Misofar (Misoprostol)

Misoprostol acts on prostaglandin pathways to induce uterine contraction and protect gastric mucosa.

• Medical termination of pregnancy: facilitates uterine evacuation by inducing strong uterine contractions.
• Induction of labor: promotes cervical softening and stimulates regular uterine contractions to initiate labor.
• Cervical ripening before surgical procedures: softens the cervix to allow easier access for procedures such as hysteroscopy.
• Prevention of NSAID‑induced gastric ulcers: reduces gastric acid secretion and enhances protective mucus production.

• Misoprostol is a synthetic analogue of prostaglandin E1 that binds to prostaglandin EP receptors on smooth muscle and gastric mucosal cells. Activation of EP receptors in the uterus triggers calcium‑mediated contraction and cervical remodeling, while in the stomach it inhibits acid‑secreting parietal cells and stimulates mucus and bicarbonate secretion, providing mucosal protection.

Adverse reactions may vary in frequency and severity.

Common Side Effects

• Abdominal pain: cramping or discomfort in the lower abdomen.
• Diarrhea: increased frequency of loose stools.
• Nausea: feeling of queasiness or urge to vomit.
• Vomiting: expulsion of stomach contents.
• Fever and chills: mild temperature elevation with shaking.
• Vaginal bleeding: spotting or light bleeding after administration.

Serious or Rare Side Effects

• Severe uterine hyperstimulation: excessive, prolonged contractions that may compromise fetal oxygenation.
• Heavy vaginal bleeding: significant hemorrhage requiring medical attention.
• Allergic reaction: rash, itching, swelling, or anaphylaxis.
• Severe abdominal pain: intense, persistent pain not relieved by analgesics.
• Hypotension: marked drop in blood pressure leading to dizziness or fainting.

Use of Misoprostol requires careful clinical assessment and monitoring.

• Assess gestational age: confirm appropriate timing for termination or induction procedures.
• Screen for contraindications: avoid in patients with known hypersensitivity or certain cardiac conditions.
• Monitor uterine activity: observe for signs of hyperstimulation or abnormal bleeding.
• Avoid concurrent prostaglandin inhibitors: NSAIDs may reduce therapeutic efficacy.
• Store at room temperature: keep in the original packaging, protect from moisture and light.

Misoprostol may interact with several drug classes, requiring attention to avoid reduced efficacy or increased risk.

Major Interactions (Avoid)

• Combined use with other uterotonic agents: heightened risk of uterine rupture.
• Concomitant NSAIDs that inhibit prostaglandin synthesis: may diminish Misoprostol's effect.
• Concurrent anticoagulants: increased potential for bleeding complications.

Moderate Interactions (Monitor Closely)

• Co‑administration with oxytocin: additive uterine stimulation may cause hyperstimulation.
• Use with antihypertensive drugs: possible additive hypotensive effect.