Cytotec 200 mcg (Misoprostol) Tablets

How Cytotec 200 mcg (Misoprostol) Works

Cytotec 200 mcg or Misoprostol is a synthetic prostaglandin that reduces the risk of stomach ulcers in patients getting treated with NSAIDs. It works by lowering the amount of acid produced in the stomach, thereby protecting the lining of the stomach. Prostaglandins are basically chemicals that are made within the organs of the body.

It is also used in combination with Mifepristone to bring about an early abortion in women (who are not more than 9 weeks pregnant). It increases uterine contractions and enables bleeding to empty the uterus. 

Uses

Cytotec 200 mcg (Misoprostol) is prescribed for the treatment of the following conditions:

1. Duodenal ulcer – a type of ulcer that occurs in the lining in the part of the small intestine.
2. Gastric ulcer – a type of ulcer that occurs in the lining of the stomach.
3. NSAIDs-induced ulcer – a type of gastric ulcer caused due to medications for pain such as diclofenac, aspirin, etc.
4. Postpartum bleeding – excessive bleeding that occurs after childbirth.
5. Cervical ripening – the softening of the cervix that begins prior to the onset of the labor contractions. 
6. Induction of labor – stimulating the uterus to start labor.
7. Termination of pregnancy – used in combination with Mifepristone to cause a first trimester (no more than 9 weeks) abortion.

Dosage

Four tablets of Cytotec 200 mcg are recommended to be taken for the termination of early pregnancy in women. These pills can be taken either orally or vaginally. For oral administration, the four pills are placed in the cheek pouch or gums for 20 to 25 minutes. After they get dissolved, the remaining fragments are then swallowed with water.

For vaginal administration, the pills are meant to be placed in the vagina. The pills are intended to be inserted one by one at the farthest spot in the vagina. 

For the treatment of gastric ulcers, four pills are recommended to be taken daily as per the doctor’s prescription.

Missed Dosage: If you are taking this medicine for the termination of pregnancy, you are unlikely to miss a dose. For the treatment of gastric ulcers, the missed dose should be taken as soon as possible. If it’s time for your next scheduled dose, skip the missed dose. Do not take an overdose to make up for the missed dose.

Overdose: An overdose of the drug can lead to various side effects. If an overdose is suspected, seek medical help immediately.

Important Advisory

Before you take Cytotec 200 mcg, tell your doctor:

1. If you are allergic to Misoprostol or any other medications.
2. If you are getting oxytocin.
3. If you have Irritable Bowel Syndrome (IBS).
4. If you have heart diseases.
5. If you have intestinal disorders.
6. If you have diseases such as diabetes, hypertension, angina, etc.
7. If you have a history of stroke, heart attack, or congestive heart failure.

Side Effects of Cytotec

Common side effects of Cytotec 200 mcg include:

1. Headaches
2. Vomiting
3. Diarrhea
4. Nausea
5. Menstrual cramps
6. Abdominal pain
7. Spotting
8. Constipation
9. Fatigue
10. Fever
11. Chills
12. Pelvic pain
13. Shortness of breath
14. Swelling of face, lips, hands, and feet
15. Vaginal bleeding
16. Upper respiratory tract infection
17. Chest pain
18. Abnormal heartbeat
19. Nosebleed
20. Acid reflux

If you experience any of the above-mentioned side effects for long, contact your doctor immediately.

Drug Interactions

Certain drugs are known to interact with Cytotec 200 mcg and affect the way it works. If you take any drugs for treating your existing illnesses or for any other purposes, let your doctor know about them.

1. Dinoprostone
2. Antacids containing magnesium
3. Croelemer
4. Eluxadoline
5. Aspirin
6. Arthritis medications

Interaction with alcohol

Alcohol can increase the chances of experiencing side effects. Consumption of alcohol should be avoided at all costs.

Storage Instructions

Cytotec 200 mcg tablets should be stored properly and safely in their original packaging.

1. Keep the pills away from direct heat, moisture, and sunlight.
2. Keep the pills out of reach of children.
3. Once the pack is opened, store the remaining pills in an airtight container.
4. Do not consume the medicine past its expiration date.

Substitutes Available

Frequently Asked Questions (FAQs)

How quickly does Cytotec work?

Ans. Cytotec is recommended to be taken 24 to 48 hours after the consumption of Mifepristone. It increases the uterine contractions and causes bleeding after 4 to 6 hours. Some women may experience mild cramping and bleeding that lasts for the next 9 to 16 days or even longer.

Is Cytotec safe for inducing labour?

Ans. Cytotec or Misoprostol has been considered a safe agent for the induction of labor by the World Health Organization (WHO). The 2011 WHO guidelines recommend misoprostol for the induction of labour, except in those with a previous cesarean section.

Will Misoprostol affect future pregnancies?

Ans. Misoprostol is considered a safe and effective treatment option. It does not have a detrimental effect on future pregnancies.

Why Misoprostol is given after delivery?

Ans. This medicine is given after delivery to treat postpartum hemorrhage. It increases the uterine tone and decreases postpartum bleeding.

Why is Cytotec put under the tongue?

Ans. When taken sublingually (or placed under the tongue), cervical ripening is found to be more effective than oral and vaginal administration routes. Cervical ripening or softening of the cervix is important for cervical dilation and the passage of the fetus.

Will Misoprostol work without Mifepristone?

Ans. Misoprostol alone is widely used for obstetric and gastrointestinal indications and can serve as an important alternative option for medical abortion. However, as per the trials conducted, the efficacy rates for first-trimester abortion range anywhere from 84% to 96%. In some cases, surgical evacuation of the uterus may be necessary to complete the abortion.

References

• [Internet]. Medicinenet.com. 2022 [cited 2022 Sep 24]. Available from: https://www.medicinenet.com/misoprostol/article.htm
• Cytotec (misoprostol) dosing, indications, interactions, adverse effects, and more [Internet]. Reference.medscape.com. 2022 [cited 2022 Sep 24]. Available from: https://reference.medscape.com/drug/cytotec-misoprostol-341995
• Chatsis V, Frey N. Misoprostol for Cervical Ripening and Induction of Labour: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2018 Nov 23. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538944/
• WHO Recommendations for Induction of Labour. Geneva: World Health Organization; 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK131963/
• Bord I, Gdalevich M, Nahum R, Meltcer S, Anteby EY, Orvieto R. Misoprostol treatment for early pregnancy failure does not impair future fertility. Gynecol Endocrinol. 2014 Apr;30(4):316-9. doi: 10.3109/09513590.2013.879855. Epub 2014 Jan 23. PMID: 24455996. Available from: https://pubmed.ncbi.nlm.nih.gov/24455996/
• Parveen S, Khateeb ZA, Mufti SM, Shah MA, Tandon VR, Hakak S, Singh Z, Yasmeen S, Mir SA, Tabasum R, Jan N. Comparison of sublingual, vaginal, and oral misoprostol in cervical ripening for first trimester abortion. Indian J Pharmacol. 2011 Apr;43(2):172-5. doi: 10.4103/0253-7613.77356. PMID: 21572652; PMCID: PMC3081456. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081456/
• Raymond EG, Harrison MS, Weaver MA. Efficacy of Misoprostol Alone for First-Trimester Medical Abortion: A Systematic Review. Obstet Gynecol. 2019 Jan;133(1):137-147. doi: 10.1097/AOG.0000000000003017. PMID: 30531568; PMCID: PMC6309472. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6309472/
• Moreno-Ruiz NL, Borgatta L, Yanow S, Kapp N, Wiebe ER, Winikoff B. Alternatives to mifepristone for early medical abortion. Int J Gynaecol Obstet. 2007 Mar;96(3):212-8. doi: 10.1016/j.ijgo.2006.09.009. Epub 2007 Feb 5. PMID: 17280669. Available from: https://pubmed.ncbi.nlm.nih.gov/17280669/