Misoprostol: what is it for? Does it cause abortion?

Medications such as Prostokos can be administered by medical professionals with the aim of terminating a risky pregnancy or to anticipate delivery in an efficient and safe way for the woman.

These drugs have in common the presence of misoprostol, a component that induces uterine contraction, being very useful in these cases. However, if used improperly, it can cause several side effects.

Therefore, learn more about the mechanism of action of misoprostol and what are the risks of using a drug with this drug.


What is misoprostol?

Used in Brazil since 1984, Misoprostol is an important active ingredient for the obstetric area.

Misoprostol is a synthetic active ingredient made in the laboratory from prostaglandin E1 (fatty acid that functions as a hormone in the female body). This substance was developed by the pharmaceutical industry in 1973, but arrived in Brazil only in 1984.

This active ingredient is used in the manufacture of medications such as Prostokos, which is used in different cases of obstetric care, ensuring women’s health.

Thus, misoprostol is indicated for pregnant women who have the need to terminate pregnancy (abortion), or to anticipate delivery, with medical monitoring.

It is important to note that in the case of termination of pregnancy, its use is permitted, according to the legislation in force in the country, in cases of rape, risk to the woman’s health and when it is attested that the child will be born with poor brain formation (anencephaly). Apart from these situations, it is considered a crime and can have serious consequences for women.

Therefore, medicines with misoprostol can only be sold to hospitals registered by the Ministry of Health and that follow the control rules established by the National Health Surveillance Agency (ANVISA).

In addition, it can also only be administered within medical facilities and under the observation of health professionals.

What is it for?

Misoprostol serves to assist processes related to obstetric care for women. Therefore, pregnant women who need to advance delivery or terminate the pregnancy can use the component, due to the action of uterine contraction that it provides.

However, it is essential that this be done according to the established legal norms, that is, only in cases where advancing the delivery is guided by a professional, and in the scenario where the termination of pregnancy is determined by law.

Because of this, medicines with misoprostol are not sold to ordinary people, only to hospitals and specialized centers authorized to buy them.

How to use the medicine?

Misoprostol facilitates uterine contraction and is indicated for inducing labor.

Medicines that have misoprostol as their active ingredient, can only be used inside hospitals and registered medical centers and that have authorization from the Ministry of Health to administer the drug. According to the leaflet for Prostokos, a misoprostol-based medicine and for gynecological use, the appropriate dosage (depending on the case) is:

  • Labor induction: at term (between 37 and 42 weeks of gestation) or close to term (less than 37 weeks), the dose of 1 tablet of the drug (25mcg) should be administered every 6 hours;
  • Termination of pregnancy: when it is determined by the obstetrician to terminate the pregnancy at around 30 weeks of gestation, it is possible for the woman to use up to 2 tablets of 50mcg in a single application to be able to finish the interruption.
  • Induction of labor with a dead fetus (before 30 weeks): for the process to be effective, it is appropriate to start with 2 tablets of 25mcg (total 50mcg) and wait for 6 hours. For if the desired effect does not occur, it is necessary to increase the dose to 4 tablets 25mcg (totaling 100mcg) or, to directly administer 1 tablet of 100 mcg.
  • Legal abortion: The doctor should ask the woman to take 1 200mcg tablet every 6 hours, until the process is complete.

It is worth mentioning that, in the induction of labor, the interval between one dose and the next should not be less than 6 hours. And that a new dose can never be taken when there is already uterine contractility (two or more contractions in 10 minutes).

What are the side effects of misoprostol?

Misoprostol does not usually cause many side effects to the health of women who use the substance under guidance and obstetric observation .

According to the Prostokos package leaflet, the symptoms that may arise are discomfort considered mild, such as mild abdominal discomfort, diarrhea (depending on the dose administered), flatulence and nausea.

Some reactions are more uncomfortable such as vomiting, fatigue , headache , fever , chills, prolonged and abundant bleeding that varies according to the gestational age (in the case of interruption of pregnancy) and the indicated dose, being more frequent when the woman takes 200mcg tablets.

In general, these effects tend to decrease in the first hours, in the case of legal abortion, after the elimination of the fetus, and may last for 24 to 48 hours.

What are the risks of using misoprostol?

The main reason that misoprostol cannot be sold to anyone who wants to buy it and can only be administered in hospital facilities are the risks and complications that can be caused to the health of the woman and also to the fetus, which are considered serious and in many cases, irreversible.

Some of them are:

  • Strong contractions that can cause the death of the fetus and even according to intensity, the rupture of the uterus;
  • Diseases resulting from the teratogenic effect (which damages the embryo or fetus) of the drug, such as hydrocephalus, bladder exstrophy, congenital facial paralysis, limbic system defect and contraction of feet and hands.

What are the contraindications for misoprostol?

Obstetric consultations are essential for the professional to know if it is possible or not to indicate misoprostol.

According to the Prostokos package insert (medicine that contains the active ingredient misoprostol) it is contraindicated for the male audience and also for people who are in the following conditions:

  • Uterine scar;
  • Anterior cesarean section;
  • Cerebral vascular disease;
  • Coronary disease (obstruction of coronary arteries);
  • Previous intake of non-steroidal anti-inflammatory drugs (within a period of 4 hours);
  • Hypersensitivity to any of the components of the formula.

It is worth mentioning that pregnant women or women with suspected pregnancy should not use the drug without medical advice, since misoprostol promotes uterine contraction, increasing the chances of an unwanted abortion.