Misoprostol

Misoprostol is a synthetic prostaglandin E₁ (PGE₁) analogue that has a wide range of clinical applications, including the prevention and treatment of gastric ulcers, induction of labor, and as a component of medical abortion regimens. It is marketed under various brand names, including Cytotec and Arthrotec (combined with diclofenac).

Pharmacology

Misoprostol is a synthetic prostaglandin E₁ analogue that exerts its pharmacological effects by binding to and activating prostaglandin E₁ receptors. The activation of these receptors leads to various physiological effects, including the inhibition of gastric acid secretion, increased uterine tone and contractions, and cervical ripening.

Indications and uses

Misoprostol has multiple clinical applications, some of which include:

• Gastric ulcers: Misoprostol is used for the prevention and treatment of gastric ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs), as it can decrease gastric acid secretion and promote the healing of the gastric mucosa.
• Induction of labor: Misoprostol is used to induce labor in cases where the induction is medically necessary, such as in pregnancies that have gone past the due date or in cases of fetal distress. It is administered vaginally or orally to promote uterine contractions and cervical ripening, facilitating the process of labor and delivery.
• Medical abortion: Misoprostol is used in combination with mifepristone as a part of medical abortion regimens. Mifepristone, a progesterone receptor antagonist, is administered first to block the action of progesterone, a hormone necessary for the continuation of pregnancy. Misoprostol is then administered to induce uterine contractions and expulsion of the products of conception.
• Postpartum hemorrhage: Misoprostol can be used to manage postpartum hemorrhage by promoting uterine contractions, which help to reduce blood loss after childbirth.

Side effects

Misoprostol can cause a range of side effects, including:

• Gastrointestinal disturbances, such as diarrhea, abdominal pain, nausea, and vomiting
• Headache
• Dizziness
• Fever and chills
• Uterine cramping and pain

These side effects are usually mild and resolve on their own. However, more severe side effects, such as excessive bleeding, severe abdominal pain, or signs of an allergic reaction, should be reported to a healthcare professional immediately.

Contraindications

Misoprostol is contraindicated in individuals with a known hypersensitivity to misoprostol or other prostaglandins. Additionally, it is contraindicated in pregnant women when not being used for its approved indications, as it can cause uterine contractions and miscarriage.

See also

• Mifepristone
• Prostaglandin
• Nonsteroidal anti-inflammatory drug
• Medical abortion

References

• Dailymed label info on Misoprostol
• FDA Misoprostol

Misoprostol Resources
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