Misoprostol

Prostaglandin E₁ analog (Systemic drug)

Prescriber Highlights

• Prostaglandin E₁ analog for treating or preventing gastric ulcers, especially associated with NSAIDs

• May be useful as an abortifacient adjunct

• Pregnant women should handle with caution

Uses, Indications

• Primary or adjunctive therapy for treating or preventing GI adverse effects (eg, anorexia, vomiting) or gastroduodenal ulceration, especially when caused by NSAIDs

  • Not as effective in reducing gastric ulceration secondary to high dose corticosteroid therapy

• Effects on uterine contractility and cervical softening/opening make it effective as an adjunctive treatment in pregnancy termination

Contraindications, Precautions, Warnings

• Contraindications

Not for use in pregnant or nursing animals

• Precautions

Sensitivity to prostaglandins or prostaglandin analogs, and patients with cerebral or coronary vascular disease

• Warnings

Although not reported with misoprostol, some prostaglandins and prostaglandin analogs have precipitated seizures in epileptic human patients, and caused hypotension

Side Effects

• GI distress is most common, usually manifested as diarrhea, abdominal pain, vomiting, and flatulence

  • Often transient and resolves over several days or may be minimized by dosage adjustments or giving doses with food

• Uterine contractions and vaginal bleeding may occur in female dogs

Drug Interactions

• Magnesium-containing antacids may aggravate misoprostol-induced diarrhea

• May enhance effects of oxytocin

• Concurrent use with phenylbutazone may result in neurosensory effects (eg, dizziness, ataxia)

Monitoring

• Efficacy

• Adverse effects

Client Information

• Give with food if upset stomach occurs, or to prevent stomach upset

• Common side effects include diarrhea, abdominal pain, vomiting, and flatulence

• Pregnant women should avoid handling this medication, as miscarriage can occur

Dosage Forms

• Misoprostol tablets: 100 µcg, 200 µcg

‒Compiled and summarized from Plumb’s® Veterinary Drugs by Shannon Palermo, VMD