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Misoprostol is a medication widely used for various medical conditions, particularly in gynecology and obstetrics. It is essential to understand its uses, side effects, and how it works to ensure its safe and effective application.

What is Misoprostol?

Misoprostol is a synthetic prostaglandin E1 analog that mimics the action of naturally occurring prostaglandins in the body. Prostaglandins are lipid compounds that have various roles, including protecting the stomach lining by increasing mucus production and bicarbonate secretion, which help prevent stomach ulcers. They also stimulate uterine contractions.

Brand Names: Common brand names of misoprostol include Cytotec.

Forms: Misoprostol is available in tablet form and can be administered orally, vaginally, sublingually (under the tongue), or buccally (in the cheek).

Misoprostol Uses

Misoprostol has several medical applications:

Prevention of Stomach Ulcers: Misoprostol is often prescribed to prevent gastric ulcers in patients who are taking nonsteroidal anti-inflammatory drugs (NSAIDs) long-term. NSAIDs can cause stomach lining irritation, and misoprostol helps protect the lining by increasing mucus production.

Induction of Labor: In obstetrics, misoprostol is used to induce labor by ripening the cervix (softening and dilating it) and stimulating uterine contractions. This use is particularly helpful when there are medical indications to induce labor, such as post-term pregnancy or preeclampsia.

Postpartum Hemorrhage: Misoprostol is used to manage severe bleeding after childbirth. It helps contract the uterus and reduce blood loss, which is crucial in preventing postpartum hemorrhage, a leading cause of maternal mortality.

Medical Abortion: Misoprostol is used in combination with mifepristone to terminate early pregnancy. Mifepristone is taken first to block the hormone progesterone, which is necessary for pregnancy maintenance. Misoprostol is then taken to induce uterine contractions and expel the pregnancy.

Misoprostol 200 mg Uses: The 200 mg dosage is commonly used for inducing labor, managing postpartum hemorrhage, and in combination with mifepristone for medical abortion.

Mifepristone and Misoprostol

Mifepristone and misoprostol are often used together for medical abortion. Mifepristone, a progesterone receptor antagonist, is taken first to block the hormone progesterone, which is necessary for pregnancy maintenance. Misoprostol is then used to induce uterine contractions to expel the pregnancy.

Uses of Mifepristone and Misoprostol Tablets: This combination is effective in terminating pregnancies up to 10 weeks.

Mechanism of Action: Mifepristone stops the pregnancy from progressing, and misoprostol causes the uterus to contract and expel the pregnancy tissue.

Misoprostol Dosage and Administration

The dosage and administration of misoprostol vary depending on the medical condition being treated and the method of administration. It is crucial to follow the prescribed dosage and instructions provided by a healthcare provider to ensure safety and effectiveness.

Condition Dosage Administration
Prevention of Stomach Ulcers 200 micrograms four times a day with food. If this dose is not tolerated, it may be reduced to 100 micrograms. Taken orally with food to minimize gastrointestinal side effects.
Induction of Labor Misoprostol 25 micrograms administered vaginally every 4-6 hours as needed to induce labor. Higher doses are not recommended due to the risk of uterine hyperstimulation. Vaginally: Inserted into the posterior fornix of the vagina.
Sublingually: 25 micrograms every 2-3 hours as needed.
Management of Postpartum Hemorrhage 600 to 800 micrograms administered orally or sublingually. Orally: Taken as a single dose.
Sublingually: Placed under the tongue and allowed to dissolve.
Medical Abortion Typically, 800 micrograms (four 200 microgram tablets) are used in combination with mifepristone. Orally: Taken 24 to 48 hours after mifepristone.
Buccally: Placed between the gum and cheek and left to dissolve for 30 minutes.
Vaginally: Inserted deep into the vagina, usually at bedtime.
Cervical Ripening Before Surgery 400 micrograms administered vaginally or sublingually 3-4 hours before the procedure. Vaginally: Inserted into the posterior fornix of the vagina.
Sublingually: Placed under the tongue and allowed to dissolve.

How to Use Misoprostol Vaginally:

Procedure: Wash hands thoroughly. Lie down in a comfortable position, either on your back with knees bent or on your side. Insert the tablet deep into the vagina using a finger, aiming for the posterior fornix. Remain lying down for at least 30 minutes to ensure the tablet stays in place and is absorbed properly.

Precautions: Follow the exact instructions provided by the healthcare provider. Avoid using tampons or douching during the treatment period.

Misoprostol Warnings:

Misoprostol should not be used by pregnant women to prevent ulcers due to its ability to induce labor and cause abortion.

It should be used with caution in patients with cardiovascular disease, inflammatory bowel disease, or those who are dehydrated.

Side Effects of Misoprostol

Misoprostol can cause a range of side effects, from mild to severe. It is important for patients to be aware of these potential side effects and to consult their healthcare provider if they experience any unusual symptoms.

Common Side Effects:

Gastrointestinal Symptoms: Nausea, vomiting, diarrhea, and abdominal pain are common side effects of misoprostol. These symptoms are usually temporary and often resolve as the body adjusts to the medication.

Headache: Some patients may experience headaches while taking misoprostol.

Dizziness: Dizziness can occur, especially if the medication is taken on an empty stomach.

Less Common Side Effects:

Muscle Cramps: Some patients report muscle cramps, particularly in the lower abdomen.

Dizziness and Fatigue: These symptoms may occur but are less common.

Serious Side Effects:

Heavy Bleeding: Severe bleeding can occur, particularly when misoprostol is used for medical abortion. Patients should seek immediate medical attention if they experience heavy or prolonged bleeding.

Severe Cramping: While some cramping is expected, severe and persistent cramping should be reported to a healthcare provider.

Allergic Reactions: Although rare, allergic reactions to misoprostol can occur. Symptoms may include rash, itching, swelling, severe dizziness, and difficulty breathing. Immediate medical attention is necessary if these symptoms occur.

Infection: Signs of infection, such as fever, chills, or foul-smelling vaginal discharge, should be promptly evaluated by a healthcare provider.

Misoprostol Warnings:

Pregnancy Warning: Misoprostol should not be used to prevent stomach ulcers in pregnant women due to its ability to induce labor and cause abortion. It is classified as a pregnancy category X medication, meaning it can cause birth defects, premature birth, or miscarriage.

Precautions for Use: Patients with a history of allergies to prostaglandins should avoid misoprostol. Additionally, those with underlying health conditions such as cardiovascular disease, inflammatory bowel disease, or dehydration should use it with caution and under close medical supervision.

Misoprostol Mechanism of Action

Misoprostol works by mimicking the action of prostaglandins, which are naturally occurring substances in the body that protect the stomach lining and regulate uterine contractions. It binds to prostaglandin receptors, causing smooth muscle contraction in the uterus and increasing mucus production in the stomach to protect against ulcers.

Pricing and Accessibility

Misoprostol price: The cost can vary depending on the location and pharmacy but generally ranges from $10 to $50 per dose.

Mifepristone and misoprostol tablets price: Combined therapy for abortion can cost between $300 to $800, depending on the provider and region.

Can you buy misoprostol over the counter at Walmart? Misoprostol is not available over the counter and requires a prescription. It is essential to consult a healthcare provider for its use.

Where can I buy misoprostol? Misoprostol can be purchased at pharmacies with a prescription from a healthcare provider.

How to buy misoprostol: Obtain a prescription from a healthcare provider and purchase it from a licensed pharmacy.

Online Purchase Options

Buy misoprostol abortion pill online: Some online pharmacies offer misoprostol, but it is crucial to ensure they are reputable and require a prescription.

Buy cheap misoprostol online: While purchasing online can be cost-effective, it is essential to verify the legitimacy of the source to avoid counterfeit medications.


Misoprostol plays a critical role in various medical treatments, particularly in obstetrics and gynecology. Understanding its uses, side effects, and proper administration is vital for its safe and effective use. Always consult a healthcare provider before using misoprostol to ensure it is appropriate for your condition.