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Misoprostol - instructions for use, analogs, reviews and release forms (200 μg tablets) of a drug for the treatment of stomach ulcers and abortion (medical abortion) in adults, children and pregnancy

Misoprostol - instructions for use, analogs, reviews and release forms (200 μg tablets) of a drug for the treatment of stomach ulcers and abortion (medical abortion) in adults, children and pregnancy

In this article, you can read the instructions for using the drug Misoprostol. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Misoprostol in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of misoprostol in the presence of existing structural analogues. Use to treat stomach ulcers and abortion (medicalabortion) in combination with Mifepristone in adults, children, as well as during pregnancy and lactation.

 

Misoprostol - a synthetic analogue of prostaglandin E1. Has cytoprotective effect associated with increased mucus formation in the stomach and increased secretion of bicarbonate by the gastric mucosa. Having direct influence on the parietal cells of the stomach, misoprostol suppresses the basal, night and stimulated (food, histamine, pentagastrin) secretion. Reduces basal (but not stimulated by histamine) pepsin production.

 

It induces a contraction of the smooth muscles of the myometrium and expands the cervix of the uterus. Increases the frequency and strength of contractions of the myometrium, exerting a weak stimulating effect on the smooth muscle of the gastrointestinal tract.

 

The action begins in 30 minutes and lasts at least 3-6 hours. At a dose of 50 μg the effect is moderate and short, 200 μg - pronounced.

 

Composition

 

Misoprostol + excipients.

 

Pharmacokinetics

 

When administered orally, quickly and completely absorbed (food delays absorption). Binding to plasma proteins is 85%. In the walls of the gastrointestinal tract and the liver is metabolized to pharmacologically active misoprostolic acid.Do not cumulate with multiple admission. It is excreted by the kidneys (80%) and with bile (15%).

 

Indications

  • prevention of the development of gastric ulcers associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs), in patients with an increased risk of ulceration;
  • treatment of exacerbation of peptic ulcer of the duodenum;
  • stomach ulcer.

 

In combination with mifepristone: termination of pregnancy in early periods (up to 42 days amenorrhea).

 

Forms of release

 

Tablets 200 mcg.

 

Instructions for use and dosing regimen

 

The dosage regimen is determined individually, depending on the indications.

 

For the prevention of gastric ulcers caused by non-steroidal anti-inflammatory drugs, and the treatment of erosive gastritis and peptic ulcer of the stomach and duodenum: 200 μg 2-4 times a day (the last intake - before bedtime); The daily dose is 400-800 micrograms. With poor tolerance, a single dose can be reduced to 100 μg. With renal failure, the daily dose is reduced by 50%.

 

To interrupt pregnancy (in combination with mifepristone): 36-48 hours after taking mifepristone, 400 μg of misoprostol are prescribed.

 

Side effect

  • abdominal pain;
  • flatulence;
  • nausea, vomiting;
  • diarrhea;
  • constipation;
  • pains in the lower abdomen associated with contractions of the myometrium;
  • dysmenorrhea;
  • polymenorea;
  • menorrhagia;
  • metrorrhagia;
  • skin rash;
  • itching;
  • angioedema;
  • change in body weight;
  • asthenia;
  • increased fatigue;
  • convulsions (in women in the pre- or post-menopausal period).

 

Contraindications

  • severe liver dysfunction;
  • inflammatory bowel disease;
  • pregnancy;
  • lactation period;
  • severe renal insufficiency;
  • enteritis;
  • children and adolescents under 18;
  • hypersensitivity to misoprostol.

 

Application in pregnancy and lactation

 

Contraindicated in pregnancy and lactation (breastfeeding).

 

It should be borne in mind that misoprostol raises the tone of the uterus and can provoke miscarriage when used as a gastroprotective agent.

 

If it is necessary to use women of childbearing age, a serum pregnancy test should be carried out beforehand, which should remain negative for 2 weeks before starting misoprostol therapy. Treatment can be started only on the 2-3rd day of normal menstruation.During the course of treatment, reliable methods of contraception should be used.

 

Use in children

 

Contraindicated in children and adolescents under 18 years.

 

special instructions

 

They are used with caution in patients with arterial hypotension, ischemic heart disease, cerebral circulation disorder, coronary cariesclerosis, epilepsy, enterocolitis, diarrhea, hypersensitivity to prostaglandins or their analogues.

 

The use for abortion is carried out only in combination with mifepristone and only in specialized medical institutions that have appropriately trained medical personnel and who have the capacity to provide emergency surgical gynecological and blood transfusion care. In a regular pharmacy, the drug is not sold.

 

The use of the drug requires the prevention of Rh-conflict and other common activities associated with abortion. Before the appointment of misoprostol, the patient should be informed in detail about the effect and possible side effects of the drug. The patient should be observed in the conditions of the medical institution for 4-6 hours before taking the drug.During and after taking the drug, the patient should receive timely medical attention in the event of massive bleeding or other complications. After taking the drug in patients, as a rule, there is a slight vaginal bleeding, in some women - very long. At very early gestation, abortion is possible after taking mifepristone, but in this case, it is also necessary to take misoprostol tablets to optimize the results of medical abortion. After taking misoprostol in about 80% of women, abortion occurs within 6 hours and about 10% of women within 1 week. The patient must undergo a second examination in the same medical institution 8-15 days after taking the drug. If necessary, an ultrasound or a level of chorionic gonadotropin in the blood serum should be performed. If there is a suspicion of incomplete abortion or the maintenance of pregnancy, a comprehensive medical examination should be conducted in a timely manner. In case of incomplete abortion or continuing pregnancy, estimated 10-14 days after taking mifepristone, vacuum-aspiration is mandatory, followed by a histological examination of the aspirate.

 

Admission of the drug as a gastroprotector should be discontinued if diarrhea occurs (mild diarrhea is not considered a reason for withdrawal, the drug is canceled for severe diarrhea - approximately 2% of cases), itching, bleeding from the vagina, lowering blood pressure and increasing the activity of transaminases.

 

For 1 week after taking misoprostol, Acetylsalicylic acid and other NSAIDs should not be prescribed.

 

Drug Interactions

 

With simultaneous use with antacids, the concentration of misoprostol in the blood plasma decreases.

 

With simultaneous use with magnesium-containing antacids, it is possible to increase diarrhea.

 

With simultaneous use with acenocoumarol, the case of decreasing the anticoagulant effect of acenecoumarol has been described.

 

With simultaneous use with diclofenac, indomethacin, side effects of Diclofenac and Indomethacin are enhanced.

 

Analogues of the drug Misoprostol

 

Structural analogs for the active substance:

  • Misoprostol HPMC;
  • Mirolyut;
  • Saitotec.

 

Analogues for the pharmacological group (funds for medical abortion):

  • Pencrofton;
  • Resonative;
  • Enzaprost F.

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