Medications & Drugs

Everything you need to know about Misoprostol

Misoprostol is a medication that is primarily used to reduce the risk of stomach ulcers caused by NSAID use. However, there are other, off-label uses of misoprostol as well.

Read the article to know more about Misoprostol, its uses, side effects, dosage, and top misoprostol brands available in Pakistan.

Key takeaways

  • Misoprostol is used to prevent stomach ulcers from NSAIDs/aspirin.
  • It is often used off-label for inducing labor, terminating early pregnancy, managing miscarriage, and treating postpartum hemorrhage.
  • Common side effects of misoprostol include headache, diarrhea, nausea, and stomach cramps.
  • Risks include uterine rupture, excessive bleeding, and allergic reactions.
  • Misoprostol requires a valid prescription and should only be used under medical supervision.
  • Top misoprostol brands in Pakistan include Breeky and S.T. Mom.

Misoprostol uses

Misoprostol (Cytotec) is a synthetic prostaglandin used for the following purposes:

  • It helps protect the stomach lining from damage caused by NSAIDs or aspirin. (approved by FDA). Misoprostol exhibits antisecretory and mucosal protective properties that reduce stomach acid production and strengthen the stomach’s mucosal barrier. It works by enhancing the production of protective mucus and bicarbonate that helps shield the stomach from NSAID/aspirin induced damage. This way it can help reduce the risk of stomach ulcers.
  • To induce labor and cervical ripening in women (off-label use).
  • For the termination of an early pregnancy (off-label use).
  • For miscarriage management to speed up the expulsion of pregnancy tissue. (off-label use).
  • Prevention and treatment and management of postpartum hemorrhage.

How it works

Misoprostol works in the following ways:

  • For the treatment and prevention of ulcers: As a synthetic prostaglandin, misoprostol is indicated for the prevention of NSAID and aspirin induced damage to the stomach lining. Hence it can treat and prevent stomach ulcers in patients undergoing NSAID/aspirin treatment.
  • For the termination of early pregnancy: By softening the cervix, it causes the uterus to stimulate and contract. It leads to cramping, bleeding, and ultimately the expulsion of the pregnancy tissue from the uterus. This is a non-approved use of misoprostol for women who wish to terminate pregnancy in the first trimester.
  • For the prevention and treatment of postpartum hemorrhage: The use of misoprostol for postpartum hemorrhage is also widely recognized although it comes with certain side effects which range from common like shivering and chills to more severe such as uterine rupture. It works by stimulating the muscles of the uterus causing them to contract and increasing uterine tone. This action helps prevent and control excessive bleeding.

Dosage

The dosage of this drug depends on the condition being treated. According to drugs.com here are the recommended dosages of misoprostol:

Dosage for treatment and prevention of stomach ulcers

It is used for the treatment and prevention of duodenal and gastric ulcers. In both cases you can take:

  • 200 mcg orally 4 times/day after meals and at bedtime.
  • 100 to 200 mcg orally 4 times a day (maintenance dose).
  • Or as directed by your physician.

Dosage for the termination of early pregnancy

It is usually taken in combination with mifepristone for first trimester pregnancy terminations. Here’s how much you should take:

  • Take 200 mg of mifepristone on Day 1, follow this up with 800 mcg of misoprostol taken buccally (between the cheeks & gums) 24 to 48 hours later.
  • Follow the exact instructions given by your doctor.

Dosage for the management of postpartum hemorrhage

Based on FIGO (The International Federation of Gynecology and Obstetrics) recommendations, take 600 mcg orally or 800 mcg sublingually (placed under the tongue) once right after delivery.

Side effects of misoprostol

Common side effects of misoprostol include:

  • Headache
  • Diarrhea
  • Nausea and vomiting
  • Upset stomach
  • Indigestion
  • Stomach pain
  • Stomach cramps

Refer to a doctor in case of an allergic reaction or symptoms such as black or tarry stools (melena), or vomiting blood (hematemesis).

Risks and warnings

Following are the risks and warnings of misoprostol:

1. Pregnancy

If you are pregnant or planning to conceive, you should avoid taking misoprostol. It is contraindicated for the treatment and prevention of gastric ulcers in pregnant individuals.

If taken for other purposes such as the management of miscarriage or inducing labor, misoprostol should be administered under the supervision of a doctor or a medical team in a hospital setting to mitigate health risks.

2. Allergic reactions

If you have a known allergy to prostaglandins, refrain from misoprostol use as it can lead to an allergic reaction causing symptoms like difficulty breathing, itching, rash, swelling, etc.

3. Serious risks

Misoprostol use has been associated with serious risks such as uterine rupture, excessive uterine bleeding, miscarriage, and premature birth.

Do not take this medication without prior approval of a licensed healthcare practitioner.

Top misoprostol brands in Pakistan

NameIngredientsPriceManufacturer
BreekyMisoprostol181 per boxSami Pharmaceuticals
S.T. MomMisoprostol193 per boxZafa
Disclaimer: Prices/rates may vary depending on your selected pharmacy.

Frequently asked questions (FAQs)

1. Do you need a prescription to purchase misoprostol?

Yes. Misoprostol can only be purchased with a valid prescription from a licensed physician.

2. Who should not take misoprostol?

Misoprostol should not be taken by individuals who are allergic to prostaglandins, or by those who are pregnant or planning to become pregnant.

References

Disclaimer: The contents of this article are intended to raise awareness about common health issues and should not be viewed as sound medical advice for your specific condition. You should always consult with a licensed medical practitioner prior to following any suggestions outlined in this article or adopting any treatment protocol based on the contents of this article.
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