Misoprostol

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Misoprostol is used for the treatment of duodenal and gastric ulcers. It works by reducing the amount of acid secreted in the stomach. There are different ways of getting such ulcers, such as maybe non-steroidal anti-inflammatory drugs. These drugs can block certain prostaglandins and misoprostol can be used to cure or prevent these type of ulcers. The healing process for these ulcers is usually a few weeks. In some cases misoprostol is given as a preventative and combined preparations are avaliable, these will reduce the likelihood of ulcers occurring. Antacids containing magnesium should be avoided as one of the side effects of misoprostol is diarrhoea and magnesium can make this symptom worse. Cytotec can also be used to heal existing ulcers.

Sometimes Cytotec can be prescribed for use other than the approved ones of healing or prevention of ulcers this is refered to as ‘off label’ (to treat a condition for which it has not been specifically approved for).

Quick Guide

• Anti-ulcer medication with overdose danger – LOW.
• Dependency is said to be – LOW.
• Prescription only drug – YES.
• Available as generic – NO.
• Alcohol Avoidance – NO.
• Avoid excessive amounts of alcohol it may undermine the desired effects of misoprostol.
• Cytotec tablet (misoprostol) should be taken with food.
• Cytotec contains hydrogenated castor oil which may cause stomach upset and diarrhoea.
• Take misoprostol at the same times each day. This may help you to remember to take your medicine (become habit forming).

Side Effects

You may if prescribed Misoprostol suffer one or more of these side effects, in the initial stages. However, you may find you do not suffer any at all. It does not follow that being on this medication will cause unwanted adverse effects.

Common: Diarrhoea, Indigestion
Rare: Abdominal Pains, Nausea, Rash, Vomiting, Vaginal/Intermenstrual Bleeding

The side effects listed here are the most common and rare problems reported by patients using Misoprostol. It may not include all of the side effects reported by the drug’s manufacturer. If common side effects persist you need to inform your doctor. Notify your doctor if you suffer any of the rare or some other side effects not listed here. For total peace of mind, seek information from your doctor or chemist.

Prolonged Use

There would be no problems expected with long term use of this medication.

Driving, Hazardous Work & Alcohol

There would be no problems expected with any of these activities. However, excessive amounts of alcohol may undermine the desired effects of misoprostol.

Pregnancy and Breast-Feeding

Manufacturer advice: It is not recommended that women of childbearing years take misoprostol. In exceptional cases if the patient requires non-steroidal anti-inflammatory (NSAID) therapy and is at high risk of complications from NSAID-induced ulceration, it may be prescribed on the condition that effective contraception is being used.

If you are pregnant or planning to become pregnant. Do not take cytotec (misoprostol). Breastfeeding should also be avoided. Misoprostol taken during pregnancy can cause the uterus to contract before the baby is due.

• Some women may experience period problems including cramp, prolonged heavy bleeding, bleeding between periods, irregular periods and severe uterine pain. Some older women may have vaginal bleeding even though they have gone through the menopause.

Patient information misoprostol is classified as a pregnancy Category X medicine Category X… Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Tell Your Doctor or Pharmacist

You should tell your doctor if you have a current health problem. For example: heart disease, kidney problems, if you are pregnant or you intend to become pregnant, or if you think you may be at risk from drug treatment for any other reason. Some types of medication can cause serious adverse effects when taken side by side so it is important to tell your doctor of any other medication you are already taking. This should also include any over-the-counter medication. For example: Painkillers, cold remedies, herbal and complimentary/alternative medication.

Over 60’s & Children

There would be no problems expected if taken by the over sixties. Misoprostol is not recommended for infants or children.

Overdose

If an unintentional extra dose has been taken accidently there would not be any cause for concern. However, if you notice any unusual symptoms or a large overdose has been taken you should notify your doctor immediately.

Failing this go to your nearest accident and emergency department of your local hospital. Take the container with you. This will help the hospital staff identify what has been taken and work towards given the right kind of help, without delay.

Other Medication Reactions

Manufacturer advice: You can take Cytotec with most medicines without any problems. However, as already mentioned antacids containing magnesium may increase any symptoms of diarrhoea, one of the side effects of misoprostol (avoid antacids with magnesium in them). If you are taking any medicines for a heart condition, please consult your doctor before taking Cytotec (misoprostol).

Missed 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 continue the regular dosing schedule. Do not take a double dose to make up for a missed one. Ideally you would have already checked with your doctor.

Reducing or Stopping Medication

It is important that you do not stop taking the drug without consulting your doctor. It is possible that the symptoms will recur.

Effect Of Medication (from one dose)

The effects of this drug can be felt within 24 hours. It has a lasting effect of up to 24 hours. It is possible that some effects may be longer lasting.

Safety and Storage

• Never take more than the original dosage prescribed by your doctor.
• If your due to have treatment like an operation or dental work tell the person carrying out the treatment which medicines you are taking.
• When you buy any medicines over-the-counter check with the pharmacist that they are safe to take with your other medicines.
• Never take Misoprostol if it has past the expiry date shown on the box or container.
• Do not store medication above a temperature of 25°C or above a working area where high condensation may exist.
• Keep Misoprostol in its original container, in a cool dry place, away from the reach and eye sight of children.
• Always read the printed information leaflet that comes with your medicine if possible, before beginning treatment.
• Do not discard old or unwanted drugs into your trash, sink or toilet.
• Return all unused or old medicines/drugs to your pharmacist. who will dispose of them safely. without causing unwanted effects on our enviroment.

If Misoprostol has been prescribed for you never allow anyone else to use it, even if you know or others feel their symptom are similar to your own.

Do not leave your doctors surgery until you have a clear understanding of what the drug your doctor has prescribed for you does, and why you have been prescribed it. It is common for people who do not understand the reason behind there treatment to take their medication correctly.

Reference:

• Pharmacia Limited Patient Information Leaflet (PIL) last updated on electronic Medicines Compendium eMC: 24/11/2010. Cytotec Tablets.
• British National Formulary – 61st Edition (March 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London.