Misoprostol

  • Generic Name : Misoprostol
  • Brand Name : Misoprostol
  • Availibility : In Stock
  • Expiry Date : 1/08/2021
  • Average Delivery Time : 10 - 12 Working Days
  • Strength : 200 MCG
$36

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What is Misoprostol?

Misoprostol is a generic form of Cytotec and is used to terminate pregnancies. It is taken after taking Mifeprostine, which is about 2 or 3 days later. Misoprostol works by hindering the action of the hormone progesterone (which maintains pregnancy) and widening the cervix. Diminished levels of progesterone detach the fetus from the uterine wall. The fetus lacks food and oxygen.

Take four pills of misoprostol, each 200mcg after taking Mifepristone. Place the tablets under your tongue and let them melt away. Chewing, crushing, swallowing, or breaking them may reduce their efficacy. However, when taken with food or milk, at night, they have a better impact.

What are the dosages and administrations of misoprostol?

Misoprostol is prescribed to women who want to abort. A gynecologist administers the drug only after assessing the age of the pregnancy. Sometimes it is self-administered. The recommended dosage is 800mcg (4 pills), placed under the tongue. The drug must be taken three days after receiving a 200 mg pill of Mifepristone. 

800mcg is enough to expel the fetus within 3 hours. Misoprostol induces the contraction of the uterine wall to expel the already detached fetus. If it doesn't, then a second dose of 400mcg is administered.  

The drug is effective if the pregnancy is less than 9 weeks. The age of the pregnancy is determined based on the first day of amenorrhea or the last menstrual period. For this treatment, doctors use the former, presuming a 28-day cycle and ovulation occurring on the 14th day.

Menstrual history, clinical examination, and in uncertain cases, ultra-sonogram (USG) scans are used to determine the exact age of the pregnancy. For ectopic pregnancies, USG eradicates it. 

Remove any intrauterine device (IUD) before using the kit, and in cases where misoprostol fails, the pregnancy is terminated by the surgical method. Similarly, in case of severe bleeding or incomplete abortion, a gynecologist should intervene using a surgical means.  

After using misoprostol, a patient must go for a checkup between 7 and 14 days. This is to confirm whether the abortion was successful or not. A clinical examination or USG scan is done. At this stage, there is a high risk of fetal malformation; surgical termination is advised.

For patients using Misoprostol tablets

The whole process occurs in 3 steps

  • Visiting the doctor for a prescription of one Mifepristone pill
  • Two days later, a prescription of 4 200mcg tablets of misoprostol.
  • After two weeks, where the status of the pregnancy is assessed through tests such as sonograms.

You will experience bleeding and cramping for between 2 to 4 weeks. Little or no vaginal bleeding may be a sign that the medication has not worked; inform your doctor. And, if remnants of the pregnancy remained in your uterus, surgical intervention is advised to remove them. 

What are the contraindications?

Administration of Misoprostol is contraindicated in patients who have:

  • Hypersensitivity to Mifepristone and Misoprostol 
  • Ectopic pregnancy
  • Migraine 
  • Intrauterine devices
  • Chronic adrenal failure
  • Bleeding disorders
  • Anticoagulant, corticosteroid therapies
  • Inherited porphyria
  • Severe uncontrolled asthma

These are not all contraindications: In case of any other complication, do not hesitate to call your doctor. 

The use of misoprostol may be a problem for patients without adequate access to medical facilities. In some cases, medical emergencies are necessary, e.g., in case of an incomplete abortion, blood transfusions, or emergency resuscitation.

What are the warnings and precautions?

People with renal failure, hepatic failure, and malnutrition should take misoprostol under the supervision of a certified gynecologist. Otherwise, they should avoid it.  

No scientific data exists on the efficacy and safety of misoprostol in women with a chronic condition like cardiac disease, hypertension, liver dysfunction, respiratory or kidney disease, insulin-dependent diabetes, severe anemia, or heavy smoking above 35. 

Animal studies have demonstrated fetal abnormalities. Similarly, based on marketing data and investigational surveys, there is a high human fetal risk. It is important to note that the risk outweighs the benefits of pregnant women.

It is vital to confirm if the pregnancy was terminated entirely after treatment.

Be ready to use contraceptives immediately after an abortion with misoprostol because another pregnancy may occur. 

Some women may experience a decrease in hemoglobin concentration, hematocrit, and red blood cell count may occur for those who bleed heavily.

Comments on using misoprostol

The doctors provide painkillers to manage pain arising from cramps

Checkups (revisit) are highly recommended. They should be done 7 to 14 days after administration of the drug

Incase Misoprostol fails; patients have two options, i.e., expectant management or suction curettage.

What are the drug interactions?

No specific food or drug interactions have been studied. However, there is a high possibility that ketoconazole, itraconazole, erythromycin, and grapefruit could inhibit the metabolism of misoprostol. Again, dexamethasone, rifampicin, and certain anticonvulsants may induce Misoprostol metabolism.

Misoprostol doesn’t interfere with the effects of aspirin. It doesn’t exert a clinical impact on the absorption and antiplatelet effects of aspirin. Similarly, it doesn't have effects on several NSAIDs such as ibuprofen, diclofenac, piroxicam, aspirin, naproxen, or indomethacin.

Do not take Antacids containing magnesium during treatment with misoprostol, as this may worsen diarrhea if it already exists. 

Some drugs are not allowed to be used together, while others are used under supervision. In both cases, a doctor may change the dosage, or you may take necessary precautions to avoid adverse effects. Nevertheless, you need to tell your doctor all the medications you are taking.

Misoprostol interacts with the medications listed below. These drugs are not all-inclusive but base on potential significance.  

  • Dinoprostone topical- primary drug interaction
  • Magaldrate- moderate drug interaction
  • magnesium carbonate- moderate drug interaction
  • Sodium citrate- small drug interaction
  • Magnesium hydroxide- moderate drug interaction
  • Magnesium oxide- moderate drug interaction
  • Quinapril- moderate drug interaction
  • Aluminum carbonate- minor drug interaction
  • Aluminum hydroxide- small drug interaction
  • Calcium carbonate- minor drug interaction
  • Dihydroxy aluminum sodium carbonate- minor drug interaction
  • Sodium bicarbonate- minor drug interaction
  • Naproxen- minor drug interaction

What are the side effects?

Common side effects are abdominal/stomach pain and diarrhea. Rare effects are vaginal bleeding, painful menstruation, and cramps. A woman may experience one or more side effects. 

Less common side effects are:

  • Acid or sour stomach
  • Belching
  • Excess air or gas in the stomach and intestines
  • Heartburn, indigestion, passing gas
  • Stomach discomfort or upset

Other side effects that might occur are:

Other side effects that might occur are

Bladder pain Difficulty with breathing Muscle pain or stiffness Sore throat Change in taste
Bloody nose Difficulty with moving Nasal congestion Sweating Continuing ringing or buzzing noise in the ears
Bloody or black, tarry stools Difficulty with swallowing Nervousness Tightness in the chest Cracked, dry, scaly skin
Bloody or cloudy urine Faintness/ lightheadedness/Dizziness when suddenly  getting up Pain in the joints Troubled breathing with exertion Depression
Blurred vision Ear congestion Pale skin Unusual bleeding or bruising Discharge, excessive tearing
Body aches or pain Feeling unusually cold Pounding in the ears Unusual tiredness or weakness Hair loss or thinning of the hair
Chest pain Fever Swoll of the eyelids or around the eyes, face, lips, and tongue Blood vomiting Hearing loss
Chills Frequent urge to urinate Runny nose Blistering Lack or loss of strength
Confusion Headache Severe stomach pain Crusting Paleness of the skin
Constipation Hives, itching, or skin rash Shivering Irritation, itching Redness
Cough Loss of voice Slow or fast heartbeat Breast pain Weight changes
Severe burning, or painful urination Lower back or side pain Sneezing Burning, dry, or itching eyes  

What is the case of overdose?

Studies of Misoprostol intolerance do not point towards any adverse side effects even with a dosage higher than three times of that advised for pregnancy termination. However, massive consumption leads to symptoms of adrenal failure. 

When acute intoxication occurs, special treatment, including dexamethasone administration, is advised. Note that the toxic dose of misoprostol in humans is not determined yet. But a total daily dose of 1600 mcg can be tolerated well, with only symptoms of gastrointestinal discomfort.  

Typical overdosing signs are tremor, sedation, breathlessness, convulsions, abdominal pain, hypotension, diarrhea, fever,  and bradycardia. In cases of overdose, seek medical attention immediately.

Where should I store misoprostol?

Store the drug in a place devoid of moisture, heat, or direct sunlight. It should away from children and pets. It is good practice to ensure that the drug container remains closed.

Misoprostol: FAQs

Will I vomit after taking the Misoprostol pill?

Nausea is common in some people. In such a case,  check with their doctor for the administration of an antiemetic drug to stop vomiting.

What happens if I skip/miss a dose?

Misoprostol is a one-time drug. Take 4 pills at once, 2 to 3 days after taking Mifepristone. If you miss, consult your doctor. 

What's the way out if I accidentally swallowed Misoprostol pills?

Swallowing Misoprostol is safe and effective. But it may lead to gastrointestinal problems when the drug enters the stomach. 

Does misoprostol affect my fertility?

It is highly unlikely because many women start ovulating within few weeks after treatment. Again, they resume their menstruation within four weeks. That implies that within a month, a woman can get pregnant. 

When can I resume sexual intercourse after the treatment?

At least after a week.

Will I have any psychological disturbances after treatment?

It is less likely to develop psychological disturbances such as depression and anxiety.

 

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