Misoprostol is a synthetic analogue of prostaglandin E1 that has a gastroprotective action. It increases production of the protective mucus and hydrocarbon and intensifies the blood flow in the mucous membrane. Misoprostol speeds up the healing of gastric erosions, gastric and duodenal ulcers. In some cases Misoprostol is able to prevent their development. The medication directly influences parietal cells and decreases basal, night or stimulated release of hydrochloric acid. Mysoprostol protects stomach against the damage caused by such drugs as aspirin, ibuprofen, meloxicam, indomethacin, celecoxib, and others.
The medication starts acting in 30 minutes after the intake; the action lasts within 3-6 hours. The dosage of 50 mcg shows mild effect; Misoprostol 200 mcg has a pronounced effect.
Misoprostol also induces the contraction of plain muscles of myometrium and widens the cervix. It increases the frequency and strength of myometrium contractions and has a weak effect on the plain muscles of gastrointestinal tract.
Misoprostol (Cytotec) Uses
Misoprostol pills are applied for the treatment and prophylaxis of gastric and duodenal ulcers and erosive and ulcer damages of gastrointestinal tract caused by NSAID therapy. The medication is also prescribed in case of the gastric and duodenal ulcer recurrence and erosive gastroduodenitis associated with gastric and duodenal ulcers. Misoprostol in combination with Mifepristone is designed for the abortion (up to 42 days of amenorrhea).
How to take Misoprostol pills
Misoprostol is taken orally. The single dose varies from 200 to 400 mcg. In case of kidney failure the single dose does not exceed 100 mcg. The dose and the therapy duration depend upon the health state and therapeutic indication.
- Duodenal Ulcer: adults can take 200 mcg 4 times a day or 400 mcg 2 times a day. The pill should be taken after the meal.
- Gastric Ulcer and NSAID-Induced Ulcer Prophylaxis: the schedule and dosage is the same as for the duodenal ulcer.
- Labor Induction: the medication is applied vaginally in the dose of 25 mcg every 4-6 hours.
- Postpartum Bleeding: Misoprostol is used after the delivery of the baby and before placenta is delivered. The dose of 400 – 600 mcg is taken orally or rectally.
- Cervical Ripening: 400 mcg of Misoprostol is taken vaginally before surgical abortion or 3-4 hour prior to suction curettage.
- Abortion in the first trimester: in case of combination with Mifepristone Misoprostol is taken orally in the dose of 400 mcg 48 hours after Mifepristone is administered. If taken vaginally the dose of Misoprostol makes up 800 mcg. The schedule is the same. In case of combination with Methotrexate Misoprostol is taken vaginally in the dose of 800 mcg 5-7 days later. The dose can be repeated one day later, if necessary.
- Failed pregnancy / fetal death: the dose of 800 mcg is taken vaginally. The dosage can be repeated in 24 hours, if necessary.
- Abortion on the second trimester: the dose of Misoprostol is 600 mcg taken vaginally 36 -48 hours after Mifepristone is administered. After that 400 mcg of Misoprostol should be taken orally or vaginally not more than 5 times within 24 hours.
- Fetal death in the third trimester: the dose of 100 mcg is applied vaginally every 12 hours.
- Gynecologic Surgery: the dose of 400 mcg is taken orally 12 -24 hours prior to the surgery.
Misoprostol and other medications
If taken with some other medication Misoprostol may cause negative consequences to the human health. It is vitally important to apply to the doctor for a consultation before starting the Misoprostol therapy. The patient should inform about all the medical drugs he or she takes on regular basis. One should also mention that vitamins and herbal pharmaceutical product may also be in the risk group if taken together with Misoprostol. That is why thorough medical examination and comprehensive information about the patient’s health state is required for the doctor to take a decision regarding the application of Misoprostol.
Below the short list of the drugs that are in the risk group is given:
- Antacids. The simultaneous intake of antacids and Misoprostol causes the reduction of Misoprostol concentration in the blood plasma.
- Magnesium-bearing antacids. If taken together Misoprostol and magnesium-bearing antacids may cause diarrhea.
- Acenocoumarol. In rare cases the reduction of anticoagulant action of acenocoumarol is possible.
- Diclofenac / Indometacin. If taken together with Indometacin or Diclofenac Misoprostol intensifies their side effects.
Misoprostol is an effective medication that has a strong influence on the human body. That is why the medication is not used in children and young people under 18. People with hypersensitivity to the ingredients of Misoprostol are not recommended to apply its therapy. Lactating and pregnant women are strongly advised to refrain from taking Misoprostol due to its influence on the women’s reproductive system.
If case of abortion Misoprostol contraindications include:
- Cardiovascular diseases;
- Liver and kidney disorders;
- Arterial hypertension;
- Diabetes and other endocrinal disorders;
- Bronchial asthma;
- Eye diseases such as glaucoma;
- Blood problems (anemia, etc.);
- Danger of extrauterine pregnancy.
The above-mentioned list does not contain all the contraindications. Before using the medicine the patient should thoroughly study all the contraindications and consult the doctor.
Side Effects of Misoprostol
When Misoprostol is applied as a gastroprotective medicine the following side effects are defined:
- Gastrointestinal system: stomach ache, constipation or diarrhea, vomiting, nausea;
- Genitourinary system: abdominal pains connected with the myometrium contractions, dysmenorrhoea, polymenorrhoea, menorrhagia;
- Allergic reactions: itching, impetigo, angioneurotic edema;
- Other: sharp change of weight, asthenia, increased fatigability, seizures (very rare in women of pre- or post-climacteric period).
If taken for the purpose of pregnancy termination Misoprostol side effects may involve nausea, vomiting, abdominal pains, hot flashes, high temperature, itching and other allergic reactions.
In case of any unusual health condition the urgent medical aid is required.
If Misoprostol is prescribed to women of reproductive age it is important to make serumal pregnancy test prior to the therapy. The test should remain negative within 2 weeks before the medicine is taken. The therapy should be started on the second or third day the periods start. Within the whole therapy course effective and reliable birth control methods should be applied. One should take into account that Misoprostol increases uterine tonus and may cause the miscarriage if taken as a gastroprotective remedy.
One should take Misoprostol with care in case of diarrhea as the dehydratation may occur and develop. That state may lead to the increase of the medicine concentration in the human body.
Being a drug for the pregnancy termination Misoprostol should be used only in combination with Mifepristone in specialized medical clinics that are able to provide urgent surgery and transfusion aid.
Before the medication is taken the patient should be informed about its pharmacological action and possible side effects. The patient should be followed up in the hospital within 4 to 6 hours prior to the Misoprostol intake. In case of any serious side effects including heavy bleeding the patient should be delivered an urgent medical aid. In most cases (up to 80%) the miscarriage occurs within 6 hours, in rare cases (not more than 10%) – within the period of one week. In case of early pregnancy the abortion is possible even after Mifepristone is taken. However it is necessary to take Misoprostol in any case in order to optimize the medical action of the drugs. As a rule, after the given medical procedure women suffer from a light vaginal bleeding, in some cases the bleeding may by quite long-lasting.
In 8-15 days the repeated examination is required. In case of necessity ultrasound investigation or human chorionic gonadotropin definition test are conducted. During one week after the intake of Misoprostol one should avoid taking aspirin and other NSAIDs.
The market provides several analogues of Misoprostol that contain Misoprostol as an active ingredient. Mirolut and Cytotec are the most popular of them.
Mirolut is produced in the form of tablets containing 200 mg of Misoprostol. The medication is used for the pregnancy termination at early stages (up to 42 days of amenorrhea). The medication should be taken in combination with Mifepristone and only in special medical centers under the guidance of health care professionals. Mirolut should be taken in the dose of 400 mcg 36 – 48 hours after Mifepristone is taken. Mirolut has the same contraindications as those of Misoprostol. Side effects involve nausea, stomach ache, tremor, arterial hypotension, fever, somnolence and heart beating. Mirolut is available on prescription.
Cytotec is designed for the treatment of duodenal ulcer recurrence and gastric and duodenal ulcers caused by the NSAID therapy. Another application of Cytotec is a pregnancy termination at early stages in combination with Mifepristone. The contraindications include liver and kidney disorders, inflammatory bowel disease, young age under 18, pregnancy and lactation (in case of gastroprotective therapy). Side effects are similar to those of Misoprostol. Cytotec available in Canada Pharmacy mycanadianpharmacypro.com.
What should I do if I have severe side effects?
In case of some severe side effects like irregular heart beating or strong abdominal pains, heavy bleeding, strong allergic reactions and others please apply for the medical assistance as soon as possible. In order to avoid negative consequences you should follow your doctor’s instructions and ask him to inform you about all the possible side effects and your actions in the situation when any of them occur.
How can I avoid overdosing?
You take the medication in accordance with your doctor’s recommendations. As a rule, recommended dosages do not cause any negative effect. Don’t try to change the dosage without consulting your health care expert.
Can Misoprostol be used by children?
The therapeutic action in children has not been thoroughly studied yet. As a rule, the list of contraindication of Misoprostol and its analogues includes the young age under 18.
Is it safe to take Misoprostol at home for the purpose of miscarriage?
No, it is very dangerous to take Misoprostol without medical guidance. The procedure should be conducted only in special medical centers where all the necessary things are available if the unusual situation occurs. Moreover, Misoprostol is applied in combination with Mifepristone which is also very strong medication that should be taken only under the doctor’s control.
Where can I get Misoprostol?
Misoprostol is available on prescription in regular drug stores. Besides, one can buy Misoprostol online. As there are a lot of offers of Misoprostol pills online it is necessary to choose the reliable online pharmacy which deals only with the certified products. Study the webside of the pharmacy, get in touch with the customer support service and look for the customers’ feedbacks. All this information will help you decide upon whether to cooperate with the given online pharmaceutical shop or not.