MISOPROSTOL

Synthetic prostaglandin that causes labour-like contractions during pregnancy and ripens the cervix

Dosage Forms

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Tablet

200 μg

Uses

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  • Incomplete abortion and miscarriage (to expel retained products from the uterus)
  • Excessive bleeding after childbirth
  • Induction of labour

Dose and Duration

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Incomplete abortion

600 μg swallowed orally or 400 μg sublingually

Excessive bleeding after childbirth

800 μg (4 tablets) sublingually or 1000 μg (5 tablets) rectally

Induction of labour

25 μg inserted vaginally every 6 hours. If no response after 2 doses of 25 μg, insert 50 μg every 6 hours. Do not use more than 200 μg in 24 hours

Contraindications

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  • Baby presenting abnormally in uterus
  • History of caesarean section, multiple pregnancies, or major uterine surgery
  • Untreated pelvic infection
  • Foetal distress
  • History of difficult or traumatic pregnancy

Side Effects

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  • Stomach upset, abdominal pain
  • Headache, dizziness
  • Fever
  • Low blood pressure
  • Foetal distress

Interactions

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  • Oxytocin: (increased contractions)

Patient Instructions

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  • Can cause stomach upset, vomiting, loose stools

Pregnancy

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  • Can be used

Breast-feeding

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  • Can be used

⚠️ Caution

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  • When used for termination of pregnancy, check for complete uterine emptying after treatment
  • If a woman vomits within 30 minutes of oral administration, administer the same dose vaginally
  • Vaginal route is preferred over oral administration
  • Never give a repeat dose of misoprostol even if bleeding persists, unless very sure that it has been vomited