Misoprostol
Mechanism :
Misoprostol is a synthetic prostaglandin E1 analog.
Indication :
- Cystic fibrosis on pancreatic enzyme therapy - to increase fat absorption.
Contraindications :
Contraindicated in cases of known allergy prostaglandins, in patients who are pregnant or who may become pregnant because it can cause uterine contractions. Use with caution in cardiovascular disease. No dosage adjustment is needed in liver or renal impairment.
Dosing :
To improve fat absorption in cystic fibrosis.
>8 years: 100 mg PO 4 times a day.
Adverse Effect :
Diarrhea, abdominal pain with or without dyspepsia, flatulence, nausea and vomiting, increased contraction of the uterus and abnormal vaginal bleeding, including menorrhagia and intermenstrual bleeding. Skin rashes, headache dizziness and hypotension are rarely seen.
Interaction :
Phenylbutazone: Increased risk of CNS toxicity with phenylbutazone.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Dose as in normal renal function |
| HD | Unlikely to be dialysed. Dose as in normal renal function |
| HDF/High flux | Unknown dialysability. Dose as in normal renal function |
| CAV/VVHD | Unlikely to be dialysed. Dose as in normal renal function |
Hepatic Dose :
No dose adjustments are recommended.