Misoprostol is a synthetic analogue of a natural prostaglandin E1, used in the treatment and prevention of stomach ulcers, sometimes administered concomitantly with NSAIDs to prevent the formation of duodenal/gastric ulcers. It is also used to induce abortion, and for post-partum hemorrhage. It is believed to induce the mucous membranes lining the gastrointestinal [GI] tract to secrete more mucous and mucosal blood flow, while acting on the parietal cells to limit the production of pepsin in the gastric juices, increasing the thickness of the mucosal layer, and stabilizing the tissues, which protects the GI tract and prevents the formation of ulcers.
What are the main uses of Misoprostol ?
It is often administered with NSAIDs to reduce the risk of ulceration in the stomach. It is also used to induce early abortion, in the treatment of a missed miscarriage, and to induce labor. As an abortifacient, Misoprostol proves to be more economical than surgery, with lesser complications. It is also used to prevent and treat post-partum hemorrhage.
How to use Misoprostol?
This medication should be taken orally, together with food, four times a day. The final dose of the day should always be administered before retiring for the night. You should also avoid taking any antacids containing magnesium within an hour before or two hours after taking Misoprostol. Women should not take their first dose until after the second or third day of their period to rule out or confirm pregnancy.
What are the side effects of Misoprostol?
Some of the less serious and common side effects of this medicine include:- Diarrhea,Indigestion,Headache,Nausea,Vomiting and Constipation. If you have an allergic reaction such as:- Hives, Rash, Itching, Swelling in the face-lips-tongue-throat, Tightness in the chest, let the doctor know at once. If any of the following symptoms, or, any other serious or unusual symptoms occur, contact the physician and seek emergency help immediately:- Severe diarrhea,Persistent vomiting,Black stools,Dark vomit.
Precautions & Interaction
Prior to beginning this therapy, inform your doctor about the ailments you've had, as well as the medicines [OTC and prescription]-nutritional supplements-herbal products you are taking, and especially inform the doctor if you have any allergy to this medicine or any substance.
Let your treating doctor know if you have any disease of the heart, liver or kidney, have an adrenal insufficiency, suffer from inflammatory bowel disease, or are prone to dehydration.
Women who are pregnant, planning to conceive, or lactating should not take this medicine. Use of Misoprostol in pregnancy has been known to have caused partial/complete abortions, and resulted in fetal birth defects.
For womenwho are taking this medicine to induce an abortion, may have a natural abortion after this medication, but should be aware that there can be abnormal bleeding for many days.
The doctor will want to determine whether the abortion has been complete, and women who are seeking an early termination of pregnancy may be required to undergo an ultrasound examination, or their blood levels may have to be checked a week after taking this medication.
Avoid becoming pregnant for at least 1 month after you have stopped this medicine, or let 1 menstrual cycle lapse before conceiving.
When it is administered in the reproductive tract, it may suppress the immune function and a bacterial infection caused by C.sordellii may erupt.
As Misoprostol can cause dizziness, do not take it with alcohol, or medicines that make you drowsy, and be very alert if you have to drive or perform risky tasks while you are taking this medicine.
Use this medicine for children only if the pediatrician advises you to do so.
Interactions: Some of the medications with which this drug interacts, include:-
Overdose symptoms can include:- difficulty in breathing, seizures, tremors, extreme dizziness/drowsiness, erratic/slow heartbeat, fever, or stomachache. If overdose is suspected, US residents can call the US national poison hotline at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911. The Crisis Pregnancy Helpline for America is 1-800-672-2296.
Misoprostol should not be taken in the following conditions:-
If a woman is pregnant or nursing her baby;
Women of child-bearing age must have a negative serum pregnancy within 2 weeks prior to taking Misoprostol, adopt effective birth control measures, and take this medicine only on the 2nd or 3rd day of their next menstrual period.
Missed Dose of Misoprostol
In case you have missed a dose, try to take it as soon as you remember, but if it's going to be time for the next dose, leave the missed dose and follow the normal dosage pattern. If in doubt, you can always check with your doctor.
Dosage of Misoprostol
The dosage varies according to the medical condition, and must be taken as prescribed by the doctor. Small doses are usually given 4 times a day along with NSAIDs to prevent the formation of ulcers. In abortion - whether it is induced, incomplete, or missed - the dosage varies according to gestation, and the route of administration. Misoprostol is also a highly potent stimulator of uterine contractions in late pregnancy. It causes ripening of the cervix, and has greater effectiveness in starting labor than other drugs used for this purpose.
Storage for Misoprostol
Keep the medicine at a temperature of 25oC, protected from heat, light, and dampness; and, secure from children and pets.
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