Misoprostol

Misoprostol is a drug that is FDA-approved for the treatment and prevention of stomach ulcers. It is also used to induce laborand as an abortifacient. It is marketed by Pfizerunder the trade name Cytotec, but generic versionsare available as well.

Chemically, misoprostol is a synthetic prostaglandinE₁ (PGE₁) analogue.

When administered, misoprostol stimulates increased secretion of the protective mucusthat lines the gastrointestinal tractand increases mucosal blood flow, thereby increasing mucosal integrity. It is sometimes co-prescribed with non-steroidal anti-inflammatory drugs (NSAIDs) to prevent the occurrence of gastric ulceration, a common adverse effect of the NSAIDs.

More common adverse effects of misopristol include nausea, vomiting, diarrhea, abdominal pain, chills, shivering and fever. Because of its abortifacient properties, it should not be taken by pregnant women.

Gynecological uses

Although not licensed for the indication (over 60% of the drugs that American doctors prescribe are not used for a licensed indication), misoprostol is commonly prescribed to expedite the onset of laborby causing uterine contractionsand the ripening (opening) of the cervix. Other prostaglandins very similar to Misoprostol have been approved by the FDAfor this purpose. The drug is highly effective and much less expensive than the other FDA-approved drugs for this purpose. As with any drug there can be complications; high doses can cause fetaldeath and uterinerupture.

Misoprostol is one of the drugs used for medical (non-surgical) termination of pregnancy (see abortion). In many countries it is used in conjunction with mifepristone(RU-486). After mifepristone is taken orally, misoprostol is taken 24-72 hours later causing the expulsion of the fetus and associated matter in over 98% of the cases.

In some cases, Misoprostol is used to expel a dead embryoor fetusin a miscarriage. It can also be used to dilate the cervix in preparation for a surgical abortion.

Misoprostol alone has been shown to be highly effective (about 90%) in inducing an abortion, and it is used for self-induced abortionsin many countries where abortions are illegal. This method is especially common in South Americancountries where misoprostol is available from pharmacies for other medical indications. Poor immigrant populations in New Yorkhave also been observed to use self-administered misoprostol to induce abortions, as this method is much cheaper than a surgical abortion (about $2 per dose). (Leland 2005)

If abortion became illegal in the United States, this is a likely method that would be widely used to illegally induce abortion. There is a serious risk that, when the method is not successful, the fetus can be born with severe physical abnormalities.

Further reading

• John Leland: "Abortion Might Outgrow Its Need for Roe v. Wade", The New York Times, October 2, 2005
• Misoprostolfrom Drugdigestpt:Misoprostol

es:Misoprostol

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It uses material from the http://en.wikipedia.org/wiki/Misoprostol Wikipedia article Misoprostol.