Cytotec

Generic and Brand Names

Cytotec is the brand name for the drug Misoprostol. Misoprostol is the generic name for this medication.

Therapeutic Class

It belongs to a class of drugs known as prostaglandins.

Indications for Use

Cytotec is indicated for the prevention of non-steroidal anti-inflammatory drug (NSAID) induced gastric ulcers in patients at high risk for complications from gastric ulcer, such as the elderly and patients with concomitant debilitating disease, as well as patients at high risk of developing gastric ulceration, such as those with a history of ulcer.

Pharmacodynamics

Misoprostol, a synthetic prostaglandin E1 analog, exerts its action by protecting the gastric mucosa by increasing mucus and bicarbonate production and enhancing blood flow. It also inhibits basal, nocturnal, and stimulated gastric acid secretion.

Pharmacokinetics

After oral administration, Misoprostol is rapidly absorbed with a peak plasma concentration reached in approximately 30 minutes. It undergoes de-esterification to its free acid, which is responsible for its clinical activity and, unlike the parent compound, is detectable in plasma. The half-life of the absorbed free acid ranges between 20 to 40 minutes.

Dosage Forms and Strengths

Cytotec is available in tablet form for oral administration, typically in a dosage strength of 100 mcg (micrograms) or 200 mcg.

Dosing Information

The recommended adult oral dose of Cytotec for reducing the risk of NSAID-induced gastric ulcers is 200 mcg four times daily with food. If this dose cannot be tolerated, a dose of 100 mcg can be used. Therapy usually should be continued for as long as NSAID administration is continued.

Administration Guidelines

Cytotec should be taken with food to reduce the risk of gastrointestinal distress. The last dose of the day should be taken at bedtime. The tablets can be taken with water.

Contraindications

Cytotec is contraindicated in pregnant women as it can induce labor or cause abortion, premature birth, or birth defects. It is also contraindicated in individuals with known hypersensitivity to misoprostol or prostaglandins.

Potential Drug Interactions

Misoprostol should be used cautiously with other drugs that may cause diarrhea, hypotension, or uterine contractions. Concomitant use of antacids containing magnesium should be avoided, as it may worsen misoprostol-induced diarrhea.

Special Populations

Special caution should be exercised when administering Cytotec to the elderly or patients with underlying conditions as they may be more sensitive to the effects of prostaglandins. No adjustment of the dose is needed for patients with renal impairment, but as misoprostol is metabolized by fatty acid oxidizing systems, patients with significant hepatic dysfunction may have an altered response to the drug.

Adverse Reactions and Side Effects

Common side effects of Cytotec include diarrhea, abdominal pain, headache, dyspepsia, flatulence, nausea, and vomiting. Gastrointestinal side effects are dose-related and may diminish with time.

Use in Pregnancy and Lactation

Cytotec is pregnancy category X. It must not be used by pregnant women as it can induce abortion, premature birth, or birth defects. It is advised that adequate contraceptive measures are taken by women of childbearing potential taking Cytotec. It is not known if misoprostol can be detected in human breast milk or if it has a harmful effect on the breastfed infant; however, due to the potential for serious adverse reactions in infants from misoprostol, a decision should be made whether to discontinue breastfeeding or to discontinue the drug.

Overdosage

In case of overdosage, seek emergency medical attention or contact a Poison Control Center immediately. Symptoms of overdose may include drowsiness, tremor, seizures, difficulty breathing, diarrhea, fever, palpitations, hypotension, or bradycardia. Management should be symptomatic and supportive.

Storage Conditions

Store Cytotec at or below 25°C (77°F). Keep the tablets in their original container, away from moisture and heat. Do not freeze.

Disposal of Unused Medication

Unused or expired Cytotec should be disposed of in accordance with local requirements for pharmaceutical waste. Do not dispose of the medication in household waste or wastewater, e.g., down the sink or in the toilet.

Patient Counseling Information

Patients should be provided with clear instructions on the use of Cytotec, including the need to take it with food and to be aware of contraindications and serious side effects. Women of childbearing potential should be warned about the potential harm to an unborn baby.