Misoprostol

Adults: Benign gastric and duodenal ulceration and NSAID associated ulceration: 800 mcg daily, given in 2 to 4 divided doses with breakfast or main meals and at bedtime. Treatment should be continued for at least 4 weeks and may be continued for up to 8 weeks if required. Prophylaxis of NSAID-induced gastric and duodenal ulcer: 200 mcg 2 to 4 times daily, taken with the NSAID. If this dose cannot be tolerated, a dose of 100 mcg can be used. Misoprostol should be taken for the duration of NSAID therapy as prescribed by the physician. Induction of labor: Place 25 mcg in the posterior fornix of the vagina. Repeat every 6 hours if necessary until the maximum total dose of 200 mcg of misoprostol is reached. Fetal heart rate and uterine contractions should be monitored. Alternatively, 100 mcg may be taken orally. If cervical ripening or active labor does not occur, a repeated dose of 100 to 200 mcg of oral misoprostol is given every 4 hours until labor is established, as shown by a Bishop score of 7 or more. The maximum number of doses is 6. Maternal vital signs, fetal heart rate and contractions should be monitored. Oxytocin can be started 4 hours after the last dose of misoprostol. The physician should be notified of any signs of fetal distress or tetanic uterine contractions. Oral misoprostol therapy should be monitored by a physician. Prevention of postpartum hemorrhage: 600 mcg orally immediately following delivery. Treatment of postpartum hemorrhage: 600 mcg orally or 1000 mcg rectally.