Contraindicated in:
- Hypersensitivity to prostaglandins
- OB: Should not be used to prevent NSAID-induced gastric injury in pregnancy due to potential for fetal harm or death
- Lactation: Lactation.
Use Cautiously in:
- Rep: Women of reproductive potential
- Pedi: Safety and effectiveness not established in children.
Exercise Extreme Caution in:
- Late trimester pregnancy, previous Caesarian section or uterine surgery, advanced gestational age, or ≥5 previous pregnancies (when used for cervical ripening or to induce abortion, may cause uterine rupture).
GI: abdominal pain, diarrhea, constipation, dyspepsia, flatulence, nausea, vomiting.
GU: miscarriage, menstrual disorders.
Neuro: headache.
Prevention of NSAID-Induced Ulcers
- PO (Adults): 200 mcg 4 times daily with or after meals and at bedtime, or 400 mcg twice daily, with the last dose at bedtime. If intolerance occurs, dose may be ↓ to 100 mcg 4 times daily.
Pregnancy Termination
- PO (Adults): 400 mcg single dose 2 days after mifepristone if abortion has not occurred.
Cervical Ripening and Labor Induction
- Intravaginally (Adults): 25 mcg (¼ of 100-mcg tablet); may repeat every 3–6 hr, if needed.
Therapeutic Classification: antiulcer agents, cytoprotective agents, abortifacients
Pharmacologic Classification: prostaglandins
Absorption: Well absorbed following oral administration.
Distribution: Unknown.
Protein Binding: 85%.
Metabolism/Excretion: Metabolized in liver to its active form (misoprostol acid); 80% excreted by the kidneys.
Half-life: 20–40 min.
(effect on gastric acid secretion)
