Indications
Gynecological Indication: Labor induction (in unfavorable cervical conditions) and In the prevention & treatment of Postpartum Hemorrhage (PPH).
Therapeutic Class
Pharmacology
Dosage & Administration
- The recommended adult oral dose for reducing the risk of NSAID-induced gastric ulcers: 200 mcg Misoprostol four times daily with food. If this dose cannot be tolerated, a dose of 100 mcg can be used. Misoprostol should be taken for the duration of NSAID therapy as prescribed by the physician. Misoprostol should be taken with a meal, and the last dose of the day should be at bedtime.
- Renal impairment: Adjustment of the dosing schedule in renally impaired patients is not routinely needed, but dosage can be reduced if the 200 mcg dose is not tolerated.
Gynecological dosage & administration-
- Induction of Labor: 25 mcg vaginally 6 hourly or 50 mcg orally 4 hourly.
- Postpartum Hemorrhage (PPH) prophylaxis: 400 mcg to 600 mcg orally or rectally immediately following delivery of the child.
- Postpartum Hemorrhage (PPH) treatment: 1000 mcg rectally or, 200 mcg orally with 400 mcg sublingually.
Interaction
Contraindications
Side Effects
Gynecological: Gynecological disorders such as spotting, cramps, hypermenorrhea, menstrual disorder and dysmenorrhea have been reported. Postmenopausal vaginal bleeding may be related to Misoprostol administration.
Elderly: Overall, there were no significant differences in the safety profile in patients 65 years of age or older compared with younger patients.
Pregnancy & Lactation
In such patients, it may be prescribed if the patient:
- Has had a negative serum pregnancy test within 2 weeks prior to beginning therapy.
- Is capable of complying with effective contraceptive measures.
- Has received both oral and written warnings of the hazards of Misoprostol, the risk of possible contraception failure, and the danger to other women of childbearing potential should the drug be taken by mistake.
- Will begin it only on the second or third day of the next normal menstrual period.
Excretion of the active metabolite (Misoprostol acid) into milk is possible, but has not been studied. Because of the potential for serious adverse reactions in nursing infants, it is not recommended for use by nursing mothers.
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