Antacids reduce the total availability of misoprostol acid but this dos not appear clinically
important.

 

GU- spotting, cramps, hypermenorrhoea, menstrual disorder, dysmennorhea.
  Postmenopausal vaginal bleeding may be reduced by misoprostol administration.

GI- diarrhea, abdominal pain, nausea, flatulence, dyspepsia, vomiting, constipation.

 

History of allergy  to prostagladins; pregnancy.

Special precautions:
Women of child bearing potential- advise them they must not become pregnant when
misoprostol therapy is initiated, and they must use an effective contraceptive method while
taking misoprostol.

Diarrhea- usually develops in the course of therapy. The incidence can be minimised  by
administering after meals or at bed time and by avoiding coadministration of misoprostol  with
magnesium-containing antacids.

 

Approved by FDA in 1988.

Prevention of NSAID(including aspirin) induced ulcers in patients at high risk of complications  from a gastric ulcer.

Dosage:
Adults- 200mcg 4 times daily with food. if this cannot be tolerated, 100mcg can be used.
 Take with meals, the last dose of the day with bedtime.

Renal impairment- dosage adjustments is not routinely needed. If necessary, dosage can be reduced, if 200mcg is not tolerated.

 

MISOPROSTOL- PROSTAGLANDINS

1. Misoprostol can cause miscarriage, often associated with potentially dangerous bleeding.
    This   can result in hospitalisation, surgery, infertility, or death.  Do not take  misoprostol,  if pregnant,  and do not become pregnant while taking the medication.  If pregnancy occurs   during therapy, discontinue the drug and contact physician

2. Take misoprostol only according to the directions of the physician.

3. Do not give misoprostol to any one else.

5. Allergy- tell your doctor if you ever had any unusual or allergic reactions.to misoprostol or any  other substances such as foods, presevative or dyes.

6. Pregnancy- Misprostol must not be used during pregnancy

7. Breast feeding- Not recommended for use during breast feeding becaue it may cause diarrhea    in nursng babies

7. Children- No specific information comparing use of misoprostol in children with use with other   age groups.

8. Older patients- Medicine has been tested and has not shown to cause different side effects   or problems in  older people than it does in younger adults.

9.  Other medicines- Although certain medicines should not be used at all , in other cases two    different medicines    may be used together even if an interaction might occur.
   Tell you doctor if you are taking any other prescription    or nonprescription medicines
   (OTC)  

10. Other medical problems- Presence of other medical problems may affect the use of
       misoprostol.       Tell your doctor if you have any other medical problems especially-
      
       Blood vessel disease- medicines similar to misoprosol have been shown to make this condtion   worse
       
       11. Dosing - dosing of misoprostol may  be different for different patients. Follow your doctors orders   If your dose is   different do not change unless told by your doctor.

     To prevent stomach ulcer in patients taking anti-inflammatory medicines including
       aspirin-   Tablets-  Adults- 200mcg ( micromilligrams) four  a day with or after meals and  at bed time, or 400mcg two times a day, with last dose takem at bed time.

      Children and teen agers- dose may be determined by the doctor.

12. Missed dose-If you have missed a dose of this medicine, take it as s soon as possible.
     If it is almost time for the  next dose,skip the dose and follow the regular schedule.
     Never double doses.      

13. Storage-
      Do not store in bath room or near the kitchen or in damp places. Heat and moisture
      may affect the medicine and cause to break down.
      Do not keep outdated medicines  or medicines no longer in use
      Make sure that you keep outdated medicines out of reach of children.

Pharmacology:
Misoprostol, a synthetic prostaglandin E, analog, has both antisecretory(inhibition of gastric acid) and in (animals) mucosal protective properties. Misoprostol can increase bicarbonate and mucous production.

Pharmacokinetics:
Misoprostol is extensively absorbed and undergoes rapid de-esterification to its free acid. After oral administration, peak concentration of misoprostol is reached  in about 12+/- 3 minutes and a terminal half-life of 20 to 40 minutes.

 

Maximum plasma concentrations of misoprostol acid are diminished when taken with food.

Pregnancy:
Misoprostol  may cause miscarriage. If a women is or becomes pregnant, while taking the drug, discontinue the drug and appraise the patient of the potential hazards to the fetus.

Lactation:
Do not administer to nursing mothers, because of the potential excretion of misoprostol acid
which could cause significant  dirrhoea to the infant