Uses

Misoprostol is a synthetic prostaglandin E1 analogue used for cervical ripening and labor induction, management of postpartum hemorrhage, and as a gastroprotective agent to prevent NSAID-induced gastric ulcers. It is also used in medical management of miscarriage.

Do not use if

Contraindicated in pregnancy when used for ulcer prevention (except in combination regimens). Contraindicated in patients with previous uterine surgery including caesarean section when used for labor induction due to risk of uterine rupture. Known hypersensitivity to misoprostol or other prostaglandins is a contraindication.

Side effects

Common side effects include uterine hyperstimulation, diarrhea, nausea, vomiting, abdominal cramping, and fever. Uterine rupture is a rare but serious risk, particularly in women with prior uterine surgery.

Warnings

Carries a black box warning for risk of uterine rupture, abortion, premature birth, and birth defects when used in pregnancy. Must not be used for labor induction in patients with prior uterine scar without close monitoring. Use in obstetric settings only with appropriate facilities.

How it works

Misoprostol is a synthetic PGE1 analogue that binds to myometrial prostaglandin receptors, causing uterine contractions for labor induction. It also binds to gastric prostaglandin receptors, reducing acid secretion and increasing mucus production, providing gastroprotection. Oral absorption is rapid.

Storage

Store at or below 25°C in a dry place. Keep in original packaging to protect from moisture and light.