Last update Aug. 23, 2022

Dinoprostone

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Dinoprostone or prostaglandin E2 causes contraction of uterine muscle. It is mainly used in induction of labor and also for termination of pregnancy, missed miscarriage, hydatidiform mole, and intrauterine fetal death. Administration as vaginal or cervical gel, oral and intravenous.

At latest update no published data on excretion into breast milk were found.

Itsvery rapid removal from plasma make it highly unlikely the passage into breast milk in significant amount.

It is a natural component of breast milk (Shimizu 1992, Neu 1988, Alzina 1986, Friedman 1986, Lucas 1980) that increases in concentration in the first week postpartum. (Hawkes 1999). Prostaglandins in breast milk can protect the integrity of gastro-intestinal epithelial cells in infants. (Bedrick 1989)

The use of vaginal prostaglandin for labor induction is associated with a reduction in the percentage of breastfeeding, at the beginning, at one month and at three months. (Zanardo 2017, Jordan 2009)

Although dinoprostone can be used to inhibit lactation by reducing prolactin levels (Toppozada 1992, England 1988, Bremme 1980), it would be necessary to achieve a higher dose than that used at the time of partum for several days. (Berić 1992)

It would not be recommended to use it for relief of breast engorgement in women who are willing to breastfeed. The effect of reducing prolactin levels induced by dinoprostone only occurs during the first days postpartum. (Caminiti 1980)

Alternatives

  • Misoprostol (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Other names

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Dinoprostone in other languages or writings:

Group

Dinoprostone belongs to this group or family:

Tradenames

Main tradenames from several countries containing Dinoprostone in its composition:

Pharmacokinetics

Variable Value Unit
Molecular weight 353 daltons
Protein Binding 73 %
pKa 4.3 -
Tmax 0.5 - 1 hours
T½ 0.04 - 0.1 hours

References

  1. Zanardo V, Bertin M, Sansone L, Felice L. The adaptive psychological changes of elective induction of labor in breastfeeding women. Early Hum Dev. 2017 Jan;104:13-16. Abstract
  2. Jordan S, Emery S, Watkins A, Evans JD, Storey M, Morgan G. Associations of drugs routinely given in labour with breastfeeding at 48 hours: analysis of the Cardiff Births Survey. BJOG. 2009 Abstract
  3. Hawkes JS, Bryan DL, James MJ, Gibson RA. Cytokines (IL-1beta, IL-6, TNF-alpha, TGF-beta1, and TGF-beta2) and prostaglandin E2 in human milk during the first three months postpartum. Pediatr Res. 1999 Abstract
  4. Li SY, Geng ZC, Wang AZ, Gao YL, Li M, Wang HD, Wang WY. The relationship between PGE2 level in mothers' milk and physiological diarrhea of the baby and the treatment. Chin Med J (Engl). 1994 Abstract
  5. Shimizu T, Yamashiro Y, Yabuta K. Prostaglandin E1, E2, and F2 alpha in human milk and plasma. Biol Neonate. 1992 Abstract
  6. Toppozada M, Gerges F, Khalil H, Marzouk S, Kholeif A. Effect of prostaglandin E2 or prostaglandin synthesis inhibitors on human gonadotrophins and prolactin. Eicosanoids. 1992 Abstract
  7. Berić B, Mitreski A, Kuzmancev O, Curcić A, Ilić V, Vukelić J, Budakov D. [Inhibition of initial puerperal and postabortion lactation using oral prostaglandin E2 (Dinoprostone)]. Med Pregl. 1992 Abstract
  8. Bedrick AD, Britton JR, Johnson S, Koldovský O. Prostaglandin stability in human milk and infant gastric fluid. Biol Neonate. 1989;56(4):192-7. Abstract
  9. Neu J, Wu-Wang CY, Measel CP, Gimotty P. Prostaglandin concentrations in human milk. Am J Clin Nutr. 1988 Abstract
  10. England MJ, Tjallinks A, Hofmeyr J, Harber J. Suppression of lactation. A comparison of bromocriptine and prostaglandin E2. J Reprod Med. 1988 Abstract
  11. Alzina V, Puig M, de Echániz L, Villa I, da Cunha Ferreira R. Prostaglandins in human milk. Biol Neonate. 1986 Abstract
  12. Friedman Z. Prostaglandins in breast milk. Endocrinol Exp. 1986 Aug;20(2-3):285-91. Abstract
  13. Tulandi T, Gelfand MM, Maiolo L. Effect of prostaglandin E2 on puerperal breast discomfort and prolactin secretion. J Reprod Med. 1985 Abstract
  14. Reid B, Smith H, Friedman Z. Prostaglandins in human milk. Pediatrics. 1980 Abstract
  15. Lucas A, Mitchell MD. Prostaglandins in human milk. Arch Dis Child. 1980 Abstract
  16. Caminiti F, De Murtas M, Parodo G, Lecca U, Nasi A. Decrease in human plasma prolactin levels by oral prostaglandin E2 in early puerperium. J Endocrinol. 1980 Abstract
  17. Nasi A, De Murtas M, Parodo G, Caminiti F. Inhibition of lactation by prostaglandin E2. Obstet Gynecol Surv. 1980 Abstract
  18. Bremme K, Eneroth P. Changes in serum hormone levels during labor induced by oral PGE2 or oxytocin infusion. Acta Obstet Gynecol Scand Suppl. 1980 Abstract
  19. Ounsted MK, Hendrick AM, Mutch LM, Calder AA, Good FJ. Induction of labour by different methods in primiparous women. I Some perinatal and postnatal problems. Early Hum Dev. 1978 Abstract

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