Cytotec is a prescription medication used to treat stomach ulcers, prevent NSAID-induced ulcers, and induce labor. Its active ingredient is misoprostol, which belongs to a class of drugs called prostaglandin analogues.
What is Cytotec?
Misoprostol is a synthetic prostaglandin E1 analogue. It works by reducing stomach acid production and protecting the stomach lining. This makes it useful for healing stomach and intestinal ulcers.
Cytotec comes as 200 microgram tablets that are taken by mouth. It is usually taken 2-4 times per day with food.
What Conditions is Cytotec Used For?
Cytotec is approved for the following uses:
- Treatment of gastric ulcers
- Prevention of NSAID-induced gastric ulcers in high risk patients
- Prevention of stress ulcers after surgery
- Medical abortion/labor induction (off-label use)
Gastric and Duodenal Ulcers
Cytotec can help treat acute gastric and duodenal ulcers. It works by increasing bicarbonate and mucus secretion, which protects the stomach lining.
Several studies have found Cytotec to be as effective as other ulcer medications like antacids, H2 blockers, and proton pump inhibitors (PPIs).
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can damage the stomach lining and cause gastric ulcers.
Cytotec can help prevent NSAID-induced ulcers by strengthening the mucosal barrier of the stomach. It is especially useful in high risk patients taking NSAIDs long-term.
Clinical trials show Cytotec reduces the risk of NSAID-induced ulcers by 60-90% compared to placebo.
Stress Ulcer Prevention
Major surgery, trauma, or critical illness can increase the risk of stress ulcers and upper GI bleeding.
Cytotec helps prevent stress ulcer formation by stimulating prostaglandin release and increasing mucosal blood flow.
Research indicates Cytotec is as effective as IV H2 blockers for stress ulcer prophylaxis in critically ill or post-op patients.
Off-Label Uses of Cytotec
While not FDA approved, Cytotec is also commonly used off-label for:
- Medical abortion
- Cervical ripening before labor induction
- Postpartum hemorrhage prevention
Its ability to stimulate uterine contractions makes it an effective drug for abortion and managing labor.
However, Cytotec has more side effects when used for these gynecologic indications compared to other prostaglandin drugs.
How Does Cytotec Work?
Cytotec contains the active ingredient misoprostol, which is a synthetic prostaglandin E1 analog. Here’s how it works:
- Increases Prostaglandins: Misoprostol mimics natural prostaglandin E1. This increases prostaglandin levels which protect the stomach lining.
- Reduces Acid Secretion: Prostaglandins inhibit histamine release and reduce gastric acid secretion. Lower stomach acid gives the lining a chance to heal.
- Stimulates Mucus/Bicarbonate: Prostaglandins also stimulate mucus and bicarbonate production. This creates a protective barrier over the stomach lining.
- Increases Blood Flow: Increased prostaglandins dilate mucosal blood vessels and improve mucosal circulation. Better blood flow aids healing.
- Stimulates Contractions: In pregnant women, prostaglandins ripen the cervix and cause uterine contractions. This empties the uterus.
So in summary, Cytotec works by increasing prostaglandin levels via misoprostol. The prostaglandins reduce acid, stimulate mucus production, and improve mucosal blood flow.
What are the Uses of Cytotec in Pregnancy?
Cytotec can be used in pregnancy for:
- Medical abortion
- Cervical ripening before labor induction
- Postpartum hemorrhage prevention
However, it is not FDA approved or recommended for these uses. More effective and safer prostaglandin drugs exist for pregnant women.
Misoprostol alone or combined with mifepristone is used for early medical abortion. It ends pregnancy by detaching the embryo and stimulating uterine contractions.
Multiple studies have found the combination regimen to be over 90% effective in the first trimester. Misoprostol-only regimens are slightly less effective.
Misoprostol can help ripen the cervix before labor induction. By applying prostaglandins directly to the cervix, it causes it to soften, thin out, and dilate.
This speeds up the induction process and makes it more likely to be successful. However, misoprostol is less effective than other prostaglandins like dinoprostone.
Giving misoprostol after birth helps prevent excessive bleeding (postpartum hemorrhage). Uterine atony is a leading cause of PPH.
Misoprostol causes sustained uterine contractions that compress blood vessels and slow bleeding. Studies show it significantly reduces the need for additional interventions.
However, oxytocin is the first-line drug for postpartum hemorrhage prevention and treatment.
Is Cytotec Safe During Pregnancy?
No, Cytotec is contraindicated in pregnant women. It can cause serious adverse effects if used incorrectly in pregnancy.
Cytotec use during pregnancy has been linked to the following risks:
- Uterine rupture – Uterine scar separation, especially in women with prior cesarean delivery
- Uterine hyperstimulation – Excessive uterine stimulation leading to fetal distress
- Abortion complications – Heavy bleeding, infection, incomplete abortion requiring surgery
- Premature birth – Use before 37 weeks may trigger premature labor and delivery
- Birth defects – Increased risk of birth abnormalities
Due to the risks, Cytotec should not be used without medical supervision. It should be avoided in early pregnancy and only used when necessary in late pregnancy.
Safer prostaglandin drugs like dinoprostone are recommended for pregnant women. Use should be limited to approved indications like cervical ripening.
What are the Side Effects of Cytotec?
Cytotec can cause various side effects, especially with prolonged use. Common side effects include:
- Stomach pain
- Heavy menstrual bleeding
Gastrointestinal side effects like diarrhea and stomach pain are most frequently reported with Cytotec. Taking it with food can help minimize GI upset.
Rare but serious side effects may include:
- Uterine rupture (if used in late pregnancy)
- Allergic reaction
- Postpartum hemorrhage
- Toxic megacolon
- Clostridium difficile infection
Tell your doctor right away if you experience any concerning or severe side effects while taking Cytotec. Do not stop taking it before speaking to your doctor.
What Drugs Interact with Cytotec?
Cytotec can interact with several types of medications:
- NSAIDs – Increased risk of stomach ulcers
- Steroids – Increased chance of bleeding
- Anticoagulants – Higher risk of bleeding/hemorrhage
- Other prostaglandins – Excessive drug effects
- Mifepristone – Enhances abortion effects
Using NSAIDs together with Cytotec increases the risk of stomach ulcers and related complications. Combining Cytotec with blood thinners like warfarin also raises the risk of bleeding issues.
Let your doctor know about any medications you are taking before starting Cytotec. Dosage adjustments or extra monitoring may be required to avoid drug interactions.
Is Cytotec Addictive?
No, Cytotec does not have any addictive properties. Misoprostol is not a controlled substance and has no potential for abuse or dependence.
Patients do not build tolerance to Cytotec over time or experience any withdrawal symptoms after stopping the medication. It can be safely taken for as long as needed under medical supervision.
How to Take Cytotec
Cytotec should be taken exactly as prescribed by your doctor. Here are some general dosing guidelines:
- Dose: 200-800 mcg taken 2-4 times per day
- Frequency: Space doses evenly throughout the day
- With food: Take with meals to reduce stomach upset
- Duration: May be used long-term for ulcer prevention
Do not exceed prescribed dosage. For abortions, misoprostol is typically used as a single 800 mcg vaginal or oral dose.
It’s best to take Cytotec at the same times each day to keep prostaglandin levels stable. If you miss a dose, take it as soon as possible unless it is close to your next scheduled dose.
Warnings and Precautions
Cytotec use requires some precautions:
- Tell your doctor about any medical conditions, especially inflammatory bowel disease.
- Use effective birth control while taking Cytotec. Stop taking it if you become pregnant.
- Avoid activities requiring alertness until you know how Cytotec affects you. It may cause dizziness.
- Limit alcohol intake, as it can increase the risk of stomach issues.
- Store Cytotec tablets at room temperature away from excess heat and moisture.
- Seek immediate medical care for severe diarrhea, bleeding, or allergic reactions.
Let your doctor know if you experience any concerning side effects after starting Cytotec. Seek emergency help for severe stomach pain, heavy vaginal bleeding, or shortness of breath.
Cytotec (misoprostol) is a prescription prostaglandin analog used to treat and prevent stomach ulcers. It protects the stomach lining by reducing acid secretion and increasing mucus production.
Cytotec is also used off-label for medical abortion, cervical ripening, and postpartum hemorrhage prevention. However, it carries risks in pregnant women and is not recommended.
Use Cytotec exactly as prescribed. Take with food to reduce GI side effects. Let your doctor know about any other medications you are taking. Seek medical help for severe reactions.
When used appropriately under medical supervision, Cytotec can provide effective relief from gastric ulcers. But it should be avoided in early pregnancy due to safety concerns.
Frequently Asked Questions
What is Cytotec used for?
Cytotec is used to treat stomach ulcers, prevent NSAID-induced ulcers, and for off-label uses like medical abortion. It protects the stomach lining and stimulates uterine contractions.
How does Cytotec induce abortion?
Misoprostol, the active ingredient in Cytotec, causes uterine contractions similar to labor. This empties the uterus and ends the pregnancy.
Is Cytotec safe during pregnancy?
No. Cytotec should be avoided in early pregnancy due to risks like uterine rupture and birth defects. It should only be used under medical supervision.
What are the side effects of Cytotec?
Common side effects include stomach pain, diarrhea, nausea, headaches, fever, and heavy vaginal bleeding. Seek immediate care for severe reactions.
Can Cytotec be taken long-term?
Yes, Cytotec may be used long-term for ulcer prevention in high risk patients taking NSAIDs. Follow your doctor’s instructions.
Is Cytotec addictive?
No, Cytotec does not have any addictive properties and is not a controlled substance. It is not habit-forming with long-term use.
How long does it take for Cytotec to work?
Cytotec begins working within 1-2 hours, but it may take several doses over days for full effectiveness. Time depends on the condition being treated.
Can I drink alcohol while taking Cytotec?
Drinking alcohol can further irritate the stomach. Limit alcohol intake while taking Cytotec, especially if you have a stomach ulcer.
What should I avoid while using Cytotec?
Avoid NSAIDs, aspirin, steroids, and anticoagulants to reduce bleeding risk. Avoid driving or hazards until you know how Cytotec affects you.