misoprostol only regimen: an overview
TRANSCRIPT
Misoprostol only regimen: an overview
Despite the spectacular and overwhelming evidence of safety and effectiveness of using the combination of Mifepristone and Misoprostol regime, various factors have kept the distribution of Mifepristone limited.
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History of single drug regimen There are several political and commercial reasons that interfere with the women’s access to Mifepristone worldwide. In the early 1990’s, several researchers came together to revisit a possibility that Misoprostol alone can be used as a single agent to induce an early pregnancy termination, as there was a considerable amount of evidence that suggested the drug alone could safely terminate a pregnancy which was not progressed further than 10 weeks.
Since Misorpostol alone could provide benefits like inexpensiveness, easy to transport, stable at ambient temperatures, easy to administer, non-requirement of refrigerating (even in hot climate), it is thought to have a potential for making access easy for woman in developing areas where they could just buy Misoprostol without needing Mifepristone or its equivalent.
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Worldwide usage of Misoprostol
The secondary abortive drug is a prostaglandin analogue, which is used by several women with restrictive laws on pregnancy termination. There are reports from Latin America that prove that women frequently use the medication to induce a termination process early in gestation. However, due to lack of standard information, some women use that drug with high degree of variation in dosage and timing; which result in them having poor results. Misoprostol is currently registered in over 100 countries globally. In some of these regions it is only approved for specific usage of preventing NSAID caused stomach ulcers, while other off-label usage include gynecological and obstetric indications.
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Usage in America
In the US, Misoprostol, also known by brand name Cytolog, is approved by the FDA. It has been approved for treatment and prevention of gastric ulcers and termination of early pregnancies. American physicians also make off-label use of it for inducing labor, treating post-natal hemorrhage and for cervical ripening etc.
Even so, the prostaglandin analogue drug is not widely used singularly for abortive procedure, as both Mifepristone and Misoprostol are approved by the FDA. Even so state restrictions have created barrier for women seeking clinic abortive care. This has resulted in increase in the number of women who buy abortion pills online and self-induce in some parts of the country.
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Mechanism Misoprostol is a prostaglandin analogue that causes contractions in the uterine. It results in the expulsion of conception tissues from the body though vaginal discharge. In this kind of regimen, the patient has to administer 800 mcg pills through cheek pouches and wait for them to dissolve and further repeat the dose twice. Another method is to insert 800 mcg prostaglandin analogue pills inside the vagina, wait for three-four hours and repeat the process twice. This regimen has 76-88% of efficiency which is indirectly proportionate with gestational period, i.e. the earlier the pregnancy, the more chances of succeeding.
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