Navigation Links
Concerns About Popular Anti-Ulcer Pill Used For Inducing Labor

A review study conducted on a popular anti-ulcer pill used worldwide for inducing labor and preventing post-delivery bleeding reveals that it is equally effective// as the other expensive drugs. Researchers have however urged that the drug must be used with caution.

The pill – a prostaglandin known generically as misoprostol and sold as Cytotec – is used primarily for treatment of peptic ulcers and is not approved for use in pregnant woman in most countries, including the United States. However, because of the convenience of oral dosing compared to standard vaginal or cervical treatments to speed delivery, 'off-label' use is common in many countries.

'Due to the limited evidence about the safety, oral misoprostol should be used with caution for the induction of labor,' said authors Dr. Zarko Alfirevic and Dr. Andrew Weeks, both obstetricians at England's University of Liverpool.

Legal liability, as well as safety concerns, make use of misoprostol problematic 'because of a relatively high rate of uterine hyperstimulation and the lack of appropriate dose ranging studies,' they said.

However, the authors acknowledged that other approved drugs are expensive and must be refrigerated, whereas misoprostol is relatively cheap and can be stored at room temperature. Off-label use is thus especially attractive in developing countries and is likely to continue.

'In those situations, clinicians should use as low a dose as possible and report serious adverse outcomes,' say the authors. They recommend a maximum dose of 50 mcg. Higher doses could lead to tearing of the uterus, which could be life-threatening to both mother and fetus.

The history of misoprostol use for induction of labor in full-term pregnancies has been complicated by the fact that the drug is also used for termination of first-trimester pregnancies, routinely used in combination with RU-486, the so-called 'morning after' abortion pill.

Alfirevic said that despite the safety, legal and political issues surrounding misoprostol, 'Clinicians felt that they had a duty to investigate this drug because this is the only prostaglandin that could be used effectively orally. It could potentially be a lifesaving drug in developing countries, where they didn’t have access to any safe drug for abortion, induction of labor, or prevention of post-partum hemorrhage.'

Nigeria this month became the latest country to approve its use to induce labor, a procedure recommended when carrying a pregnancy is riskier than giving birth.

The updated review included 41 randomized trials – 28 of them new since the previous study – and involved 8,606 women. The studies compared misoprostol administered orally versus vaginally and compared oral misoprostol with vaginal use of the prostaglandin dinoprostone and with intravenous oxytocin. The review concluded that oral misoprostol 'appears to be at least as effective as current methods of induction.'

Although the authors found no evidence of serious problems among the participants, Alfirevic warned that 'much more data are needed before we can be confident that there are really no adverse fetal effects that can be attributed to misoprostol.' To address the risks of rare adverse outcomes, studies would need to include in excess of 30,000 women, the authors said.

Use of oral misoprostol by American obstetricians is likely to remain relatively stable for the foreseeable future, predicts Dr. Deborah Wing, a specialist in maternal fetal medicine at the University of California, Irvine. 'Because of the highly litigious nature of medical practice in the United States, there are practitioners that have grave concern about the use of the medication without FDA labeling.'

Still, Wing envisions a day when, in appropriate circumstances, a safe and effective regimen of oral misoprostol can be prescribed on an outpatient basis around a woman’s due date. 'What woman wouldn’t want to be able to take a pill to control when she went into labor?' she asks. 'But we’re a long way away from that.'

The review itself noted that 'most studies … did not assess women’s views or satisfaction rates' regarding induced labor versus possible safety risks. br>


Related medicine news :

1. Reports Of New Bird Flu Outbreak In China Raise Concerns
2. Advertisements to Assuage Bird Flu Concerns
3. Fertility Treatment And Its Concerns
4. Childhood Obesity Cause For Increasing Concerns
5. Concerns That Heel-Prick Consent May Decrease Testing In Babies
6. Precautionary Recall of Beef over E.coli Contamination Concerns
7. Concerns About Working Overtime May Be Misplaced
8. Childhood Obesity Among Quebec Communities Raises Concerns
9. Breast Cancer Survivors Worry About Infertility
10. Breast Cancer Survivors Worry About Infertility
11. Improving Lighting Could Bring About A Change In Alzheimers Patients
Post Your Comments:

(Date:11/27/2015)... ... November 27, 2015 , ... Lizzie’s Lice Pickers just announced a ... customers 10% off of their purchase of lice treatment product. In addition, customers will ... to a company spokesperson. “Finding lice is a sure way to ruin the holidays, ...
(Date:11/27/2015)... LOS ANGELES, CA (PRWEB) , ... November 27, 2015 , ... MPWH, the No.1 Herpes-only ... age of 30 (see Table 1-1 ). More than 3.7 billion people under ... simplex virus type 1 (HSV-1), according to WHO's first global estimates of HSV-1 infection ...
(Date:11/27/2015)... ... November 27, 2015 , ... A simply groundbreaking television series, "Voices in ... that delves into an array of issues that are presently affecting Americans. Dedicated to ... dialogue, this show is changing the subjects consumers focus on, one episode at a ...
(Date:11/27/2015)... ... ... CBD College is proud to announce that on November 20th, ... its Diagnostic Medical Sonography program. CBD College is honored to join this very short ... universities in the state of California make the cut. CBD College is officially the ...
(Date:11/27/2015)... ... 2015 , ... Avid collector, Andrew Hawley from Vintage Rock Posters, announces his ... is one of Joplin's most famous and beautiful concert posters. The concert was held ... Ann Arbor. The According to Hawley, "It is hard to believe that Joplin's stardom ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... ) has announced ... High Viscosity Drugs" report to their offering. ... addition of the "Self Administration of High ... --> Research and Markets ( ) ... Administration of High Viscosity Drugs" report to ...
(Date:11/25/2015)... , Nov. 25, 2015 ... addition of the "Global Brain Monitoring ... offering. --> ) has ... Brain Monitoring Devices Market 2015-2019" report ... and Markets ( ) has announced ...
(Date:11/25/2015)... , Nov. 25, 2015  Linden Care, LLC, a ... treatment outcomes for patients suffering from chronic pain, said ... a Temporary Restraining Order (TRO) enjoining Express Scripts from ... companies. --> --> ... of its legal options. --> ...
Breaking Medicine Technology: