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Misoprostol

Also known as: Cytotec, Arthrotec

Prostaglandin E1 Analog

Route: Oral

4 interactions on record⛔ Black Box Warning

Misoprostol has 4 known drug interactions based on U.S. FDA drug labeling data. Of these, 1 are contraindicated combinations that should be avoided entirely. Notable interactions include combinations with Oxytocin. Patients taking Misoprostol should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.

Total: 4
Contraindicated: 1
Minor: 3

Contraindicated (1)

Misoprostol + Oxytocin— Prostaglandins such as misoprostol may augment oxytocic activity, especially when given less than 4 hours prior to oxyto…

Minor (3)

Misoprostol + Aspirin— Misoprostol does not interfere with beneficial effects of aspirin or exert clinically significant effects on absorption,…
Misoprostol + Diclofenac— Misoprostol has no clinically significant effect on the kinetics of diclofenac.
Misoprostol + Ibuprofen— Misoprostol has no clinically significant effect on the kinetics of ibuprofen.

Misoprostol + Oxytocin⛔Contraindicated

Prostaglandins such as misoprostol may augment oxytocic activity, especially when given less than 4 hours prior to oxytocin. Concomitant use is not recommended.

Misoprostol + Aspirin🟢Minor

Misoprostol does not interfere with beneficial effects of aspirin or exert clinically significant effects on absorption, blood levels, and antiplatelet effects of therapeutic doses.

Misoprostol + Diclofenac🟢Minor

Misoprostol has no clinically significant effect on the kinetics of diclofenac.

Misoprostol + Ibuprofen🟢Minor

Misoprostol has no clinically significant effect on the kinetics of ibuprofen.

⛔ FDA Black Box Warning

WARNINGS MISOPROSTOL ADMINISTRATION TO WOMEN WHO ARE PREGNANT CAN CAUSE BIRTH DEFECTS, ABORTION, PREMATURE BIRTH OR UTERINE RUPTURE. UTERINE RUPTURE HAS BEEN REPORTED WHEN MISOPROSTOL WAS ADMINISTERED IN PREGNANT WOMEN TO INDUCE LABOR OR TO INDUCE ABORTION. THE RISK OF UTERINE RUPTURE INCREASES WITH ADVANCING GESTATIONAL AGES AND WITH PRIOR UTERINE SURGERY, INCLUDING CESAREAN DELIVERY (See also PRECAUTIONS and LABOR AND DELIVERY ). MISOPROSTOL SHOULD NOT BE TAKEN BY PREGNANT WOMEN TO REDUCE THE RISK OF ULCERS INDUCED BY NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) (See CONTRAINDICATIONS , WARNINGS , and PRECAUTIONS ). PATIENTS MUST BE ADVISED OF THE ABORTIFACIENT PROPERTY AND WARNED NOT TO GIVE THE DRUG TO OTHERS. Misoprostol should not be used for reducing the risk of NSAID-induced ulcers in women of childbearing potential unless the patient is at high risk of complications from gastric ulcers associated with use of the NSAID, or is at high risk of developing gastric ulceration. In such patients, misoprostol may be prescribed if the patient has had a negative serum pregnancy test within 2 weeks prior to beginning therapy. is capable of complying with effective contraceptive measures. has received both oral and written warnings of the hazards of misoprostol, the risk of possible contraception failure, and the danger to other women of childbearing potential should the drug be taken by mistake. will begin misoprostol only on the second or third day of the next normal menstrual period.

Contraindications

CONTRAINDICATIONS See boxed WARNINGS. Misoprostol should not be taken by pregnant women to reduce the risk of ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs). Misoprostol should not be taken by anyone with a history of allergy to prostaglandins.

Pregnancy & Breastfeeding

Pregnancy Teratogenic effects See boxed WARNINGS. Congenital anomalies sometimes associated with fetal death have been reported subsequent to the unsuccessful use of misoprostol as an abortifacient, but the drug's teratogenic mechanism has not been demonstrated. Several reports in the literature associate the use of misoprostol during the first trimester of pregnancy with skull defects, cranial nerve palsies, facial malformations, and limb defects. Misoprostol is not fetotoxic or teratogenic in rats and rabbits at doses 625 and 63 times the human dose, respectively. Nonteratogenic effects See boxed WARNINGS . Misoprostol may endanger pregnancy (may cause abortion) and thereby cause harm to the fetus when administered to a pregnant woman. Misoprostol may produce uterine contractions, uterine bleeding, and expulsion of the products of conception. Abortions caused by misoprostol may be incomplete. If a woman is or becomes pregnant while taking this drug to reduce the risk of NSAID-induced ulcers, the drug should be discontinued and the patient apprised of the potential hazard to the fetus.

Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine, supplemented with a small number of well-established interactions from curated clinical references. For informational purposes only. Always consult your pharmacist or physician.