Misotol

Indications

Misoprostol is used to help prevent stomach and duodenal ulcers in people who need to take anti-inflammatory painkillers (NSAIDs), and to help ulcers heal. In hospitals and clinics, doctors also use it for some pregnancy-related and gynaecological purposes, such as preventing or treating heavy bleeding after childbirth, preparing the cervix, inducing labour and managing miscarriage. These uses are only under a doctor's direct care.

How It Works

It is similar to prostaglandin E1, a natural body substance. In the stomach it reduces acid and strengthens the protective lining. In the womb it causes the muscle to contract and the cervix to soften.

Dosage and Administration

Ulcer prevention in adults: usually 200 micrograms 2 to 4 times a day with food, as prescribed. For any pregnancy-related or gynaecological use, the dose, route and timing are decided by the doctor and given as prescribed under medical supervision; never use it on your own for these purposes.

Interactions

• Antacids containing magnesium can make diarrhoea worse; ask the pharmacist for a suitable antacid if needed.
• It should not be combined with Oxytocin or other medicines that make the womb contract unless the doctor directs it.

Contraindications

Allergy to misoprostol or other prostaglandins. For ulcer prevention, it must not be taken by women who are pregnant or may be pregnant.

Side Effects

Common: diarrhoea, stomach cramps, nausea, wind and headache. After pregnancy-related use: fever, shivering, cramping and vaginal bleeding are expected for a short time.

Get urgent medical help for very heavy vaginal bleeding (soaking two or more large pads an hour for two hours in a row), severe stomach or pelvic pain that does not ease, fever lasting more than 24 hours, fainting or feeling very unwell, severe or persistent diarrhoea with dehydration, or signs of a serious allergic reaction.

Pregnancy and Lactation

Misoprostol can cause miscarriage, premature birth and birth defects. Women who could become pregnant must use reliable contraception while taking it for ulcer prevention and must stop and see the doctor if pregnancy is suspected. In pregnancy it is used only by a doctor for specific medical reasons. Small amounts pass into breast milk and may cause diarrhoea in the baby; ask the doctor about breastfeeding.

Precautions and Warnings

• Women with a previous caesarean section or other womb surgery have a higher risk of womb rupture when it is used in pregnancy; this is managed by the doctor.
• Take care if you have inflammatory bowel disease, heart or blood vessel disease, or are prone to dehydration.
• Do not give this medicine to anyone else.

Overdose

Overdose can cause drowsiness, shaking, fever, fast heartbeat, low blood pressure, severe diarrhoea, stomach pain and, in pregnancy, strong contractions and bleeding. Get emergency medical help.

Therapeutic Class

Prostaglandin analogue (stomach-protecting and womb-contracting agent).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Keep tablets in the original blister until use, as they are damaged by moisture.