Misoprostol

ArticleLast Updated November 20182 min readWeb-Exclusive
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Prostaglandin E1 analog (Systemic drug)

Prescriber Highlights

  • Prostaglandin E1 analog for treating or preventing gastric ulcers, especially associated with NSAIDs

  • May be useful as an abortifacient adjunct

  • Pregnant women should handle with caution

Uses, Indications

  • Primary or adjunctive therapy for treating or preventing GI adverse effects (eg, anorexia, vomiting) or gastroduodenal ulceration, especially when caused by NSAIDs

    • Not as effective in reducing gastric ulceration secondary to high dose corticosteroid therapy

  • Effects on uterine contractility and cervical softening/opening make it effective as an adjunctive treatment in pregnancy termination

Contraindications, Precautions, Warnings

  • Contraindications

Not for use in pregnant or nursing animals

  • Precautions

Sensitivity to prostaglandins or prostaglandin analogs, and patients with cerebral or coronary vascular disease

  • Warnings

Although not reported with misoprostol, some prostaglandins and prostaglandin analogs have precipitated seizures in epileptic human patients, and caused hypotension

Side Effects

  • GI distress is most common, usually manifested as diarrhea, abdominal pain, vomiting, and flatulence

    • Often transient and resolves over several days or may be minimized by dosage adjustments or giving doses with food

  • Uterine contractions and vaginal bleeding may occur in female dogs

Drug Interactions

  • Magnesium-containing antacids may aggravate misoprostol-induced diarrhea

  • May enhance effects of oxytocin

  • Concurrent use with phenylbutazone may result in neurosensory effects (eg, dizziness, ataxia)

Monitoring

  • Efficacy

  • Adverse effects

Client Information

  • Give with food if upset stomach occurs, or to prevent stomach upset

  • Common side effects include diarrhea, abdominal pain, vomiting, and flatulence

  • Pregnant women should avoid handling this medication, as miscarriage can occur

Dosage Forms

  • Misoprostol tablets: 100 µcg, 200 µcg

Compiled and summarized from Plumb’s® Veterinary Drugs by Shannon Palermo, VMD