Informational only — Not medical advice. Always consult a licensed healthcare provider.

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Indications

Peptic Ulcer

Cytomis is used for several purposes. It helps prevent stomach and duodenal ulcers in people who take NSAIDs and are at high risk of complications from a gastric ulcer, such as older people, patients with a debilitating disease at the same time, and patients who have had an ulcer before. Prophylaxis here means prevention, so this use is for stopping ulcers from forming in the first place. It also helps heal stomach and duodenal damage that NSAIDs have already caused. Cytomis can heal gastric and duodenal ulcers even when the person is not taking NSAID therapy. Doctors also use it to induce labor, and to prevent and treat postpartum hemorrhage, which is heavy bleeding after childbirth.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Misoprostol is extensively absorbed and rapidly de-esterified to its free acid, which is responsible for its clinical activity and, unlike the parent compound, can be detected in plasma. Peak plasma levels of misoprostol acid are lower when the dose is taken with food, and taking an antacid alongside it reduces the total amount of misoprostol acid available. Misoprostol has both antisecretory action, in that it inhibits gastric acid secretion, and, in animal studies, a protective effect on the stomach lining. NSAIDs inhibit prostaglandin synthesis, and a resulting shortage of prostaglandins in the gastric mucosa can reduce bicarbonate and mucus secretion, contributing to the mucosal damage these drugs cause. Misoprostol can boost bicarbonate and mucus production, but in humans this has only been shown at doses of 200 mcg and above, doses that are also antisecretory. It is therefore not possible to say whether misoprostol's ability to lower the risk of gastric ulcer comes from its antisecretory effect, its protective effect on the mucosa, or both.

Pregnancy & Breastfeeding

Misoprostol can cause abortion, so it must not be used by women who are pregnant. It should also not be given to women who could become pregnant, with one exception. That is when the patient needs nonsteroidal anti-inflammatory drug (NSAID) therapy and is at high risk of developing a gastric or duodenal ulcer, or of developing complications from such an ulcer linked to the NSAID. In these patients Misoprostol may be prescribed if the patient has had a negative serum pregnancy test within 2 weeks before starting therapy. The patient must also be able to comply with effective contraceptive measures, and she must have received both oral and written warnings about the hazards of Misoprostol, the risk that contraception may fail, and the danger to other women of childbearing potential if the drug is taken by mistake. Finally, she should begin it only on the second or third day of her next normal menstrual period.

The active metabolite (Misoprostol acid) may pass into breast milk, but this has not been studied. Because of the potential for serious adverse reactions in nursing infants, Misoprostol is not recommended for nursing mothers.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

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.

Side Effects & Interactions

Side Effects

No side-effect data recorded yet.