Products
Dinoprostone is commercially available as a vaginal insert and vaginal tablet (Propess, Prostin E2). It is also available as a vaginal gel and vaginal suppository in some countries. Dinoprostone has been approved in many countries since 1986.
Structure and properties
Dinoprostone (C20H32O5, Mr = 352.5 g/mol) corresponds to the natural prostaglandin E2. It exists as a white crystalline powder that is practically insoluble in water.
Effects
Dinoprostone (ATC G02AD02) induces rhythmic uterine contractions that lead to induction of labor. It also promotes maturation of the cervix. The drug is absorbed into the blood through the vaginal mucosa. It is rapidly metabolized and has a short half-life in the minutes range.
Indications
For induction of labor at term or near term with adequate cervical ripeness for labor (38 weeks of gestation or older).
Dosage
According to the SmPC. The drugs are administered vaginally into the posterior vaginal vault.
Contraindications
Numerous precautions must be observed during use. Full details of precautions and drug interactions can be found in the Drug Information Leaflet.
Interactions
Concomitant use of other labor-promoting agents is not recommended. Adequate time interval must be observed for subsequent use of oxytocin. Nonsteroidal anti-inflammatory drugs (NSAIDs) may attenuate the effects of dinoprostone and should be discontinued if appropriate.
Adverse Effects
The most common possible adverse effects include fetal distress, altered fetal heart rate, abnormal uterine contractions, a feeling of warmth in the vagina, vomiting, diarrhea, nausea, fever, headache, and back pain.
