Misoprostol is a drug that is Food and Drug Administration (FDA)-approved for the treatment and prevention of stomach ulcers. It is also used to induce labor and as an abortifacient. It is marketed by Pfizer under the trade name Cytotec, but generic versions are available as well.

Chemically, misoprostol is a synthetic prostaglandin E₁ (PGE₁) analogue.

When administered, misoprostol stimulates increased secretion of the protective mucus that lines the gastrointestinal tract and increases mucosal blood flow, thereby increasing mucosal integrity. It is sometimes co-prescribed with non-steroidal anti-inflammatory drugs (NSAIDs) to prevent the occurrence of gastric ulceration, a common adverse effect of the NSAIDs.

More common adverse effects of misopristol include nausea, vomiting, diarrhea, abdominal pain, chills, shivering and fever. Because of its abortifacient properties, it should not be taken by pregnant women.

Gynecological uses

---

Although not licensed for the indication, misoprostol is commonly prescribed to expedite the onset of labor by causing uterine contractions and the ripening (opening) of the cervix. Other prostaglandins very similar to Misoprostol have been approved by the FDA for this purpose. The drug is highly effective and much less expensive than the other FDA-approved drugs for this purpose. A clinical trial is currently underway to obtain FDA approval for this use of the drug. As with any drug there can be complications; high doses can cause fetal death and uterine rupture.

Misoprostol is one of the drugs used for medical (non-surgical) termination of pregnancy (see abortion). In many countries it is used in conjunction with mifepristone (RU-486). After mifepristone is taken orally, misoprostol is taken 24-72 hours later causing the expulsion of the fetus and associated matter in over 98% of the cases.

In some cases, Misoprostol is used to expel a dead embryo or fetus in a miscarriage. It can also be used to dilate the cervix in preparation for a surgical abortion.

Misoprostol alone has been shown to be highly effective (about 90%) in inducing an abortion, and it is used for self-induced abortions in many countries where abortions are illegal. This method is especially common in South American countries where misoprostol is available from pharmacies for other medical indications. Poor immigrant populations in New York have also been observed to use self-administered misoprostol to induce abortions, as this method is much cheaper than a surgical abortion (about $2 per dose).John Leland: "Abortion Might Outgrow Its Need for Roe v. Wade", The New York Times, October 2, 2005

There is a serious risk that, when the method is not successful, the fetus can be born with severe physical abnormalities.

Misoprostol is also used to prevent and treat post-partum hemorrhage.

References

---

External links and further reading

---

• ^* Clinical Trial Description at clinicaltrials.gov
• Misoprostol from Drugdigest
• Pro-Life Nation, The New York Times Magazine, April 9, 2006. Reports on the use of Misoprostol in El Salvador, where abortion is illegal in all circumstances.

Abortifacients | Gastroenterology | Gynecology | Prostaglandins

Misoprostol | Misoprostol