Misoprostol

Introduction To Misoprostol

Misoprostol is a medicine used for medical abortion (terminating a pregnancy). It is also used for preventing excessive bleeding after delivery. This medicine acts on the uterus and increases its contraction.

Misoprostol is given alone or in combination with some other medicine to attain the maximum benefit. It should be taken with food or as your doctor's advice. It should be taken orally, by swallow the tablets whole with a drink of water. If you experience vomiting within 30 minutes of tablet intake, inform your doctor or take another tablet. The medicine may take 24 hours to show its action and you experience bleeding.

Common side effects of this medicine include infection following abortion, nausea, vomiting, diarrhea, cramps, uterine contractions or cramping, uterine bleeding, heavy bleeding, and fetal malformations. If these bother you or appear serious, let your doctor know. There may be ways of reducing or preventing them. Usually, vaginal bleeding may last for 12 days, inform your doctor if it lasts for more than 12 days or you notice severe abdominal pain.

Before taking this medicine, tell your doctor if you have ever had an ectopic pregnancy, or you are breastfeeding or using an intrauterine device. Your doctor should also know about all other medicines you are taking as many of these may make this medicine less effective or change the way it works. You must avoid strenuous activity like heavy exercise, running, and driving while abortion as it can affect the bleeding. Your doctor may perform an ultrasound or pelvic examination to check for abortion completion.

Uses of Misoprostol

  • Medical abortion
  • Treatment of Post-delivery bleeding

Benefits of Misoprostol

Medical abortion
Misoprostol is used to cause an abortion during the early part of pregnancy. It is used up to week 10 of pregnancy (up to 70 days after the first day of your last menstrual period). This medicine effectively blocks the natural female hormone, called progesterone, that is needed for your pregnancy to continue. Please use it only as advised by the doctor.

Misoprostol is used to cause an abortion during the early part of pregnancy. It is used up to week 10 of pregnancy (up to 70 days after the first day of your last menstrual period). This medicine effectively blocks the natural female hormone, called progesterone, that is needed for your pregnancy to continue. Please use it only as advised by the doctor.

Treatment of Post-delivery bleeding
Misoprostol helps to control excessive bleeding after giving birth. This helps to prevent severe loss of blood that can lead to dropping of blood pressure, shock and even death if not controlled in time. It helps proper contraction of the uterus and therefore prevents hemorrhage and further complications.

Side effects of Misoprostol

Most side effects do not require any medical attention and disappear as your body adjusts to the medicine. Consult your doctor if they persist or if you’re worried about them

Common side effects of Meprostol

  • Cramps
  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach cramp
  • Uterine contractions
  • Uterine cramps
  • Menorrhagia (heavy menstrual bleeding)
  • Infection following abortion

How to use Misoprostol

Take this medicine in the dose and duration as advised by your doctor. Misoprostol is to be taken with food.

How Misoprostol works

Misoprostol increases contractions of the uterus to cause abortion. It can also prevent post-delivery bleeding due to poor contraction of the uterus.

Quick tips

  • Misoprostol helps terminate pregnancy when used along with another medicine called mifepristone.

  • It may also be used to prevent excessive bleeding after delivery.

  • For pregnancy termination:

    • Take it no later than 63 days after the first day of your last menstrual period.
    • Take it 36 – 48 hours after taking mifepristone.
    • Rest for at least 3 hours after taking the medicine.
    • If you vomit within 30 minutes of taking the tablet, talk to your doctor immediately, as you may need to take another tablet.
    • Take it only as prescribed by the doctor. Miscarriages, if incomplete, may result in serious medical complications leading to hospitalization, surgery and possible infertility.
    • Vaginal bleeding lasting for approximately 12 days may occur after taking this medicine. Inform your doctor immediately if excessive bleeding occurs or if you suffer from severe abdominal pain.
  • Use caution while driving or doing anything that requires concentration as it can cause dizziness and sleepiness.

  • It does not affect fertility. Use contraception to avoid pregnancy.

Safety Advice

sdsPregnancyUNSAFE

Can I take Misoprostol if I’m pregnant?

Misoprostol is highly unsafe to use during pregnancy. Seek your doctor's advice as studies on pregnant women and animals have shown significant harmful effects to the developing baby.

sdsBreastfeedingCAUTION

Can I take Misoprostol if I’m breastfeeding?

Misoprostol should be used with caution during breastfeeding. Breastfeeding should be held until the treatment of the mother is completed and the drug is eliminated from her body.

sdsAlcoholCAUTION

Is drinking alcohol while taking Misoprostol safe?

Caution is advised when consuming alcohol with Misoprostol. Please consult your doctor.

sdsDrivingUNSAFE

Can I drive after taking Misoprostol?

Misoprostol may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.

sdsKidneySAFE IF PRESCRIBED

Can I take Misoprostol if I have/had kidney diseases?

Misoprostol is safe to use in patients with kidney disease. No dose adjustment of Misoprostol is recommended. However, inform your doctor if you have an underlying kidney disease. This medicine may be started with a low dose and then increased with caution by your doctor.

sdsLiverSAFE IF PRESCRIBED

Can I take Misoprostol if I have/had liver diseases?

Misoprostol is probably safe to use in patients with liver disease. Limited data available suggests that dose adjustment of Misoprostol may not be needed in these patients. Please consult your doctor.

Frequently Asked Questions

Q. What is Misoprostol and what is used for?

Misoprostol contains a medicine called Misoprostol. It helps in medical termination of the pregnancy. It is prescribed along with another medicine called Mifepristone. It is only used to terminate a pregnancy which should not be more than 63 days old, counting from the first day of the last menstrual period. It works by increasing the contractions of the uterus. It may also be used in the prevention or treatment of post-delivery bleeding and for cervical ripening.

Q. How and in what dose should I take Misoprostol?

This medicine is administered only in a clinic or healthcare facility under the supervision of a gynaecologist.

Q. What should I expect after taking Misoprostol?

For medical termination of pregnancy: You may experience abdominal cramping, diarrhea, stomach pain, and nausea immediately after taking Misoprostol. You may also have vaginal bleeding within 4 hours of taking Misoprostol. You may also be asked to stay at the clinic or healthcare center for at least 3 hours after taking this medicine. After 14 days of taking Mifepristone (pill you took before Misoprostol) your gynaecologist may run some blood tests or perform ultrasonography to confirm whether pregnancy has been terminated or not.

Q. Can Misoprostol affect my future chances of getting pregnant?

No, studies have shown that this medicine does not impair the fertility of the women. Your future chances of getting pregnant are as equal as of those who have not taken this medicine.

Q. What are the common side effects of taking Misoprostol?

The common side effects of using Misoprostol are abdominal pain, abdominal cramping, nausea, diarrhea, dizziness, uterine contractions, pelvic pain, and shivering. If you experience a very heavy vaginal bleeding or if any of these side effects bother you please consult with your gynaecologist.

References

Written By:

Dr Advikka Ridhy

Dr Advikka Ridhy

MBBS

RMO, Aster MIMS

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