Products
Misoprostol tablets for medication abortion were approved in many countries in 2015 (MisoOne). This article refers to abortion. In addition, other drugs exist with other indications (gastric protection, induction of labor).
Structure and properties
Misoprostol (C22H38O5, Mr = 382.5 g/mol) is a synthetic derivative of prostaglandin E1 and exists as a mixture of two enantiomers. It is a viscous liquid that is soluble in water. Misoprostol is an ester prodrug that is converted to active misoprostolic acid in the body.
Effects
Misoprostol (ATC G02AD06) causes contractions of the myometrium (smooth muscle layer of the uterus) and relaxation of the cervix. This opens the cervix and allows the fetus to be expelled.
Indications
For drug abortion of early intrauterine pregnancy up to amenorrhea duration of 49 days in adults, after taking mifepristone. In addition, other indications exist (induction of labor).
Dosage
According to the SmPC. The single dose is taken 36 to 48 hours after taking mifepristone.
Contraindications
- Hypersensitivity
- Pregnancy that has not been confirmed by sonography or biological tests
- Suspicion of ectopic pregnancy
- Duration of pregnancy > 49 days
- Presence of contraindications to mifepristone
Full precautions can be found in the drug label.
Interactions
Antacids may reduce the bioavailability of misoprostol. NSAIDs may reduce the effectiveness of the drug. Increased diarrhea may occur with magnesium administration.
Adverse effects
The most common possible adverse effects include infection, nausea, vomiting, diarrhea, flatulence, cramps, uterine contractions, and bleeding.
