II. Mechanism

  1. Gastric Mucosa Protection by prostaglandin replacement

III. Preparations

  1. Misoprostol (Cytotec)

IV. Indication

  1. Peptic Ulcer Disease prevention
    1. Prevents ulcers in those on NSAIDs chronically
  2. Cervical Ripening agent in Pregnancy Labor Induction

V. Dosing

  1. See Cervical Ripening for pregnancy dosing
  2. Option 1: 100 ug qid with food
  3. Option 2: 200 ug bid with food
    1. Better tolerated than qid dosing

VI. Side Effects

  1. Diarrhea
  2. Poorly tolerated

VII. Efficacy: Peptic Ulcer Disease reduction

  1. Dosing qid: 4% Peptic Ulcer Disease recurrence
  2. Dosing bid: 8% Peptic Ulcer Disease recurrence
  3. Placebo: 16% Peptic Ulcer Disease recurrence
  4. Reference
    1. Raskin (1995) Ann Intern Med 123:344-50 [PubMed]

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Cost: Medications

misoprostol (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
MISOPROSTOL 100 MCG TABLET Generic $0.44 each
MISOPROSTOL 200 MCG TABLET Generic $0.82 each

Ontology: Misoprostol (C0085174)

Definition (NCI_NCI-GLOSS) A radioprotective agent that belongs to the family of drugs called prostaglandins.
Definition (MSH) A synthetic analog of natural prostaglandin E1. It produces a dose-related inhibition of gastric acid and pepsin secretion, and enhances mucosal resistance to injury. It is an effective anti-ulcer agent and also has oxytocic properties.
Concepts Pharmacologic Substance (T121) , Eicosanoid (T111)
MSH D016595
SnomedCT 387242007, 43684009
English Misoprostol, Prost-13-en-1-oic acid, 11,16-dihydroxy-16-methyl-9-oxo-, methyl ester, (11alpha,13E)-, Methyl (11alpha,13E)-11,16-Dihydroxy-16-methyl-9-oxoprost-13-en-1-oate, (11alpha,13E)-(+-)-11,16-Dihydroxy-16-methyl-9-oxo-prost-13-en-1-oic Acid Methyl Ester, misoprostol, prostaglandins misoprostol, misoprostol (medication), MISOPROSTOL, Misoprostol [Chemical/Ingredient], Misoprostol product, Misoprostol (product), Misoprostol (substance)
Swedish Misoprostol
Czech misoprostol
Finnish Misoprostoli
Russian MIZOPROSTOL, МИЗОПРОСТОЛ
Japanese ミソプロストール
Polish Mizoprostol
Spanish misoprostol (producto), misoprostol (sustancia), misoprostol, Misoprostol
French Misoprostol
German Misoprostol
Italian Misoprostolo
Portuguese Misoprostol

Ontology: Cytotec (C0591321)

Concepts Pharmacologic Substance (T121) , Eicosanoid (T111)
MSH D016595
English Pfizer Brand of Misoprostol, Misoprostol Pfizer Brand, cytotec, Cytotec