ADVERSE REACTIONS
The following have been reported as adverse events in subjects receiving misoprostol:
Gastrointestinal
In subjects receiving misoprostol 400 or 800 mcg daily in clinical trials, the most frequent gastrointestinal adverse events were diarrhea and abdominal pain. The incidence of diarrhea at 800 mcg in controlled trials in patients on NSAIDs ranged from 14–40% and in all studies (over 5,000 patients) averaged 13%. Abdominal pain occurred in 13–20% of patients in NSAID trials and about 7% in all studies, but there was no consistent difference from placebo.
Diarrhea was dose-related and usually developed early in the course of therapy (after 13 days), usually was self-limiting (often resolving after 8 days), but sometimes required discontinuation of misoprostol (2% of the patients). Rare instances of profound diarrhea leading to severe dehydration have been reported. Patients with an underlying condition such as inflammatory bowel disease, or those in whom dehydration, were it to occur, would be dangerous, should be monitored carefully if misoprostol is prescribed. The incidence of diarrhea can be minimized by administering after meals and at bedtime, and by avoiding coadministration of misoprostol with magnesium-containing antacids.
Gynecological
Women who received misoprostol during clinical trials reported the following gynecological disorders: spotting (0.7%), cramps (0.6%), hypermenorrhea (0.5%), menstrual disorder (0.3%) and dysmenorrhea (0.1%). Postmenopausal vaginal bleeding may be related to misoprostol administration. If it occurs, diagnostic workup should be undertaken to rule out gynecological pathology. (See boxed WARNINGS.)
Elderly
There were no significant differences in the safety profile of misoprostol in approximately 500 ulcer patients who were 65 years of age or older compared with younger patients.
Additional adverse events which were reported are categorized as follows:
Incidence greater than 1%
In clinical trials, the following adverse reactions were reported by more than 1% of the subjects receiving misoprostol and may be causally related to the drug: nausea (3.2%), flatulence (2.9%), headache (2.4%), dyspepsia (2.0%), vomiting (1.3%), and constipation (1.1%). However, there were no significant differences between the incidences of these events for misoprostol and placebo.
Causal relationship unknown
The following adverse events were infrequently reported. Causal relationships between misoprostol and these events have not been established but cannot be excluded:
Body as a whole: aches/pains, asthenia, fatigue, fever, rigors, weight changes.
Skin: rash, dermatitis, alopecia, pallor, breast pain.
Special senses: abnormal taste, abnormal vision, conjunctivitis, deafness, tinnitus, earache.
Respiratory: upper respiratory tract infection, bronchitis, bronchospasm, dyspnea, pneumonia, epistaxis.
Cardiovascular: chest pain, edema, diaphoresis, hypotension, hypertension, arrhythmia, phlebitis, increased cardiac enzymes, syncope, myocardial infarction (some fatal), thromboembolic events (e.g., pulmonary embolism, arterial thrombosis, and CVA).
Gastrointestinal: GI bleeding, GI inflammation/infection, rectal disorder, abnormal hepatobiliary function, gingivitis, reflux, dysphagia, amylase increase.
Hypersensitivity: anaphylaxis
Metabolic: glycosuria, gout, increased nitrogen, increased alkaline phosphatase.
Genitourinary: polyuria, dysuria, hematuria, urinary tract infection.
Nervous system/Psychiatric: anxiety, change in appetite, depression, drowsiness, dizziness, thirst, impotence, loss of libido, sweating increase, neuropathy, neurosis, confusion.
Musculoskeletal: arthralgia, myalgia, muscle cramps, stiffness, back pain.
Blood/Coagulation: anemia, abnormal differential, thrombocytopenia, purpura, ESR increased.
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REPORTS OF SIDE EFFECTS / ADVERSE REACTIONS RELATED TO MISOPROSTOL
Below is a sample of reports where side effects / adverse reactions may be related to Misoprostol. The information is not vetted and should not be cosidered as verified clinical evidence.
Possible Misoprostol side effects / adverse reactions in 39 year old female
Reported by a health professional (non-physician/pharmacist) from United Kingdom on 2007-01-11
Patient: 39 year old female
Reactions: Abdominal Pain, Laparotomy, Uterine Rupture
Adverse event resulted in: hospitalization
Suspect drug(s):
Syntocinon
Mifepristone
Dosage: 200 mg, unk
Misoprostol
Dosage: 800 ug/day
Misoprostol
Dosage: 400 ug/day
Administration route: Oral
Gemeprost
Dosage: 1 mg/day
Possible Misoprostol side effects / adverse reactions in 39 year old female
Reported by a individual with unspecified qualification from United States on 2007-01-24
Patient: 39 year old female
Reactions: Abdominal Pain, Haemorrhage, Muscle Spasms, Infection
Adverse event resulted in: hospitalization
Suspect drug(s):
Mifepristone Tablets, 200 MG (Danco Labs)
Dosage: 200 mg, oral
Administration route: Oral
Indication: Abortion Induced
Start date: 2006-09-29
Misoprostol
Dosage: 800 mcg, buccal
Start date: 2006-10-01
Possible Misoprostol side effects / adverse reactions in 27 year old female
Reported by a individual with unspecified qualification from United States on 2007-01-25
Patient: 27 year old female
Reactions: Induced Abortion Failed, PRE-Eclampsia
Suspect drug(s):
Misoprostol
Indication: Abortion Induced
Methotrexate
Administration route: Oral
Indication: Abortion Induced
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