Misoprostol
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| Clinical data | |
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| Trade names | Cytotec, Misodel, other |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a689009 |
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| Routes of administration |
By mouth, vaginal, under the tongue |
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| Pharmacokinetic data | |
| Bioavailability | extensively absorbed |
| Protein binding | 80-90% (active metabolite, misoprostol acid) |
| Metabolism | Liver (extensive to misoprostic acid) |
| Biological half-life | 20–40 minutes |
| Excretion | Urine (80%) |
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| ChEMBL | |
| ECHA InfoCard | 100.190.521 |
| Chemical and physical data | |
| Formula | C22H38O5 |
| Molar mass | 382.534 g/mol |
| 3D model (Jmol) | |
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Misoprostol, sold under the brandname Cytotec among others, is a medication used to start labor, cause an abortion, prevent and treat stomach ulcers, and treat postpartum bleeding due to poor contraction of the uterus. For abortions it is often used with mifepristone or methotrexate. By itself effectiveness for this purpose is between 66% and 90%. It is taken either by mouth, under the tongue, or placed in the vagina.
Common side effects include diarrhea and abdominal pain. It is pregnancy category X meaning that it is known to result in negative outcomes for the baby if taken during pregnancy. Uterine rupture may occur. It is a prostaglandin analogue — specifically, a synthetic prostaglandin E1 (PGE1).
Misoprostol was developed in 1973. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. It is available as a generic medication. The wholesale cost in the developing world is about 0.36 to 2.00 USD a dose. A months supply to treat stomach ulcers in the United States is between 100 and 200 USD. The same costs between 30 and 55 EUR in Europe.
Misoprostol is used for the prevention of NSAID-induced gastric ulcers. It acts upon gastric parietal cells, inhibiting the secretion of gastric acid by G-protein coupled receptor-mediated inhibition of adenylate cyclase, which leads to decreased intracellular cyclic AMP levels and decreased proton pump activity at the apical surface of the parietal cell. Because other classes of drugs, especially H2-receptor antagonists and proton pump inhibitors, are more effective for the treatment of acute peptic ulcers, misoprostol is only indicated for use by people who are both taking NSAIDs and are at high risk for NSAID-induced ulcers, including the elderly and people with ulcer complications. Misoprostol is sometimes coprescribed with NSAIDs to prevent their common adverse effect of gastric ulceration (e.g. with diclofenac in Arthrotec).
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Wikipedia