Prevention of NSAID-induced ulcers, duodenal ulcer, and gastric ulcer
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Prostaglandin
Misoprostol is a synthetic prostaglandin E1 analog that replaces the protective prostaglandins consumed with prostaglandin-inhibiting therapies (eg, NSAIDs); has been shown to induce uterine contractions

1. Onset of action: 30 minutes
2. Duration of action: 3 hours
3. Protein binding: (Misoprostol acid) <90%
4. Metabolism: Hepatic; rapid de-esterification to misoprostol acid (active)
5. Half-life elimination: (Misoprostol acid) 20 to 40 minutes
6. Time to peak: (Misoprostol acid) 12 ± 3 minutes
7. Excretion: Urine

1. Hypersensitivity to misoprostol, other prostaglandins, or any component of the formulation
2. Pregnancy

1. Use is contraindicated during pregnancy
2. Misoprostol should not be used for reducing the risk of NSAID-induced ulcers in patients of childbearing potential unless the patient has had a negative serum pregnancy test within 2 weeks prior to beginning therapy.<20220330>

The manufacturer recommends that caution be used if administered to a breastfeeding woman.

Diarrhea, abdominal pain, uterine bleeding, dyspepsia, headache, nausea

Prevention of NSAID-induced gastric ulcers:
200 mcg 2 to 4 times daily; if not tolerated, may decrease dose to 100 mcg 4 times daily
Duodenal and/or gastic ulcer:
800 mcg 2 to 4 times daily for at least 4 weeks

1. Dose adjustment is not routinely needed; however, the dose may be reduced if the recommended dose is not tolerated.
2. It is not known if misoprostol is removed by dialysis.

There are no dosage adjustments provided in the manufacturer's labeling.