Misotab
Generic Name
Misoprostol 600 mcg tablet
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| misotab 600 mcg tablet | ৳ 38.00 | ৳ 380.00 |
Description
Overview of the medicine
Misoprostol is a synthetic prostaglandin E1 analogue that decreases stomach acid secretion and protects the gastrointestinal lining. It also causes uterine contractions and cervical ripening. The 600 mcg dosage is commonly used for medical abortion or management of postpartum hemorrhage.
Uses & Indications
Dosage
Adults
For medical abortion (alone): 800 mcg vaginally or sublingually, followed by 400 mcg every 3 hours for up to 3 doses. For PPH prevention: 600 mcg orally, immediately after delivery. For PPH treatment: 600 mcg sublingually/orally.
Elderly
Use with caution due to potential decreased renal function; dosage adjustment may be needed.
Renal_impairment
Dosage adjustment may be required in severe renal impairment; consider lower doses and monitor.
How to Take
Can be administered orally, sublingually, buccally, or vaginally depending on the specific indication and clinical situation. Follow healthcare provider's instructions carefully.
Mechanism of Action
Misoprostol binds to prostaglandin E1 receptors, leading to inhibition of gastric acid secretion and enhancement of mucosal protection. In the uterus, it causes strong contractions of the myometrium and cervical softening, leading to expulsion of uterine contents.
Pharmacokinetics
Onset
Uterine effects: 10-20 minutes (vaginal), 30 minutes (oral).
Excretion
Primarily excreted in urine (approximately 80%) and feces (approximately 15%).
Half life
Misoprostol acid has a short elimination half-life of 20-40 minutes.
Absorption
Rapidly absorbed after oral administration; peak plasma concentrations of misoprostol acid (the active metabolite) achieved within 15-30 minutes.
Metabolism
Undergoes rapid and extensive de-esterification to its active metabolite, misoprostol acid. Further metabolized by oxidation.
Side Effects
Contraindications
- Known hypersensitivity to misoprostol or other prostaglandins
- Pregnancy (unless used for medical abortion or induction of labor)
- Ectopic pregnancy (when used for abortion)
- Inflammatory bowel disease (for gastric ulcer indication, due to potential for exacerbation of diarrhea)
Drug Interactions
Oxytocin
Concurrent use may increase uterine stimulant effects; administer with caution and monitor uterine activity.
Antacids containing magnesium
May exacerbate misoprostol-induced diarrhea. Avoid concurrent use or use magnesium-free antacids.
Storage
Store in a cool, dry place, below 30°C (86°F). Protect from moisture and light. Keep out of reach of children.
Overdose
Symptoms of overdose include sedation, tremor, convulsions, dyspnea, abdominal pain, diarrhea, fever, palpitations, hypotension, and bradycardia. Treatment is supportive and symptomatic.
Pregnancy & Lactation
Highly contraindicated in pregnancy unless used for medical abortion or labor induction due to its potent uterotonic effects. Small amounts pass into breast milk; caution is advised during lactation, and the potential risks versus benefits should be discussed with a healthcare provider.
Side Effects
Contraindications
- Known hypersensitivity to misoprostol or other prostaglandins
- Pregnancy (unless used for medical abortion or induction of labor)
- Ectopic pregnancy (when used for abortion)
- Inflammatory bowel disease (for gastric ulcer indication, due to potential for exacerbation of diarrhea)
Drug Interactions
Oxytocin
Concurrent use may increase uterine stimulant effects; administer with caution and monitor uterine activity.
Antacids containing magnesium
May exacerbate misoprostol-induced diarrhea. Avoid concurrent use or use magnesium-free antacids.
Storage
Store in a cool, dry place, below 30°C (86°F). Protect from moisture and light. Keep out of reach of children.
Overdose
Symptoms of overdose include sedation, tremor, convulsions, dyspnea, abdominal pain, diarrhea, fever, palpitations, hypotension, and bradycardia. Treatment is supportive and symptomatic.
Pregnancy & Lactation
Highly contraindicated in pregnancy unless used for medical abortion or labor induction due to its potent uterotonic effects. Small amounts pass into breast milk; caution is advised during lactation, and the potential risks versus benefits should be discussed with a healthcare provider.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the date of manufacture, depending on the manufacturer.
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established misoprostol's efficacy and safety for medical abortion, postpartum hemorrhage management, and NSAID-induced ulcer prevention. Ongoing research explores new applications and optimal dosing strategies.
Lab Monitoring
- No specific routine lab monitoring is required for most indications.
- For long-term use in ulcer prevention, periodic complete blood counts and liver/kidney function tests may be considered.
Doctor Notes
- Confirm patient's pregnancy status and gestational age accurately before prescribing for abortion.
- Monitor closely for signs of hemorrhage, infection, or uterine rupture, especially in high-risk patients.
- Provide clear instructions on administration route and follow-up care.
- Educate patients on potential side effects and when to seek emergency care.
Patient Guidelines
- Follow all dosage instructions precisely as prescribed by your healthcare provider.
- Do not use if you are pregnant and not seeking medical abortion or labor induction.
- Report any severe abdominal pain, heavy bleeding, fever, or signs of infection immediately.
- Do not share this medication with others.
Missed Dose Advice
For regimens involving multiple doses, if a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your regular schedule. Do not double the dose. For single-dose indications (like PPH prevention), missing a dose can have serious consequences; seek immediate medical advice.
Driving Precautions
May cause dizziness or lightheadedness. Exercise caution when driving or operating machinery until you know how this medication affects you.
Lifestyle Advice
- Avoid alcohol consumption during treatment, especially if using for ulcer prevention.
- Maintain good hygiene if vaginal administration is used to prevent infection.
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