Medicine Information

Cytopag

Name: Cytopag
Brand: Cytopag
Rating: 4.5 (117 reviews)

Tablet50 mgProstaglandin E1 Analogues; Anti-ulcerant; UterotonicATC: A02BB01 (Anti-ulcerants), G02AD06 (Prostaglandins)

Generic Name

Misoprostol

Manufacturer

XYZ Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
cytopag 50 mg tablet	৳ 900.00	৳ 4,500.00

Description

Overview of the medicine

Cytopag 50 mg Tablet contains Misoprostol, a synthetic prostaglandin E1 analogue. It is primarily used to prevent gastric ulcers caused by non-steroidal anti-inflammatory drugs (NSAIDs) and for certain obstetric and gynecological purposes, such as cervical ripening and induction of labor, or medical abortion, when prescribed by a specialist.

Uses & Indications

Prevention of NSAID-induced gastric ulcers

Cervical ripening and labor induction

Medical termination of pregnancy (in combination with other drugs)

Dosage

Adults

For prevention of NSAID-induced ulcers: Typically 200 mcg orally four times daily or 400 mcg twice daily with food. For cervical ripening/labor induction: Doses vary widely, typically 25 mcg to 50 mcg vaginally or orally, repeated every 3-6 hours. For medical abortion: Typically higher doses, e.g., 800 mcg vaginally after mifepristone. Note: Misoprostol is usually dosed in micrograms (mcg). A 50 mg tablet (50,000 mcg) is significantly higher than standard therapeutic doses and would require extreme caution and specific expert guidance, likely involving careful tablet division or use in highly specialized protocols if it exists.

Elderly

Dosage adjustment not typically required, but caution advised due to increased sensitivity and potential for adverse effects.

Renal_impairment

No specific dosage adjustment guidelines available, but caution is recommended due to potential for increased plasma levels of misoprostol acid. Consider lower doses or extended dosing intervals.

How to Take

Oral administration (with food to minimize diarrhea), vaginal administration (for obstetric indications).

Mechanism of Action

Misoprostol is a synthetic prostaglandin E1 analogue. It replaces endogenous prostaglandins depleted by NSAID therapy, thereby maintaining mucosal integrity and increasing bicarbonate and mucus secretion in the stomach. In the uterus, it binds to myometrial cells, causing contractions and cervical softening and dilation.

Pharmacokinetics

Onset

30 minutes (gastroprotective effect), 15-30 minutes (uterine effects)

Excretion

Primarily excreted in urine (approximately 80%) and feces (approximately 15%).

Half life

20-40 minutes (misoprostol acid)

Absorption

Rapidly absorbed from the GI tract after oral administration. Metabolized to misoprostol acid (active metabolite).

Metabolism

Extensive first-pass metabolism to its active metabolite, misoprostol acid.

Side Effects

Contraindications

Known hypersensitivity to misoprostol or other prostaglandins
Pregnancy (unless used for specific obstetric indications under medical supervision for abortion or labor induction)

Drug Interactions

Oxytocin

Increased risk of uterine hyperstimulation when used concurrently for labor induction.

Antacids (containing magnesium)

May exacerbate misoprostol-induced diarrhea.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

Symptoms of overdose include sedation, tremor, convulsions, dyspnea, abdominal pain, diarrhea, fever, palpitations, and hypotension. Treatment is supportive and symptomatic.

Pregnancy & Lactation

Pregnancy Category X (when used for NSAID-induced ulcer prevention). Misoprostol is a potent abortifacient and should not be used in pregnant women for ulcer prevention. Small amounts are excreted in breast milk; caution is advised during breastfeeding.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets per strip30 tablets per box

Shelf Life

24 months

Availability

Pharmacies, hospitals

Approval Status

Approved by major regulatory bodies (e.g., FDA, DGDA)

Patent Status

Patent expired; available as generic

WHO Essential Medicine

Yes

Clinical Trials

Extensively studied in clinical trials for its gastroprotective effects and its various obstetric applications. Ongoing research continues to explore new uses and optimize existing protocols.

Lab Monitoring

No specific routine lab monitoring required. For women of childbearing potential, pregnancy tests should be performed before initiating treatment.

Doctor Notes

Emphasize the importance of patient counseling regarding pregnancy risk, especially for women of childbearing potential.
Carefully assess the benefit-risk ratio for obstetric indications, considering maternal and fetal well-being.
Monitor for uterine hyperstimulation or fetal distress during obstetric use.

Patient Guidelines

Do not share this medicine with others.
Take exactly as prescribed by your doctor.
Inform your doctor if you become pregnant or plan to become pregnant.
Do not take antacids containing magnesium while on this medication without consulting your doctor.

Missed Dose Advice

If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.