Misoprostol: Medication with Multiple Uses

Misoprostol, marketed under the brand name Cytotec, is a medication that belongs to the class of drugs known as prostaglandins. Prostaglandins are hormone-like substances naturally produced in the body that play various roles, including regulating inflammation, protecting the lining of the stomach and intestines, and controlling processes such as labor and menstruation.

Misoprostol is a synthetic prostaglandin analogue which mimics the effects of natural prostaglandins. It is commonly used in medical practice for several purposes due to its ability to influence smooth muscle contractions, particularly in the uterus and stomach.

While initially developed for the prevention and treatment of stomach ulcers, Misoprostol's versatility has led to its use in other medical applications. It is used off-label for inducing labor in pregnant women and for medical abortions, either alone or in combination with other medications like Mifepristone.

Use

• Stomach ulcer prevention and treatment
  When you take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, they can reduce the presence of prostaglandins which shields the stomach lining. This leaves the stomach vulnerable to damage and ulcers. Misoprostol reduces the production of stomach acid and promotes the secretion of protective mucus. This dual action makes it effective in preventing and treating gastric ulcers caused by NSAIDs.
• Labor induction
  Although not FDA-approved for this purpose, Misoprostol is sometimes used off-label to induce labor in pregnant women by kickstarting uterine contractions. Typically, it's administered at specific intervals, using lower doses than those prescribed for ulcer prevention or medical abortion.
• Medical abortion
  Misoprostol is also used off-label for medication abortions either in conjunction with another medication called Mifepristone or alone. By promoting contractions and softening the cervix, Misoprostol facilitates the expulsion of uterine contents.

Administration

• Stomach ulcers
  This medication is available in tablet form in 100 mcg and 200 mcg and can be taken by mouth, 4 times a day, with food.
• Labor induction
  This medication will be administered either orally or vaginally by a healthcare professional in significantly lower doses compared to the dosage for ulcer prevention or medical abortion.
• Medical abortion
  This medication should be administered beneath your tongue or against the inner cheeks of your mouth and dissolved for 30 minutes. Ensure full absorption of the medication by avoiding eating or drinking during the dissolving period. However, it's important to drink water to wash down the pill after the 30-minute interval. Keep in mind that experiencing some stomach cramps and vaginal bleeding within 1 to 4 hours is common.

Side Effects

Common side effects

• Diarrhea
• Abdominal pain
• Upset stomach
• Vomiting
• Nausea
• Constipation
• Fever
• Headache

If you are experiencing any of these side effects talk with your healthcare provider to see whether a dose adjustment or switching to a different medication would be beneficial for you.

Serious side effects

While Misoprostol is generally well-tolerated, it may cause serious side effects in some, including the following:

• Severe stomach pain or cramping
• Dehydration: dizziness, increased thirst, decreased urination, or confusion
• Heavy or prolonged vaginal bleeding
• Signs of infection: fever or chills
• Allergic reactions: hives, difficulty breathing, or swelling of your face, lips, tongue, or throat

If you are experiencing any of these serious side effects, immediately call your doctor and stop taking this medication.

Warnings

If you're pregnant or planning to become pregnant, do not use Misoprostol for ulcer prevention. This medication carries risks of inducing miscarriages, premature labor, or birth defects.

For women of childbearing age, it's crucial to undergo a recent negative pregnancy test, within the past 2 weeks, before considering Misoprostol for ulcer prevention. Additionally, ensure you're employing a reliable method of birth control while using this medication.

To maximize safety, it's advisable to start Misoprostol treatment on the second or third day of your menstrual period.

Should you discover you're pregnant while taking Misoprostol, cease usage immediately and call your doctor.

Interactions

When taken with antacids, Misoprostol absorption in the body might decrease. However, in clinical trials for ulcer prevention, some individuals didn't experience issues when using Misoprostol alongside antacids.

Avoid antacids containing magnesium, like Mylanta, as they could worsen diarrhea when combined with Misoprostol.