Cytotec®, or the generic Misoprostol, is a synthetic prostaglandin E1 analog used for a wide variety of medical applications. This drug is approved by the United States Food and Drug Administration for use in conjunction with non-steroidal anti-inflammatory drugs to help prevent them from causing gastric ulcerative complications. It is also listed by the World Health Organization as an obstetric drug used for the induction of labor. Cytotec® can also be used to treat early fetal death when spontaneous miscarriage does not occur or as a treatment for post-partum hemorrhage when oxytocin is not available. In the first trimester of pregnancy, Cytotec® can be used as in conjunction with RU-486 to chemically induce abortion, while it can be used in the second trimester to help thin the cervix in preparation for surgical abortion. The recommended Cytotec® dosage varies according to the purpose for which it is being administered, and can be further adjusted depending on the kidney health of the patient and how well the initial dose is tolerated.
As a preventative agent in adults receiving non-steroidal anti-inflammatory drugs who are at risk for gastric ulcers, the recommended oral Cytotec® dose is 200 mcg, administered four times each day. The first three doses of the day should be given with meals, and the last dose should give given immediately before bedtime. If the initial Cytotec® dosage level is not well tolerated by the patient, it is possible to reduce it to 100 mcg, again given four times daily. Patients with diminished levels of kidney function should be monitored more closely to determine if a reduced Cytotec® dosage is needed.
The most common side effect to indicate an intolerance of the Cytotec® dosage is diarrhea. If the patient develops diarrhea, it is important that his or her fluid and electrolyte levels are maintained. It may be necessary to administer an electrolyte solution along with the medication until the diarrhea subsides, which on average takes seven or eight days. If the diarrhea persists or if the patient begins to display symptoms of dehydration or electrolyte imbalance, such as dizziness, muscle weakness, low urine volume, mental and emotion disturbance, or irregular heartbeat, the Cytotec® dosage may need to be reduced or discontinued altogether while the patient rehydrates.
Other common side effects that may occur with the use of this medication include nausea or stomach cramps. Occasionally, more serious side effects may occur. Menstrual irregularites and unusual or heavy vaginal bleeding are indications that the medication may be causing serious complications and must be discontinued. Due to the risk to the fetus, there is no safe Cytotec® dosage level for ulcer prevention in women who are pregnant or who may become pregnant while taking the drug.
