Last update May 2, 2022

Misoprostol

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Prostaglandin E1 analogue that is used in the prevention of gastroduodenal ulcers associated with the use of NSAIDs and induction of labor and abortion provocation. Oral, vaginal or rectal administration.

It is excreted in breast milk in clinically non-significant amount. (Vogel 2004, Abdel 2003)

No reports of adverse effects of misoprostol in infants of mothers taking misoprostol have been published. (Pfizer 2021)

MIsoprostol is found naturally in breast milk and colostrum. (Shimizu 1992)

Due to the tiny concentration that it reaches in breast milk after its administration and its rapid elimination, it is not necessary to wait any time to be able to breastfeed (Sääv 2010), as some authors say. (FLASOG 2013)

Misoprostol does not affect maternal serum hormone levels of prolactin, TSH, and cortisol. (Bremme 1982)

Alternatives

We do not have alternatives for Misoprostol since it is relatively safe.

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.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Misoprostol in other languages or writings:

Tradenames

Main tradenames from several countries containing Misoprostol in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 88-100 %
Molecular weight 383 daltons
Protein Binding 80 -90 %
VD 0.19 ± 0.11 l/Kg
pKa 14.69 -
Tmax 0.35 ± 0.19 hours
0.85 ± 0.12 hours
M/P ratio 0.01 - 0.05 -
Theoretical Dose < 0.000001 mg/Kg/d
Relative Dose 0.03 - 1.5 %

References

  1. Pfizer. Misoprostol (Cytotec). Drug Summary. 2021 Full text (in our servers)
  2. Bial. Misoprostol. Ficha técnica. 2019 Full text (in our servers)
  3. FLASOG. Uso del Misoprostol en Obstetricia y Ginecología. Monografía. 2013 Full text (in our servers)
  4. Sääv I, Fiala C, Hämäläinen JM, Heikinheimo O, Gemzell-Danielsson K. Medical abortion in lactating women--low levels of mifepristone in breast milk. Acta Obstet Gynecol Scand. 2010 Abstract Full text (link to original source) Full text (in our servers)
  5. Vogel D, Burkhardt T, Rentsch K, Schweer H, Watzer B, Zimmermann R, Von Mandach U. Misoprostol versus methylergometrine: pharmacokinetics in human milk. Am J Obstet Gynecol. 2004 Abstract
  6. Abdel-Aleem H, Villar J, Gülmezoglu AM, Mostafa SA, Youssef AA, Shokry M, Watzer B. The pharmacokinetics of the prostaglandin E1 analogue misoprostol in plasma and colostrum after postpartum oral administration. Eur J Obstet Gynecol Reprod Biol. 2003 Abstract
  7. Shimizu T, Yamashiro Y, Yabuta K. Prostaglandin E1, E2, and F2 alpha in human milk and plasma. Biol Neonate. 1992 Abstract
  8. Bremme K, Eneroth P, Bygdeman M. Maternal serum hormone changes during abortion induced with 16,16-dimethyl-trans-delta 2-PGE1 methyl ester. Prostaglandins Leukot Med. 1982 Abstract

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