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Prostaglandin E1 Analogue

Misoprostol

Brand names: Cytotec

A synthetic prostaglandin E1 analogue used for medical termination of pregnancy and miscarriage management, induction of labour, prevention and treatment of postpartum haemorrhage, and prevention of NSAID-induced ulcers.

Dosing — not shown for this use

The product information we hold does not support a dose for this page's specific use, route or population, so none is shown. Follow your local or national guideline, and confirm against the product SmPC.

Clinical monograph

How it works

It stimulates uterine contractions and cervical ripening through prostaglandin E receptor activity and reduces gastric acid secretion with mucosal protective effects.

Prescribing in practice

  • It is uterotonic and must not be given to maintain an ongoing wanted pregnancy; in women with a uterine scar or grand multiparity it carries a risk of uterine hyperstimulation and rupture, so use with appropriate caution and monitoring.
  • Indication, route and timing differ markedly between obstetric uses, so follow the relevant protocol precisely.
  • Avoid where vaginal delivery is contraindicated for labour induction and in known prostaglandin hypersensitivity.

Monitoring

Monitor uterine activity, bleeding, and fetal wellbeing where relevant to the indication, watching for excessive contractions.

Counselling the patient

  • Cramping, bleeding and gastrointestinal upset such as diarrhoea or fever-like symptoms can occur.
  • Seek urgent help for very heavy bleeding or severe abdominal pain.
  • Use only as directed for the specific indication and never to continue a pregnancy.

Evidence & guidelines

Misoprostol features in NICE abortion care (NG140) and intrapartum/postpartum haemorrhage guidance, and is widely used as a uterotonic and cervical ripening agent.

Reference: WHO PPH Prevention Guidelines; RCOG Medical Management of Miscarriage; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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