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Anti-Inflammatory Agent Pharmaceutical Raw Materials Misoprostol CAS No: 59122-46-2
Misoprostol is used for:
Reducing the risk of stomach ulcers in certain patients who take nonsteroidal anti-inflammatory drugs (NSAIDs). It may also be used for other conditions as determined by your doctor.
Misoprostol is a prostaglandin. It works by reducing the amount of acid released by the stomach and protecting the stomach lining, which helps to reduce the risk of stomach ulcers.
Misoprostol is used for the prevention of NSAID-induced gastric ulcers. It acts upon gastric parietal cells, inhibiting the secretion of gastric acidby G-protein coupled receptor-mediated inhibition of adenylate cyclase, which leads to decreased intracellular cyclic AMP levels and decreasedproton 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).
Misoprostol has other protective actions, but is only clinically effective at doses high enough to reduce gastric acid secretion. For instance, at lower doses, misoprostol may stimulate increased secretion of the protective mucus that lines the gastrointestinal tract and increase mucosal blood flow, thereby increasing mucosal integrity. However, these effects are not pronounced enough to warrant prescription of misoprostol at doses lower than those needed to achieve gastric acid suppression.
However, even in the treatment of NSAID-induced ulcers, omeprazole proved to be at least as effective as misoprostol, but was significantly better tolerated, so misoprostol should not be considered a first-line treatment. Misoprostol-induced diarrhea and the need for multiple daily doses (typically four) are the main issues impairing compliance with therapy.
Misoprostol is commonly used for labor induction. It causes uterine contractions and the ripening (effacement or thinning) of the cervix. It can be significantly less expensive than the other commonly used ripening agent,dinoprostone.
Oxytocin has long been used as the standard agent for labor induction, but does not work well when the cervix is not yet ripe. Misoprostol also may be used in conjunction with oxytocin.
The US FDA has not approved the antacid form of misoprostol for the purpose of labor induction, and no clinical trial of this usage has ever been conducted. Between 2002 and 2012, a misoprostol vaginal insert was studied, and was approved in the EU. The US FDA, though, refused to grant approval to this insert, and it remains unapproved for labor induction in the US, with the FDA noting serious possible side effects including torn uterus when misoprostol is used for labor and delivery.
How should this medicine be used?
Misoprostol comes as a tablet to take by mouth. It is usually taken 4 times a day, after meals and at bedtime with food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take misoprostol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Misoprostol must be taken regularly to be effective. Women should not take their first dose until the second or third day of their menstrual period (to be sure that they are not pregnant). Do not stop taking misoprostol without talking to your doctor.
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