Misoprostol is a drug that is used to treat peptic ulcers. When used as the second drug during a non-surgical abortion with the abortion pill or injection, it promotes the expulsion of the abnormal early pregnancy, in most cases.
Chemical data :
Formula = C22H38O5
Mol. mass =
382.5 g/mol
Excretion = Renal :80% , Fecal :15%
Half life =
20–40 minutes
Routes = Oral , Vaginal , Sublingual
History :
Misoprostol is a drug that is FDA -approved in the United States for the prevention of NSAID -induced gastric ulcers . It is also used (and approved in other countries) to induce labor and as an abortifacient . It was invented and marketed by G.D. Searle & Company (Pfizer) under the trade name CYTOTEC.
Chemically, misoprostol is a synthetic prostaglandin E 1 (PGE 1 ) analogue.
Misoprostol is one of the drugs used for medical abortions in lieu of surgical evacuation. Both medical and surgical methods can be used to removed products of conception in the case of missed or incomplete miscarriage , retained postpartum placenta, and for elective abortion. There are some advantages to using drugs instead of surgical intervention in these situations, as drugs are not invasive, reducing the risk from general anesthesia , infection as well as secondary infertility due to scarring and intrauterine adhesions ( Asherman's Syndrome ). Furthermore it is cheap and easy to administer. 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 approximately 92% of the cases. No large studies have established a protocol for the use of misoprostol alone, and the range of efficacy is 65%–93% depending on sample size, gestational age, and other test variables; Misoprostol alone may be more effective in earlier gestation.
Side Effect :
The most commonly reported adverse effect of taking a misoprostol 200 µg tablet by mouth four times a day to reduce the risk of NSAID-induced gastric ulcers is diarrhea . In clinical trials, an average 13% of patients reported diarrhea, which was dose-related and usually developed early in the course of therapy (after 13 days) and was usually self-limiting (often resolving within 8 days), but sometimes (in 2% of patients) required discontinuation of misoprostol.
The next most commonly reported adverse effects of taking a misoprostol 200 µg tablet by mouth four times a day to reduce the risk of NSAID-induced gastric ulcers are: abdominal pain , nausea , flatulence , headache , dyspepsia , vomiting , and constipation , but none of these adverse effects occurred significantly more often than when taking placebos.
Misoprostol should not be taken by pregnant women to reduce the risk of NSAID-induced gastric ulcers because it increases uterine tone and contractions in pregnancy which may cause partial or complete abortions, and because its use in pregnancy has been associated with birth defects.
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