Potential Problems with Misoprostol

Misoprostol, like the vast majority of drugs, has potential adverse effects. The Summary of Product Characteristics (SPC) for Cytotec lists adverse effects and potential dangers of the drug. Click here for the SPC for Cytotec.

This SPC is for misoprostol when used as a drug to treat peptic ulcers. However, when misoprostol is used in reproductive health, different doses and routes are used. Thus the severity of side effects may differ from those mentioned in the SPC.

There are now large randomised controlled trials that have studied the side effects or complications of misoprostol when used for obstetric purposes. More detail can be found in the pages below:

Pyrexia/Fever
Shivering
Hyperstimulation
Teratogenicity

Many studies have reported that the other side effects listed in the SPC for misoprostol are not common in women using misoprostol for obstetric purposes. This is due to the lower doses used and the short duration of use.

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.