Classification: Prostaglandin Action/Kinetics: Synthetic prosta-glandin Ej analog that inhibits gastric acid secretion, protects the gastric mucosa by increasing bicarbonate and mucous production, and decreases pepsin levels during basal conditions. Rapidly converted to the active misoprostol acid. Time for peak levels of misoprostol acid: 12 min. tv2, misoprostol acid: 20—40 min. Misoprostol acid is less than 90% bound to plasma protein. NOTE: Misoprostol does not prevent development of duodenal ulcers in clients on NSAIDs.
Uses: Prevention of aspirin and other nonsteroidal anti-inflammatory-induced gastric ulcers in clients with a high risk of gastric ulcer complications (e.g., geriatric clients with debilitating disease) or in those with a history of ulcer. Non-FDA Approved Uses: Treat duodenal ulcers including those unresponsive to histamine H2 antagonists. With cyclosporine and predni-sone to decrease the incidence of acute graft rejection in renal transplant clients (the drug improves renal function).
Contraindications: Allergy to pros-taglandins, pregnancy, during lactation (may cause diarrhea in nursing infants).
Special Concerns: Use with caution in clients with renal impairment and in clients older than 64 years of age. Safety and efficacy have not been established in children less than 18 years of age. Misoprostol may cause miscarriage with potentially serious bleeding. Side Effects: GI: Diarrhea, abdominal pain, nausea, dyspepsia, flatulence, vomiting, constipation. Gynecologic: Spotting, cramps, dysmenorrhea, hy-permenorrhea, menstrual disorders,
postmenopausal vaginal bleeding. Miscellaneous: Headache. How Supplied: Tablet: 100 mcg, 200 mcg
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