Used in PPH prevention where oxytocin is not available. Exclude the second twin before administration.
- Check BNF or equivalent for UpToDate prescribing advice
Mode of action
- Prostaglandin E1 analogue.
- TOP: Termination of pregnancy
Indication/Dose
- Prophylaxis and treatment of peptic ulcers: Misoprostol 800 micrograms/24h PO in divided dose
- Post partum haemorrhage prevention: Misoprostol 400-600 micrograms sublingual PO
- Post partum haemorrhage treatment: Misoprostol 800 micrograms sublingual PO
- TOP following mifepristone (gestation up to 49 days) Misoprostol PO 400 micrograms for 1 dose, dose to be given 24–48 hours after mifepristone.
- TOP following mifepristone (gestation of 13 to 24 weeks) for misoprostol. Initially by vagina 800 micrograms for 1 dose, dose to be given 36–48 hours after mifepristone, followed by (by vagina or by mouth) 400 micrograms every 3 hours if required for a maximum of 4 doses, if abortion has not occurred 3 hours after the last dose of misoprostol, a further dose of mifepristone may be given, and misoprostol may be recommenced 12 hours later.
- Missed miscarriage [if expulsion of gestational sac incomplete following mifepristone]
for misoprostol By vagina, or by mouth, or by sublingual administration
Adult 800 micrograms for 1 dose, dose to be given 48 hours after mifepristone.
- Incomplete miscarriage
for misoprostol By vagina, or by mouth, or by sublingual administration
Adult 600 micrograms for 1 dose, alternatively 800 micrograms for 1 dose.
- Postpartum haemorrhage
for misoprostol
By sublingual administration, or by rectum
Adult
800 micrograms for 1 dose.
Interactions
Cautions
Contraindications
- Exclude second twin before administration.
Side effects
- Diarrhoea. Pyrexia, shivering, fever
References
Revisions