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Vagiprost . (Vaginal Tablets)

 

Composition:
Each tablet contains Misoprostol 25mcg.

Properties:
Misoprostol is synthetic prostaglandin E, analogue, is as effective as dinoprostone for preinducation cervical softening with Bishop scores < 4.

Indications:
Vagiprost vaginal tablet is indicated for cervical softening and induction of labour , when there are no foetal or maternal contraindication.
-Misoprostol in large doses could be used for cervical priming before surgical abortion, miscarriage and for evacuation of the uterus in cases of foetal death or anomaly.

Dosage Administration:
-In primigravid patients with unfavorable features(Bishop score of 4 or less),an initial dose of 50 mcg may br administrated vaginally .In other patients an initial dose of 25 mcg should be administrated vaginally.
In both groups of patients, a second dose of 25 mcg or 50 mcg may be used after 6 hours following assessment of cervical status, myometrial contractility and foetal condition
-25 mcg should be used in multigravid patients where uterine activity id insufficient for satisfactory progress of labour (50 mcg may be used where response to initial dose has been minimal)
-Maximum dose is 100 mcg in unfavourable primigravid patients or 75 mcg in other patients in cases of labour induction in advanced pregnancies.
-The tablet should be inserted high into the posterior fornix avoiding administration into cervical canal.
-The patient should be instructed to remain recumbent for at least 30 minutes.

Contra Indications:
Vagiprost vaginal tablet are not recommended in the following:
-For patients in whom oxytocic drugs are generally contraindicated, or where prolonged contraindication of the uterus are considered inappropriate, such as :cases with a history of caesarean section or major uterine surgery .

Precautions Warnings:
-This product is available only to hospital and clinics with specialized obstetric units and should be only used where 24 hours resident medical cover is provided
-In labour induction , cephalopelvic proportions should be carefully evaluated before use of prostaglandin E.
-During use uterine activity, foetal status and the progression of cervical dilatation should be monitored to detect possible evidence of undesired responses, e.g.hypertonus sustained uterine contractionsor foetal distress .In cases there is a known history of hyoertonic uterine contractility or titanic uterine contractions, it is recommended that uterine activity and the state of foetu should be continuously monitored throughout the possibility of uterine rupture shouls be considered where hightone contractions are sustained.

Side Effects:
-As with all prostaglandin-based medication the most commonly reported events are vomiting, nausea and diarrhea. Also hypersensitivity to the drug uterine rupture and cardiac arrest
-Other adverse events reported with prostaglandins in decreasing order of severity are: Pulmonary-amniotic fluid embolism, abruption placenta, stillbirth ,neonatal death , uterine hypercontracitility or hypertonus , foetal distress , hypertension , bronchospasm, asthma ,fever backache ,rash.

Notes:
Box of 1blisters, each blister contains 10 tablets.

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