Cytotec (Misoprostol);

This medication is used to prevent stomach ulcers while you take NSAIDs (e.g., aspirin, ibuprofen, naproxen), especially if you are at risk for developing ulcers or have a history of ulcers. Cytotec helps to decrease your risk of serious ulcer complications such as bleeding. This medication protects your stomach lining by lowering the amount of acid that comes in contact with it. This medication is also used in combination with another drug (mifepristone) to end a pregnancy (abortion).

This medicine comes with a patient information leaflet. Read it carefully. If you have any questions about this drug, ask your doctor, nurse, or pharmacist. Dosage is based on your medical condition and response to therapy. If you are taking this drug to prevent stomach ulcers, take it by mouth usually four times a day, after meals and at bedtime to minimize diarrhea, or as directed by your doctor. If you are taking this medication for abortion, take it by mouth exactly as directed by your doctor. If you are using this medication to start labor, your healthcare professional will insert it into your vagina. Avoid taking antacids that contain magnesium while using cytotec because they may make the diarrhea it causes worse. If you need an antacid, consult your doctor or pharmacist to help you choose a product. For ulcer prevention, continue to take this drug for as long as you take NSAIDs. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same times each day. Inform your doctor if your condition persists or worsens.

Cytotec is a synthetic prostaglandin. Prostaglandins are natural substances found in the stomach as well as in other organs of the human body. In the stomach, prostaglandins are believed to protect the inner stomach lining from the ulcer-producing effects of acid, aspirin, and other nonsteroidal anti-inflammatory drugs (NSAIDs), commonly used in the treatment of arthritis and other inflammatory conditions. Scientists now believe that aspirin and NSAIDs produce stomach ulceration mostly by inhibiting the production of prostaglandins in the stomach. Synthetic prostaglandin such as cytotec, given orally, has been shown to protect the stomach lining from ulcerating effects of NSAIDs.

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Store at or below 77 degrees F (25 degrees C) in a dry place away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

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Do not take this medication if you think that you may be pregnant. It may cause abortion, premature birth, or birth defects. In rare cases, serious complications (e.g., uterine rupture) have occurred when cytotec was used to start labor or when used in combination with another drug to cause abortion after the eighth week of pregnancy. These complications have resulted in harm to the fetus and mother. Avoid pregnancy while taking cytotec and for at least one month or one completed menstrual cycle after you have stopped treatment. If you become pregnant while taking cytotec, contact your doctor immediately. If you are pregnant, do not take this medication to reduce the risk of stomach ulcers due to aspirin or other related drugs (non-steroidal anti-inflammatory drugs-NSAIDs such as ibuprofen). Also, if you are of the childbearing age, do not use this drug to reduce the risk of ulcers from NSAIDs unless you are at high risk of having an ulcer or ulcer complications. Female patients must meet the following four requirements in order to use this drug: 1) test negative for pregnancy within two weeks before starting treatment; 2) use effective birth control to prevent pregnancy; 3) receive oral and written warnings on the dangers of using cytotec while of the childbearing age and the risks of possible birth control failure; 4) start taking cytotec only on the second or third day of the next normal menstrual period. This medication must not be shared with others. Before taking cytotec, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. Before using this medication, tell your doctor or pharmacist your medical history, especially of: stomach/intestinal disease (e.g., inflammatory bowel disease), risk factors for uterine rupture when this drug is used vaginally (e.g., prior Cesarean delivery, uterine surgery, five or more previous pregnancies). Daily use of alcohol and tobacco may increase your risk for stomach bleeding. Limit alcohol beverages and stop smoking. Consult your doctor or pharmacist for more information. If you are taking this medication in combination with mifepristone to end a pregnancy, an incomplete abortion may rarely occur. It is very important for you to be closely monitored by your doctor and to keep your scheduled appointments to follow your progress. Be sure to have clear instructions from your doctor about who to call and what to do in case of an emergency. Expect vaginal bleeding after you take the combined medicine, however tell your doctor immediately if you develop any unlikely symptoms such as severe/prolonged vaginal bleeding, signs of infection (e.g., fever, chills), or fainting. It is not known if this medication passes into breast milk. Breast-feeding while using this medication is not recommended because it may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Nausea or stomach cramps may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Diarrhea is common with cytotec and usually occurs about two weeks after you start taking it, and lasts for about a week. Be sure to keep up your intake of fluids and minerals/electrolytes to prevent dehydration. Persistent diarrhea may sometimes lead to a large loss of your body's water and minerals. Tell your doctor immediately if you develop any of these serious signs of dehydration and mineral imbalance: severe dizziness, decreased amount of urine, mental/mood changes, muscle weakness, slow/irregular heartbeat. Remember that your doctor has prescribed this medication because the benefit to you is greater than the risk of side effects. Many people, using this medication, do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur: menstrual problems or irregularities, unusual/heavy vaginal bleeding. A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

Do not share this medication with others.