Misoprostol Side Effects: Overdose, Interactions, And Alternatives

misoprostol side effects

In this article, we’ll discuss the side effects of Misoprostol; as well as take a look at overdosing, and available alternatives.

What Is Misoprostol?

Misoprostol is a generic medication very frequently prescribed in the United States, and sold under the brand name Cytotec. It is a medication used to prevent and treat stomach ulcers, start labor contractions, or cause an abortion. It is also used to treat postpartum bleeding which is commonly seen in females after giving birth.

In the case of abortions, misoprostol is taken besides with mifepristone or methotrexate. When used for cervical ripening, misoprostol can be administered orally, sublingually, or vaginally. Each method is unique and is used as per the woman’s medical history and needs. However, like most medications, there are side effects too. Since you can buy Misoprostol easily, you must be cautious and aware of the side effect of misoprostol before consuming it to0.

Side Effect of Misoprostol

  • Common side effects include:
    • Persistent diarrhea and abdominal pain for 4 to 5 days
    • Constipation and flatulence
    • Nausea and vomiting
    • Breast pain, joint, and muscle aches
    • Irregular blood pressure (hypertension or hypotension)
    • Gastrointestinal bleeding
  • The uncommon side effects of misoprostol include:
    • Painful menstrual cycles and cramps
    • Dermatitis and eczema
    • Loss of taste and blurriness in vision
    • Conjunctivitis or pink eye syndrome
    • Ringing in the ears (tinnitus)
  • The rare side effects of misoprostol are:
    • Rectal disorders including hemorrhoids, fissures, cancer, and abscesses
    • An increased blood level of alkaline phosphatase (ALP)
    • Chances of contracting a Urinary Tract Infection (UTI)
    • Decreased libido and disinterest in sexual activities
    • Increased erythrocyte sedimentation rate (ESR) in blood

If you are pregnant, do not take this medication to reduce the risk of stomach ulcers. Take aspirin or other related drugs including non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Before taking misoprostol, tell your doctor or pharmacist if you are allergic to it, or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems, initiating anaphylaxis.

Side Effects of Misoprostol Overdosing

Misoprostol overdosing in the first trimester of pregnancy can be fatal if not remedied instantly. In the article linked, the author presented a case of a healthy 23-year-old woman who was admitted due to a misoprostol overdose.

Manifestations of toxicity included intensive abdominal pain, vomiting combined with fatigue, diarrhea, and confusion. Treatment was supportive and included gastric lavage and administration of activated charcoal. Recovery was completed within a few hours. Moreover, the patient was scheduled for a dilatation and curettage to remove the fetus the following day.

In another shocking case, an adolescent who got accidentally impregnated developed upper gastrointestinal bleeding. This was after she self-medicated with misoprostol orally (12 mg) to cause abortion. She presented with multiorgan failure, acute abdominal signs, and hemodynamic instability.

Emergency tests showed horrifying signs of gastric and esophageal necrosis or death of the tissue. After several episodes of cardiac arrest, and despite resuscitation efforts, the patient could not be saved. Temporal relationship (48 hours after the beginning of medication) strongly suggested that misoprostol was the agent directly involved in maternal death.

The mechanism implicating misoprostol in gastrointestinal ischemia and necrosis is unknown but is highly dangerous. More research is being done in this area, to enable us to unravel more medical mysteries.

Side Effects of Misoprostol on Interaction with Other Medications

Cytotec does not produce clinically significant effects on serum levels of prolactin, gonadotropins, thyroid-stimulating hormone, and growth hormone. Thyroxine, cortisol, gastrointestinal hormones (somatostatin, gastrin, vasoactive intestinal polypeptide, and motilin), creatinine, or uric acid levels are also not affected.

Immunological competence, platelet aggregation, pulmonary function, or the cardiovascular system is not modified by recommended doses of Cytotec. However, caution should be exercised when misoprostol is administered to a woman who is nursing. In instances of severe renal and cardiovascular disorders too, misoprostol should not be consumed by the afflicted patient.

Always consult a physician to mitigate the side effect of misoprostol. Never alter a dosage by yourself. Stick to the advice of the professionals.

Ways of Avoiding the Side Effects of Misoprostol

Diarrhea is common with misoprostol and usually occurs about two weeks after you start taking it. Diarrhea usually ends up lasting for about a week. Be sure to keep up your intake of fluids and minerals along with electrolytes to prevent dehydration. Persistent diarrhea may sometimes lead to a large loss of your body’s water and essential minerals.

Other common side effects usually only last 1 to 4 hours. If any of these side effects make you very uncomfortable, you may treat your symptoms with over-the-counter medicines. These OTC medications include common analgesics, anti-emetics, and so on.

Use electrical heating pads, as they can ease cramps. You can also opt for massages if you prefer that mode of pain therapy. Also, women should have a support system in place, as they might experience emotional changes from the drastic hormone shift.

If possible, plan on staying in for a day or two, so that you can rest and recover in the comfort of your own home.

Tips and Tricks to Regulate the Side Effects of Misoprostol

For safe and effective use of this medicine, do not take more of it and do not take it more often than needed according to your dosage. Also, do not take it for a longer time than ordered by your doctor. Changing the frequency or tuning up the dosage does not increase the efficacy of misoprostol.

Taking too much of this medicine may enhance the risks of unwanted side effects even further. Do not change the dose or stop using this medicine without checking first with your doctor. This medicine should come with a patient information leaflet that is to be followed to a T. Ask your doctor any further questions whose answers you seek but do not experiment on your own under any circumstances.

Misoprostol is best taken with or after meals and at bedtime unless otherwise directed by your doctor. To help prevent loose stools, diarrhea, and abdominal cramping, always take this medicine with food or milk. Do not refer this medicine to another person without knowing their specific requirements or unique medical history.

Alternative Medicinal and Herbal Substitutes for Misoprostol

Methotrexate (both oral and intramuscular) combined with misoprostol has been under investigation since 1993. Thousands of women have had safe medical abortions in their own homes using these medications. Since buying Mifepristone is easy, it is also very commonly used to terminate unviable pregnancies.

Also Read: Medical Abortion Myths

Diclofenac is used to relieve swelling and stiffness caused by osteoarthritis and rheumatoid arthritis in patients who have a high risk of developing stomach ulcers. Diclofenac is in a class of medications called NSAIDs and acts as a substitute for misoprostol. It works by stopping the body’s production of a substance that causes pain and inflammation, namely prostaglandins.

Certain natural herbs possess abortifacient properties that may help one to get rid of their undesired pregnancy without any sort of surgery. 3-5 ml of Acacia catechu’s bark juice is to be taken orally for the first three months. Ananas comosus is also another plant whose ripened fruit is used to induce abortion.

Annona reticulata’s seeds’ paste is given orally on empty stomach for 3-5 days. Caesalpinia pulcherrima’s bark is efficacious in imitating the uses of misoprostol. Its bark juice (2 ml) is administrated orally on empty stomach for the first three months.

The medical techniques have more side effects and they can be painful but herbal abortifacient plants are natural and low cost. They also have fewer side effects and cause less pain to the body. Although misoprostol is highly effective and is widely used, it still has innumerable side effects. By using more nature-based, herbal alternatives to medications, we can curb the side effect of misoprostol to a great extent.

Misoprostol Side Effects: Conclusion

The side effect of misoprostol is more prominent with sublingual or oral misoprostol, compared to low dose (400 ugs) vaginal misoprostol. However, low dose vaginal misoprostol was linked with a low complete abortion rate. The study concluded that sublingually administered misoprostol dosed at 600 ug or 400 ug had greater instances of fever and diarrhea due to its quicker onset of action. Other factors also included higher peak concentration and bioavailability in comparison to vaginal or oral misoprostol.

Misoprostol is strictly not be taken by pregnant women with wanted pregnancies to reduce the risk of NSAID-induced gastric ulcers. This is ill-advised because it increases uterine inflammation and contractions in pregnancy, which may cause partial or complete abortions. Moreover, in addition to this already long list of cons, misoprostol’s use in pregnancy has been associated with birth defects.


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