Misoprostol
Misoprostol (Cytotec)
Misoprostol
(my-soh- PROST-ohl)
Pregnancy Category: X Cytotec (Rx)

Classification: Prostaglandin

Action/Kinetics: Synthetic prostaglandin E ₁ analog that inhibits gastric acid secretion, protects the gastric mucosa by increasing bicarbonate and mucous production, and decreases pepsin levels during basal conditions. May also stimulate uterine contractions that may endanger pregnancy. Rapidly converted to the active misoprostol acid. Time for peak levels of misoprostol acid: 12 min. t 1/2, misoprostol acid: 20-40 min. Misoprostol acid is less than 90% bound to plasma protein. NOTE: Misoprostol does not prevent development of duodenal ulcers in clients on NSAIDs.

Uses: Prevention of aspirin and other nonsteroidal anti-inflammatory-induced gastric ulcers in clients with a high risk of gastric ulcer complications (e.g., geriatric clients with debilitating disease) or in those with a history of ulcer. Investigational: Treat duodenal ulcers including those unresponsive to histamine H ₂ antagonists. With cyclosporine and prednisone to decrease the incidence of acute graft rejection in renal transplant clients (the drug improves renal function). With methotrexate to induce abortion.

Contraindications: Allergy to prostaglandins, pregnancy, during lactation (may cause diarrhea in nursing infants).

Special Concerns: Use with caution in clients with renal impairment and in clients older than 64 years of age. Safety and efficacy have not been established in children less than 18 years of age. May cause miscarriage with potentially serious bleeding.

Side Effects: GI: Diarrhea, abdominal pain, nausea, dyspepsia, flatulence, vomiting, constipation. Gynecologic: Spotting, cramps, dysmenorrhea, hypermenorrhea, menstrual disorders, postmenopausal vaginal bleeding. Miscellaneous: Headache.

Overdose Management: Symptoms: Abdominal pain, diarrhea, dyspnea, sedation, tremor, fever, palpitations, bradycardia, hypotension, seizures. Treatment: Use supportive therapy.

How Supplied: Tablet: 100 mcg, 200 mcg

Dosage
?Tablets
Adults: 200 mcg q.i.d. with food. Dose can be reduced to 100 mcg if the larger dose cannot be tolerated. In renal impairment, the 200-mcg dose can be reduced if necessary.