Absorption kinetics of misoprostol with oral or vaginal administration

Zieman, Mimi; Fong, Susan; Benowitz, Neal L.; Banskter, Deborah; Darney, Philip D.

doi:10.1016/s0029-7844(97)00111-7

Cited by 579 publications

(324 citation statements)

References 15 publications

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“…13 Drug absorption after vaginal administration varies widely. 9,14 In an observational study, Zalanyi 15 moistened the tablets with saline solution and reported expulsion in 88% of women with anembryonic or embryonic/fetal death pregnancies. Perhaps the addition of saline solution to the tablets enhanced the drug's effectiveness.…”

mentioning

confidence: 99%

A randomized trial of saline solution–moistened misoprostol versus dry misoprostol for first-trimester pregnancy failure

Gilles

Creinin

Barnhart

et al. 2004

American Journal of Obstetrics and Gynecology

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Objective-The purpose of this study was to estimate whether the efficacy of treatment with intravaginal misoprostol for first-trimester pregnancy failure is enhanced by the addition of saline solution.Study design-Eighty women with embryonic/fetal death or anembryonic pregnancy were assigned randomly to receive either 800 μg of misoprostol with saline solution (group I, 41 women) or without (group II, 39 women). Treatment was repeated on day 3 if the gestational sac remained. Curettage was performed if the gestational sac remained on day 8 or as necessary during at least 30 days of follow-up. Data were analyzed with the Student t test and the χ 2 or Fisher exact test.Results-By the first follow-up visit, 73% (group I) and 64% (group II) of women passed the gestational sac (P = .38). By the second follow-up visit, expulsion rates were 83% and 87%, respectively (P = .59). Five subjects in each group underwent curettage. Conclusion-Misoprostol is effective for the treatment of failed first-trimester pregnancy. The expulsion rate is not improved by adding saline solution. KeywordsMissed abortion; Misoprostol; Anembryonic pregnancy; Fetal death; Spontaneous abortion Approximately 15% of clinically evident pregnancies result in first-trimester loss. 1 Curettage, commonly performed for this condition, is comparatively costly when performed in the operating room. 2 Although curettage is relatively safe, it can be associated with intrauterine infection, adhesion, perforation, and cervical stenosis. 3 An alternative may be expectant or medical treatment. Expectant treatment usually results in the complete expulsion of the products of conception 4 ; however, the interval after diagnosis and expulsion varies. Luise et al 5 reported that most women passed products within 2 weeks of diagnosis. Jurkovic et al 6 found only a 25% success rate in women whose cases were followed for >6 weeks. MedicalReprints not available from the authors. NIH Public Access Author ManuscriptAm J Obstet Gynecol. Author manuscript; available in PMC 2010 May 10.Published in final edited form as: Am J Obstet Gynecol. 2004 February ; 190(2): 389-394. doi:10.1016/j.ajog.2003 NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript treatment may provide prompt expulsion and avoid costs and complications that are associated with surgery and the uncertainties of expectant treatment.A uterotonic drug that is proposed for medical treatment is misoprostol, an inexpensive widely available prostaglandin E 1 analog that is stable at room temperature. 7,8 The drug is absorbed through mucous membranes and can be administered sublingually, orally, vaginally, and rectally. 9,10 Misoprostol used alone for nonviable first-trimester pregnancy resulted in uterine expulsion in 13% to 96% of women. 11,12 Explanations for this wide range include different indications for treatment, dosing regimen, routes of administration, and measures of success. Vaginal administration appears to be more effective than oral administration for the inducement of ut...

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confidence: 99%

A randomized trial of saline solution–moistened misoprostol versus dry misoprostol for first-trimester pregnancy failure

Gilles

Creinin

Barnhart

et al. 2004

American Journal of Obstetrics and Gynecology

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“…6,7 The temperature elevations associated with misoprostol appear to be associated with shift in the hypothalamic set point as prostaglandins have been known to be associated with endogeneous fever mechanisms. 7 High fever reported in our patient appears to be related to misoprostol rather than infection despite the fact there was leukocytosis. This may be explained due to the fact that there were no further spikes of fever and total leucocyte count dropped down to normal within next few hours.…”

Section: Discussionmentioning

confidence: 99%

Severe morbidity with sublingual misoprostol in a post-partum patient: a case report

SunitaVerma

Makkar

Singh

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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“…Estudios norteamericanos comparan el manejo médico con dosis oral única de 400 µg de misoprostol contra igual dosis oral cada 4 horas, obteniendo tasas de éxito del 13% versus 50-70% respectivamente (14). La administración oral parece ser tan efectiva como la administración vaginal, pero se asocia con más efectos secundarios, probablemente relacionadas con diferencias en la farmacocinética (15).…”

Section: Discussionunclassified

Efectividad del tratamiento médico con misoprostol según dosis administrada en aborto retenido menor de 12 semanas

Errázuriz

et al. 2014

Rev. chil. obstet. ginecol.

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Absorption kinetics of misoprostol with oral or vaginal administration

Cited by 579 publications

References 15 publications

A randomized trial of saline solution–moistened misoprostol versus dry misoprostol for first-trimester pregnancy failure

A randomized trial of saline solution–moistened misoprostol versus dry misoprostol for first-trimester pregnancy failure

Severe morbidity with sublingual misoprostol in a post-partum patient: a case report

Efectividad del tratamiento médico con misoprostol según dosis administrada en aborto retenido menor de 12 semanas

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