This site has been set up to distribute dosage guidelines for the use of misoprostol in obstetrics and gynaecology. The correct dosage varies greatly according to gestation, indication and route of administration - using the correct dosage is vital for success and to prevent complications. There is ample evidence that misoprostol availability reduces mortality and morbidity in countries where unsafe abortion is common.

Recommended doses of Misoprostol (Cytotec®) are provided in this site along with instructions for use.

Misoprostol is an E1 prostaglandin analogue which has been approved in more than 85 countries since its first marketing in 1985. So far it is approved only for the treatment of gastric ulcer (although France, Brazil, Taiwan and Egypt have licensed dedicated products for gynaecological or obstetrical use). This is remarkable given the abundant literature supporting its safety and effectiveness for multiple reproductive health indications. In some of these situations, misoprostol may be life-saving.

The current patent holder has never applied to get a licence for Cytotec® for any of these indications. Consequently it is used off label in most countries and without package inserts to inform users about safe dosages.

 An extensive bibliography of over 1500 misoprostol references (produced July 2007) is also available.

 For comments on the site, e-mail misoprostol@aon.at

Figure 1: Safe single doses of vaginal misoprostol for producing uterine contractions at various gestations.  For the first trimester 800µcg 24 hourly can be safely used.  In the second trimester 200µcg 12 hourly is a common dose, whilst beyond 24 weeks 25µcg 6 hourly is usually used.  If a higher dose than this is used, then uterine hyperstimulation with uterine rupture or fetal distress might be the result