This medication is a prostaglandin, prescribed for termination of pregnancy, evacuation of the uterine contents in the missed abortion, labor induction (rarely used), and dilatation of the cervix prior to labor.
It is contraindicated in patients allergic to prostaglandins, patients with heart, lung, kidney, liver disease or pelvic inflammatory disease.
Vaginal Dilatation of cervix, induction and augmentation of labor- As gel: 0.5mg, may repeat 6 hr later if needed up to a maximum of 1.5 mg/24 hour.
Labor induction- As gel: 1 mg, then 1 or 2 mg 6 hr later if neededup to a maximum of 3 mg. As pessary: 3 mg, then 3 mg 6-8 hour later if neededup to a maximum of 6 mg. Suppository: 20mg, inserted into vagina.
Pregnancy termination: It is injected outside the amniotic sac As 100 mcg/ml solution, 1 ml, followed by 1-2 ml at 2-hr intervals according to response.
It comes as a vaginal suppository and as a gel that is inserted into the vagina and solution for injection administered by a health professional. Patient should lie down after insertion of this medication.
• It may raise eye pressure hence should be used with caution in patients with glaucoma.
• Caution needed for patients with history of previous cesarean section, asthma; anemia; uterine surgery; diabetes; high or low blood pressure; placenta previa(condition where the placenta partly or completely covers the outlet of the uterus); a seizure disorder; previous multiple pregnancies; glaucoma or increased pressure in the eye; cephalopelvic disproportion (babies head or body is too large to fit through the mother's pelvis); previous difficult or traumatic deliveries; or unexplained vaginal bleeding.
Increased uterine contraction with or without fetal distress, rupture of the uterus
• Gastrointestinal : Nausea, vomiting, diarrhea, and abdominal pain.
• Miscellaneous: Fever, low blood pressure, increase in eye pressure, headache, breathing difficulty.
• Blood: An increased risk of postpartum disseminated intravascular coagulation.
Do not change your dose unless your doctor tells you to do so.
Cervical gel: Refrigerate at 2-8°C. Vaginal supp: Store in a freezer below -20°C. Vaginal insert: Store in a freezer between -20°C & -10°C.
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