DrugindexOnline^{2nd edition}

Generic name: Misoprostol
Brand names: Cytotec

Why is Cytotec prescribed?

Cytotec, a synthetic prostaglandin (hormone-like substance), reduces the production of stomach acid and protects the stomach lining. People who take nonsteroidal anti-inflammatory drugs (NSAIDs) may be given Cytotec tablets to help prevent stomach ulcers.

Aspirin and other NSAIDs such as Motrin, Naprosyn, Feldene, and others, which are widely used to control the pain and inflammation of arthritis, are generally hard on the stomach. If you must take an NSAID for a prolonged period of time, and if you are elderly or have ever had a stomach ulcer, your doctor may want you to take Cytotec for as long as you take the NSAID.

Most important fact about Cytotec

You must not become pregnant while using Cytotec. This drug causes uterine contractions that could lead to a miscarriage. If you do have a miscarriage, there is a risk that it might be incomplete. This could lead to bleeding, hospitalization, surgery, infertility, or even death. It is vitally important to use reliable contraception while taking Cytotec.

How should you take Cytotec?

Take Cytotec with meals, exactly as prescribed.

Take Cytotec for the full course of NSAID treatment, even if you notice no stomach problems.

Take the final dosage at bedtime.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Store at room temperature in a dry place.

What side effects may occur?

Cytotec may cause abdominal cramps, diarrhea, and/or nausea, especially during the first few weeks of treatment. These symptoms may disappear as your body gets used to the drug. Taking Cytotec with food can help minimize diarrhea. If you have prolonged difficulty (more than 8 days), or if you have severe diarrhea, cramping, or nausea, call your doctor.

• Other side effects may include:
  Constipation, gas, indigestion, headache, heavy menstrual bleeding, menstrual disorder, menstrual pain or cramps, paleness, spotting (light bleeding between menstrual periods), stomach or intestinal bleeding, vomiting

Cytotec may cause uterine bleeding even if you have gone through menopause. However, postmenopausal bleeding could be a sign of some other gynecological problem. If you experience any such bleeding while taking Cytotec, notify your doctor at once.

Why should Cytotec not be prescribed?

Do not take Cytotec if you are sensitive to or have ever had an allergic reaction to it or to another prostaglandin medication.

Do not take Cytotec if you are pregnant or might become pregnant while taking it.

Special warnings about Cytotec

Since Cytotec may cause diarrhea, you should use Cytotec very cautiously if you have inflammatory bowel disease or any other condition in which the loss of fluid caused by diarrhea would be particularly dangerous.

To reduce the risk of diarrhea, take Cytotec with food and avoid taking it with a magnesium-containing antacid, such as Di-Gel, Gelusil, Maalox, Mylanta, and others. Have frequent medical checkups.

Never give Cytotec to anyone else; the dosage might be wrong, and if the other person is pregnant, the drug might harm the unborn baby or cause a miscarriage.

If you have a history of heart disease, you may not be able to use Cytotec. Be sure to tell your doctor about any heart problems.

Possible food and drug interactions when taking Cytotec

Cytotec does not interfere with arthritis medications such as aspirin and ibuprofen.

Special information if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, inform your doctor immediately. Because Cytotec can cause dangerous cases of miscarriage, sometimes leading to the mother's death, it should not be taken during pregnancy. If you are a woman of childbearing age, you should not take Cytotec unless you have thoroughly discussed the risks with your doctor and believe you are able to take effective contraceptive measures.

You will need to take a pregnancy test about 2 weeks before starting to take Cytotec. To be sure you are not pregnant at the start of Cytotec treatment, your doctor will have you take your first dose on the second or third day of your menstrual period.

Even the most scrupulous contraceptive measures sometimes fail. If you believe you may have become pregnant while taking Cytotec, stop taking the drug and contact your doctor immediately.

It is not known if Cytotec appears in breast milk. Because of the potential for severe diarrhea in a nursing infant, your doctor may have you stop breastfeeding until your treatment is finished.

Recommended dosage

ADULTS

The recommended oral dose of Cytotec for the prevention of NSAID-induced stomach ulcers is 200 micrograms 4 times daily with food. Take the last dose of the day at bedtime.

If you cannot tolerate this dosage, your doctor can prescribe a dose of 100 micrograms.

You should take Cytotec for the duration of NSAID therapy, as prescribed by your doctor.

For People with Kidney Impairment

You will not normally need an adjustment in the dosing schedule, but your doctor can reduce the dosage if you have trouble handling the usual dose.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect symptoms of an overdose of Cytotec, seek medical attention immediately.

• Symptoms of Cytotec overdose may include:
  Abdominal pain, breathing difficulty, convulsions, diarrhea, fever, heart palpitations, low blood pressure, sedation (extreme drowsiness), slowed heartbeat, stomach or intestinal discomfort, tremors