MISTOL Generic Name: Misoprostol Therapeutic Category: Endocrine-Metabolic Agent Pharmacologic Class: Prostaglandin Composition: Each uncoated tablet contains Misoprostol 200 mc Pregnancy Category: X Presentation: Available in the pack size as 4 tablets X 1 blister
DescriptionIt is a synthetic analog of natural prostaglandin E1. It produces a dose-related inhibition of gastric acid and pepsin secretion, and enhances mucosal resistance to injury. It is an effective anti-ulcer agent and also has oxytocic properties.
Mechanism of ActionAt the end of a pregnancy: There are many receptors and a small dose of misoprostol leads to strong contractions. Special attention is required in women with a live fetus [who may hyperstimulate (uterine)*]. Not for use by women with previous caesarean sections – it may cause a uptured uterus. Uterine ruptures have also been reported occasionally in unscarred uterus. In early pregnancy: There are few receptors and large doses of misoprostol may need to be given repeatedly in order to have an effect. For termination of pregnancy: The sensitivity of the uterus to prostaglandins can be increased by giving the progesterone blocker mifepristone to the women 24-48 hours before treatment with misoprostol. This is especially useful in early pregnancy, although it also works in late pregnancy.
- Softens and opens (dilates) the cervix.
- Causes uterine contraction
- Starts (induces) labor.
- To prevent postpartum hemorrhage.
- In combination with mifepristone it cause abortion
DosageRoute of administration: Vaginally, orally, sub-lingual 400 μg or 800 μg Smaller dose while given vaginally. Pharmacokinetics Absorption: Rapid absorption Protein binding: Approximately 85% Metabolism: Hepatic Route of elimination: Urine Half-life: 20-40 minutes
Adverse EffectsMost common side effect is Diarrhea followed by abdominal pain, nausea, flatulence, headache, dyspepsia, vomiting, and constipation.
ContraindicationsMISTOL is contraindicated in the following populations and situations:
- Should not be taken by pregnant women for gastric ulcers
- Women with previous cesarean section
- Less force needed for dilatation,
- makes the intervention safer and easier
- shortens the time for the procedure
- reduces blood loss in the case of a subsequent surgical abortion
*TerminologiesUterine hyperstimulation: This may result in fetal heart rate abnormalities, uterine rupture, or placental abruption.