Cytotec 200 mcg (Misoprostol) Tablets

How Cytotec 200 mcg (Misoprostol) Works

Cytotec 200 mcg or misoprostol helps induce an early abortion in women. It works in combination with mifepristone. The woman must be less than 9 weeks pregnant, or the abortion pills may not work. The medication increases uterine contractions. This enables bleeding to empty the uterus. 

The drug is a synthetic prostaglandin that reduces the risk of stomach ulcers in patients who are using NSAIDs. It works by lowering the amount of acid produced in the stomach. Thereby it protects the lining of the stomach. 

Uses

• Duodenal ulcer

A type of ulcer that occurs in the lining in the part of the small intestine. 

• Gastric ulcer

A type of ulcer that occurs in the lining of the stomach. Cytotec 200 mcg may prevent gastric ulcers. 

• NSAIDs-induced ulcer

A type of gastric ulcer caused due to pain medications such as diclofenac, aspirin, etc. The ulcer is a risk factor that comes with Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

• Postpartum bleeding

Excessive bleeding that occurs after childbirth.

• Cervical ripening/cervix softening

The softening of the cervix that begins prior to labor contractions. Cervical softening helps with the dilation (widening) of the cervix. 

• Induction of labor

Stimulating the uterus to start labor.

• Termination of pregnancy

Causing an early abortion or a first-trimester pregnancy termination. It’s used in combination with mifepristone for this purpose. 

Benefits

In pregnancy termination:

• Ends early pregnancy effectively
• Allows women to have a better control over their reproductive choices 
• Eliminates risks and trauma that are associated with a surgery 
• Offers more privacy when you are allowed to use it through a telehealth service

Other uses: 

• Prevents ulcers in certain situations 
• Induces labor in successful pregnancies to easily deliver the baby out of the birth canal

Dosage

• Four tablets of Cytotec 200 mcg are taken for the termination of early pregnancy in women. 
• Your doctor may advise you to take the pill by mouth or by inserting it in your vagina. 
• For oral use, the four pills are placed in the cheek pouch or gums for 20-25 minutes. After they get dissolved, the remaining medication is then swallowed with water.
• In another method, the pills are placed in the vagina. One by one, they are inserted to reach as far as possible in the vagina. 
• For the treatment of gastric ulcers, the usual dosage is four pills a day. 

Missed Dose 

To end your first-trimester 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 you suspect an overdose, seek medical help straight away.

Safety Advice

Alcohol : UNSAFE
Do not consume alcohol while using medical abortion pills.

Pregnancy : UNSAFE
Cytotec 200 is used to terminate pregnancy. So, it is not safe for pregnant women.

Breastfeeding :  POSSIBLY UNSAFE
Do not use Cytotec 200 if you are breastfeeding. The abortion drugs can have adverse effects on the baby.

Driving : UNSAFE
This medication may make you feel weak. You may need support until the recovery is complete. Do not drive a car after taking these pills.

Kidney : POSSIBLY SAFE
Cytotec is not known to impair kidney health. However, if you have an existing kidney problem, talk to your doctor before using a medical abortion kit.

Liver: POSSIBLY SAFE
Cytotec 200 will not affect the liver in otherwise healthy people. However, if you have a liver disease, do not use abortion pills without medical supervision.

Other Precautions

Before you take Cytotec 200 mcg, tell your doctor:

• If you are allergic to misoprostol or any other medications.
• If you are getting oxytocin.
• If you have Irritable Bowel Syndrome (IBS).
• If you have heart disease.
• If you have intestinal disorders.
• If you have diseases such as diabetes, hypertension, angina, etc.
• If you have a history of stroke, heart attack, or congestive heart failure.

Side Effects of Cytotec

Cytotec 200 mcg can cause side effects such as:

• Headache
• Vomiting
• Diarrhea
• Nausea
• Menstrual cramps
• Abdominal pain
• Spotting
• Constipation
• Fatigue
• Fever
• Chills
• Pelvic pain
• Shortness of breath
• Swelling of face, lips, hands, and feet
• Vaginal bleeding
• Upper respiratory tract infection
• Chest pain
• Abnormal heartbeat
• Nosebleed
• Acid reflux

If a side effect concerns you, check with your doctor without delay. 

Drug Interactions

Certain drugs are known to interact with Cytotec 200 mcg and affect the way it works. If you take any medications or supplements, let your doctor know about them.

This medication can interact with:

• Dinoprostone
• Antacids containing magnesium
• Croelemer
• Eluxadoline
• Aspirin
• Arthritis medications

This is not a full list of possible interactions. Speak to your doctor for further information. 

Interaction with alcohol

Alcohol can increase the chances of 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.
• Keep the pills away from direct heat, moisture, and sunlight.
• Keep the pills out of reach of children.
• Once the pack is opened, store the remaining pills in an airtight container.
• Do not consume the medicine past its expiration date.

Substitutes Available

MTP Kit

Cipla Ltd.

RU-486 (Mifepristone)

Zydus Cadila

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/