Misoprostol

Started by htyotispharm
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At our institution we use 25 mcg for term inductions (with a foley bulb is the cervix is dilated enough). The one caveat is that its prefered over Cervidil because of price, but can lead to a stat cesarean delivery from hyperstim.

For early pregnancy induction, it depends on the trimester and the scenario, and the dosing is anywhere between 400 to 800 mcg (provider dependent).

Hope this helps ya!
 
Despite the hooplah over it, and I don't have any #s for you, I have seen in the last three years that no one was using it, to now everyone (Seattle area) is.
 
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In fact, I might throw in- the naval hospital where I live doesn't even stock Cervidil in their pharmacy anymore. I had a client who wanted to refuse it but she was told by her doc AND the pharmacist separately that they didn't stock cervidil anymore and that she'd just have to accept the cytotec. 😡
 
The interesting fact about our hospital is that the Kaiser MD's go with Cytotec, and the other Privates with Cervidil. My personal experience has been better with Cytotec, even though I end up keeping an eye on the monitor a little closer.

For our staff patients however we usually roll with Cervidil. It makes for a quieter night 🙂 to focus on the gazillion pretermers on the board.
 
Back home, it wasn't used too much because the hospital risk management folks threw a fit that it was off label use and shouldn't be used in pregnant women because it can cause contractions (thus the point of using it as an induction agent???) so they wouldn't allow nurses to place it. So, if the doc wanted to use it, he/she had to come up to the hospital every 4 hours to place another tab.
 
Thanks for all of your input. I am a senior PharmD student working on my thesis and just wanted to see if it was used at all in comparison to cervidil and pitocin.
 
Go to Pubmed and do a search. There are several publications comparing it to Cervidil and Pitocin. Also, there are articles comparing its use with foley versus Cytotec alone.

Good luck with your project!
 
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