What is misoprostol and how does it work?
Misoprostol is a prescription drug used to reduce the risk of NSAID (nonsteroidal anti-inflammatory drugs, including aspirin)–induced gastric ulcers in patients at high risk of complications from gastric ulcers, such as the elderly and patients with concomitant debilitating disease, as well as patients at high risk of developing gastric ulceration, such as patients with a history of ulcer. Misoprostol has not been shown to reduce the risk of duodenal ulcers in patients taking NSAIDs. Misoprostol should be taken for the duration of NSAID therapy. Misoprostol has been shown to reduce the risk of gastric ulcers in controlled studies of 3 months duration. It had no effect, compared to placebo, on gastrointestinal pain or discomfort associated with NSAID use. Misoprostol is available under the following different brand names: Cytotec.
Important Information
Misoprostol can cause birth defects, premature birth, uterine rupture, miscarriage, or incomplete miscarriage, and dangerous uterine bleeding. Do not use misoprostol if you are pregnant. If you are able to become pregnant, you will need to have a negative pregnancy test before starting this treatment. You will also need to use effective birth control to prevent pregnancy during treatment.
How should I take misoprostol?
Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Do not share this medicine with another person. Misoprostol is usually taken with meals and at bedtime. Follow your doctor’s instructions.
You may have nausea, stomach cramps, or diarrhea while taking this medicine, especially during the first few weeks after you start taking misoprostol. These symptoms usually last for about a week. Call your doctor if you have severe nausea, stomach pain, or diarrhea lasting longer than 8 days.
Misoprostol comes in the form of a tablet and can be given through the mouth (orally), under the tongue (sublingually) or it can be inserted into the vagina. It takes around 3 minutes for the pill to dissolve. After 30 minutes, swallow what is left of the pills. Read all medication guides or patient instructions provided with this medicine each time you receive a new supply.
What happens if I miss a dose?
Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.
What should I avoid while taking misoprostol?
Ask your doctor before using an antacid, and use only the type your doctor recommends. Some antacids can increase your risk of diarrhea while you are taking misoprostol.
What are the side effects associated with using misoprostol?
Side effects of misoprostol include:
- diarrhea
- abdominal pain
- headache
- severe allergic reaction (anaphylaxis)
- anemia
- abnormal heartbeat
- chest pain
- gas (flatulence)
- gastrointestinal bleeding
- hearing loss
- heart attack (myocardial infarction)
- nausea
- vomiting
- constipation
- rupture of uterus
- blood clots
- stroke
- spotting
- menstrual cramps
- disruption in normal menstrual flow
- menstrual disorder
- painful periods
- aches/pains
- abnormal physical weakness
- fatigue
- fever
- chills
- sudden feeling of cold accompanied by a rise in temperature
- weight changes
- rash
- dermatitis, eczema
- hair loss
- pale appearance
- breast pain
- abnormal taste
- abnormal vision
- pink eye (conjunctivitis)
- ringing in the ears (tinnitus)
- earache
- upper respiratory tract infection
- bronchitis
- difficulty breathing
- pneumonia
- nose bleed
- swelling (edema)
- sweating
- low blood pressure (hypotension)
- high blood pressure (hypertension)
- irregular heartbeat (arrhythmia)
- inflammation of vein
- increased cardiac enzymes
- fainting (syncope)
- rectal disorders (hemorrhoids, abscesses, fissures, or cancer)
- abnormal liver and gallbladder function
- inflammation of the gums (gingivitis)
- reflux
- difficulty swallowing
- increased blood level of amylase enzyme
- excess sugar in the urine
- inflammatory arthritis (gout)
- increased blood level of nitrogen
- increased blood level of alkaline phosphatase (ALP)
- abnormal large volume of dilute urine
- painful or difficult urination
- blood in the urine
- urinary tract infection
- anxiety
- loss of appetite
- depression
- drowsiness
- dizziness
- thirst
- impotence
- loss of sex drive (libido)
- numbness or weakness
- neurosis (symptoms of stress: depression, anxiety, obsessive behavior, hypochondria)
- confusion
- joint pain
- muscle pain
- muscle cramps
- stiffness
- back pain
- low blood platelets (thrombocytopenia)
- rash with purple spots on the skin
- increased erythrocyte sedimentation rate (ESR) in the blood
This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.
Pregnancy and Lactation
- Do not use misoprostol during pregnancy
- The risks involved outweigh potential benefits
- Safer alternatives exist
Breastfeeding: Misoprostol is rapidly metabolized in mother to misoprostol acid, which is biologically active and is excreted in breast milk; although no published reports of adverse effects of misoprostol in breastfeeding infants exist, caution should be exercised when misoprostol is administered to breastfeeding women
