Cytotec (Misoprostol): Uses, Dosage, Side effects & Cost

Cytotec, a trade name of misoprostol is a potent orally active prostagladin E1 analogue initially developed for treatment of peptic ulcer but later discovered to be a potent drug for abortion and starting (induction) of labour.

It is commonly called Miso or abortion drug nowadays and a popular drug among women, abortion clinics, and the Obstetrics department of health facilities and primary health care centres.

Recently, it has been discovered that misoprostol is absorbed after oral ingestion and concentrated in the womb after 5 minutes where it exerts considerable oxytotic effects. Cytotec when applied vaginally at even a lower dose contracts the uterus stronger than with the oral route.

Uses of Misoprostol

The medical uses are numerous aside the termination of pregnancy that many people are familiar with. Cytotec is an essential medicine and a life saving commodity. The common uses are:

• Prevention of stomach ulcer- Misoprostol is combined with diclofenac (athrotec) to prevent peptic ulceration in patients with arthritis.
• It is used for the termination of pregnancy. Cytotec is used to abort babies between 1 to 12 weeks or less. Best results are achieved when combined with mifepristone and methotrexate.
• It is used for cervical ripening and widening in cases of endometrial biopsy, evacuation of retained products of conception, HSG, and in labour.
• Start labour (induction of labour)
• Given to women with incomplete miscarriage to help in the evacuation of retained or remaining products of conception.
• Used for the delivery of placenta after delivery of the baby.
• Cytotec is used to prevent post partum hemorrhage (bleeding)
• Misoprostol is given to women after vaginal delivery or C-section to help with uterine contraction and prevent bleeding.
• It used in the treatment of post partum bleeding.
• It given intra-op to help the uterus contract in order prevent bleeding following uterine surgeries like myomectomy and caeserean section.
• Dilate the cervix in preparation for surgical abortion.

How to take misoprostol- Route of administration

Cytotec is administered:

• Orally
• Sublingually- under the tongue
• Rectally
• Intravaginally- Deep inside the posterior fornix of the vaginal

Dosage of Cytotec

Misoprostol comes in 50, 100 and 200micrograms. A pack of cytotec contains 12 tablets and the dosage is based on the doctors prescription and discretion and hospital protocol.

However for abortion or termination of pregnancy, the World Health Organisation (WHO) guidelines recommend the use of 12 tablets of 200mcg of misoprostol for pregnancies up to 12 weeks.

The woman should put 4 tablets of misoprostol under the tongue or far up the vagina and let them dissolve for 30 minutes. She should wait 3 hours and repeat with 4 pills under the tongue or in the vagina for 30 minutes. She should wait 3 hours and repeat once more. It works in 90% after first attempt and, in case of failure, the attempt may be repeated after a minimum of 3 days.

A lady that have had a recent cesaerean section or a major uterine surgery before should not try this method. She should go instead for surgical abortion. This is to avoid uterine rupture. Please discuss with your doctor.

Side effects of Misoprostol

They include:

• Diarrhoea
• Abdominal pain
• Flatulence
• Headaches
• Bloating
• Vomiting
• Constipation
• Nausea
• Uterine rupture
• Fever
• Congenital birth defects
• Shivering.
• Allergies

Cost of Cytotec

It is affordable and available in all pharmacies across Nigeria but beware of fake and expired misoprostol. A tablet of misoprostol is sold for between #200 to #250 naira. A packet of cytotec containing 12 tablets is sold for between #1,500 to #2,500 naira. I know some pharmacies in Lagos, Abuja, Port Harcourt and Benin city that sells a packet of misoprostol for as high as around #2,500 to #4,500 naira but these are high-brow areas and it is expected. Always check the label for originality and confirm the expiry date before leaving the pharmacy. There are many fakes out there and they do not give the desired results.

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