Published February 20, 2019 | Version v1
Journal article Open

Misoprostol – Drug That Changed the Practice of Gynecology and Obstetrics with Its Off-Label Indications

  • 1. Prof & HOD Obstetrics and gynecology, MGM Medical College, Navi Mumbai, Maharashtra, India
  • 2. Registrar, Obstetrics and gynecology, MGM Medical College, Navi Mumbai, Maharashtra, India
  • 3. Resident, Obstetrics and gynecology, MGM Medical College, Navi Mumbai, Maharashtra, India

Description

Misoprostol is a synthetic analogue of prostaglandin E1. The drug was developed by G. D. Searle & Company in 1973 for prevention of stomach ulcers. Since 1986, it is being used for its ‘off label’ indications in obstetrics and gynecology. [1] The common indications are medical termination of pregnancy (MTP), medical management of incomplete abortion, induction of labor, cervical ripening before surgical procedures and prevention and treatment of postpartum hemorrhage [2]. Since it is inexpensive, heat stable, no drug interactions and wide range of applications in reproductive health, ‘WHO’ in 2011 has added it in the model list of essential medicines. In this article we have reviewed misoprostol its uses and recommendations in modern obstetrics and gynecology.

Files

(23-29)Misoprostol – Drug That Changed the Practice of Gynecology and Obstetrics-format.pdf

Additional details

References

  • Rebecca Allen & Barbara M O'Brien. Uses of Misoprostol in Obstetrics and Gynecology. Rev Obstet Gynecol. 2009 Summer; 2(3): PP. 159–168. PMCID: PMC2760893, PMID: 19826573.
  • Goldberg AB, Greenberg MB & Darney PD. Misoprostol and pregnancy. N Engl J Med. 2001; 344: pp. 38–47.
  • Graham DY, White RH, Moreland LW, et al. Duodenal and gastric ulcer prevention with misoprostol in arthritis patients taking NSAIDs. Misoprostol Study Group. Ann Intern Med. 1993; 119: pp. 257–62.
  • ACOG Committee Opinion, authors. Number 283, May 2003. New U.S. Food and Drug Administration labeling on Cytotec (misoprostol) use and pregnancy. Obstet Gynecol. 2003; 101: pp. 1049–1050.
  • L.S. & Peroff P. Amwell WR. Prostaglandins in reproductive physiology. Am J Obstet Gynecol. 1970; 7(7).
  • Compound Summary for Misoprostol https://pubchem.ncbi.nlm.nih.gov/compound/misoprostol#section=Top.
  • Robert A, Nezamis JE & Phillips JP. Inhibition of gastric secretion by prostaglandins. Am J Dig Dis. 1967 Oct; 12(10): pp. 1073–1076,
  • Misoprostol: Pharmacokinetic profiles, effects on the uterus and side-efects. O.S. Tang, K. Gemzell-Danielsson, P.C. Ho. International Journal of Gynecology and Obstetrics. (2007)99: S160-S167.
  • Fiala C & Gemzel-Danielsson K. Review of medical abortion using mifepristone in combination with a prostaglandin analogue. Contraception Journal. 2006-July; 74: pp. 66–86.
  • Orioli IM & Castilla EE. Epidemiological assessment of misoprostol teratogenicity. BJOG. 2000; 107: pp. 519–523.