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:
*Name:
*Comment:
*Email:


(Date:12/8/2016)... ... December 08, 2016 , ... After enjoying ... opened registration today for its 33rd Annual Issues & Research Conference, March ... The theme of the conference is “Persistent Challenges and New Opportunities: Using Research ...
(Date:12/8/2016)... ... December 08, 2016 , ... CURE Media Group, the nation’s ... groups, has aligned with Upstage Lung Cancer in efforts to combat lung cancer, announced ... J. Hennessy, Jr said, “CURE Media Group is honored to team up with Upstage ...
(Date:12/8/2016)... ... December 08, 2016 , ... Launching of ... Unified Instance Manager architecture, meeting the needs of multichannel growth and doubling ... unattended auto-dialing system without agents, Presence Robodialer, provides greater operational capacity, administrative ...
(Date:12/8/2016)... ... December 08, 2016 , ... ... surgery as possible. With this in mind, SIGVARIS has created a new line ... clot) during bed rest and provide the benefits of graduated compression when transitioning ...
(Date:12/8/2016)... ... 08, 2016 , ... The Dan Carlisle Agency, an Alabama-owned ... is announcing the launch of a charity drive to raise support and awareness ... and children in Birmingham has grown steadily since the 1980’s, and the Pathways ...
Breaking Medicine News(10 mins):
(Date:12/8/2016)... -- IRIDEX Corporation (NASDAQ: IRIX ) today announced ... stock, $0.01 par value (the "Offering" with such shares being ... terms of the Offering will depend on market and other ... no assurance as to whether or when the Offering may ... proceeds it will receive from this offering for working capital ...
(Date:12/8/2016)... 8, 2016 Global Interventional Radiology Market: ... global interventional radiology market analyzes the current and ... an elaborate executive summary, including a market snapshot ... sub-segments. The research is a combination of ... bulk of our research efforts along with information ...
(Date:12/8/2016)... -- Eli Lilly and Company (NYSE: LLY ) ... trial at the 9 th Clinical Trials on ... not meet the primary endpoint in the EXPEDITION3 clinical ... mild dementia due to Alzheimer,s disease (AD), and Lilly ... treatment of mild dementia due to AD. ...
Breaking Medicine Technology: