Misoprostol,
a synthetic methyl
ester analogue of
prostaglandin
E1, was approved by the FDA(USA) in December 1988
and has gained regulatory approval for more than
50 countries.
More than 30 million people in the world take
NSAID's everyday. Many of them
will develop gastric ulcers and related
complications. As it differs from classic peptic
ulcer disease in many ways, Misoprostol has been
the drug-of-choice for preventing NSAID-induced
gastropathy in addition to its cytoprotective
effects on treatment of peptic ulcer.
Globally,
healthcare policy makers and players are realizing
trade-offs between the clinical
and economical
implication of preventive medical intervention.
And, misoprostol can surely meet the challanging
requirements, especially as the call intensifies
for more efficient al
location of the health care
resources. There are also positive conclusions
regarding cost-effectiveness could be reached in
reviews of studies of misoprostol in the
prevention of NSAID-induced gastropathy.1, 2, 11
In addition, vaginal administration of misoprostol
has been found as a safe and effective alternative
for cervical ripening and labor induction.
5-10
Applications
□
Prevention of NSAIDs-induced Ulcers.
□
Healing of Gastric Ulcer and Duodenal Ulcer
□
Conjunction with Diclofenac Sodium for Treatment
of Osteoarthritis or Rheumatoid Arthritis (ArthrotecR
)3
□
Conjunction with Naproxen for Treatment of
Arthritis (CondretecR
)
□
Induction of Labor
Pharmacology
4
Misoprostol is a gastric antisecretory agent with
protective effectiveness on the gastroduodenal
mucosa. It inhibits gastric acid secretion and
protects the mucosa from the irritant and/or other
(e.g. pharmacological) effects of certain drugs,
such as NSAIDs, and may have similar antisecretory
and muscosal effects in patients with gastric or
duodenal ulcer.
Because prostaglandins can affect many tissues,
other actions of misoprostol have been identified.
Misoprostol may increase the frequency of uterine
contractions, which is responsible for its
abortifacient capability. In addition, misoprostol
has been shown to improve renal function in renal
transplant patients treated with cyclosporine and
prednisone. Misoprostol may offset
cyclosporine-induced intrarenal vasoconstriction.
Proprietary Names
CytotecR; ArthrotecR
References
1. Lanas A. et al. Toxicity of NSAIDs in the
stomach and duodenum. Eur J Gastroenterol Hepatol
1999 Apr;11(4):375-81
2. Agrawal NM et al. Comparison of the upper
gastrointestinal safety of Arthrotec 75 in
osteoarthritis patients at high risk for
developing NSAID-induced gastrointestinal ulcers.
Clin Ther 1999 Apr;21(4):659-74
3. Morgan D. Arthrotec: the evidence speaks for
itself. Scand J Rheumatol Suppl 1999;109:13-8
4. AHFS Drug InformationR 96
5. Blanchette HA et al. Comparison of the safety
efficacy of intravaginal misoprostol with those of
dinoprostone for cervical ripening and induction
of labor in a community hospital. Am J Obstet
Gynecol 1999 Jun; 180(6 Pt 1):1551-9.
6. Goldberg AB et al. Induction of labor: the
misoprostol controversy. J Midwifery Womens
Health. 2003 Jul-Aug;48(4):244-8.
7. Hofmeyr GJ et al. Vaginal misoprostol for
cervical ripening and induction of labour.
Cochrane Database Syst Rev. 2003;(1):CD000941.
Update of: Cochrane Database Syst Rev.
2001;(3):CD000941.
8. Wing DA. A benefit-risk assessment of
misoprostol for cervical ripening and labour
induction. Drug Saf.2002;25(9):665-76.
9. Blanchard K et al. Misoprostol for women's
health: a review. Obstet Gynecol. 2002
Feb;99(2):316-32.
10. Glodberg AB et al. Misoprostol and Pregnancy.
NEJM 2001; 344 (1): 38-47.
11. Morant SV et al. A pharmacoeconomic comparison
of misoprostol/diclofenac with diclofenac.
Pharmacoepidemiol Drug Saf. 2002
Jul-Aug;11(5):393-400.
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Categories
|
Products |
Applications |
|
Prostaglandins |
PG E1
|
Treatment of
cardiovascular diseases |
|
PG E2
|
Labor induction
|
|
PG I2
|
Treatment of primary
pulmonary hypertension
|
|
Misoprostol/
Misoprostol HPMC |
Treatment of peptic
and duodenal ulcers caused by the use of NSAIDs
|
|
Latanoprost |
Treatment of Glaucoma |
|
Bimatoprost |
Treatment of Glaucoma |
|
Travoprost |
Treatment of Glaucoma |
|
Cloprostenol Sodium
(racemate)/(+) |
Labor induction and
breeding management in veterinary |
|
Cardiovascular API |
Felodipine
|
Anti-hypertensive
and treatment of congestive heart failure
|