Misoprostol is a popular prostaglandin E1 analogue in Singapore. It possesses strong antacid and protective properties. Due to this, Misoprostol helps to reduce the stomach acidity and protects its mucosa from the effects of non-steroidal anti-inflammatory drugs (NSAIDs).
In addition, with vaginal use, Misoprostol improves the tone of the cervix. For this reason, Singaporean gynecologists often prescribe a vaginal dosage form of Misoprostol to their patients for labor induction or preparation for such medical procedures, as hysteroscopy.
For today, patients can buy Misoprostol in Singapore in one of two medicinal forms: in tablets or vaginal delivery system. Both dosage forms of Misoprostol are available in a single dosage strength of 200 mcg.
Misoprostol in Singapore is sold under three popular brands:
- Misodel (vaginal delivery system)
- Cytotec and Misel (oral tablets)
Misoprostol is a prescription drug. But thanks to the wide access to the Internet, modern Singaporeans can order Misoprostol without a prescription in an online pharmacy.
In Singapore, Misoprostol is one of the best-selling drugs that is used to reduce the likelihood of peptic ulcer during the course of NSAIDs. The action of Misoprostol lies in the protection of the gastric mucosa from damage by reducing the secretion of gastric acid.
Misoprostol does not interact with NSAIDs, and effectively helps reduce their negative effects on the gastric mucosa. For this reason, Misoprostol should be taken during a long-term treatment course with Ibuprofen (Advil), Diclofenac (Cataflam), Acetaminophen (Panadol), or Acetylsalicylic Acid (Ecotrin).
To effectively protect the gastric mucosa from the impact of NSAIDs, there are two recommended dosage schedules for Misoprostol, approved by the Ministry of Health of Singapore:
- to reduce the risk of peptic ulcer during the course of NSAIDs, Misoprostol is recommended in a dosage of one tablet four times a day;
- at a high risk of adverse reactions, this dose can be halved by dividing the 200 mg Misoprostol tablets in half.
The maximum daily dose of Misoprostol is 800 mcg, used in divided doses. Because of the risk of adverse events, Misoprostol dose adjustment may be required for the elderly or patients with kidney disease, including mild to moderate renal failure.
When used in high doses, Misoprostol may cause some dose-depended gastrointestinal or gynecological adverse reactions, including:
- abdominal pain
- diarrhea, sometimes with dehydration
- menstrual disorder
To reduce the risk of gastrointestinal adverse reactions, oral Misoprostol tablets should be taken with food, washed down with plenty of clean water. Other frequent undesirable phenomena of Misoprostol include: vomiting, headaches, constipation, dyspepsia, nausea, flatulence.
After oral administration, Misoprostol tablets are absorbed in the stomach in an average of 9-14 minutes, and the acid-neutralizing action onsets in about half an hour. The duration of the therapeutic effect of Misoprostol is approximately 3 hours.
Some drugs may decrease the efficacy of Misoprostol. To maintain its maximum therapeutic effect, Misoprostol should not be taken concomitantly with other antacids, including Magaldrate (Ri-Mag), Calcium carbonate (Ami-Lac) or Sodium bicarbonate (Neut).
To avoid diarrhea in an infant, mothers should not take Misoprostol during breastfeeding. If a woman needs antacid therapy, the baby should be fed with breast milk substitutes during the use of Misoprostol.
Misoprostol does not possess a carcinogenic or mutagenic effect. However, in vaginal use by pregnant women, Misoprostol can cause cervical dilatation and provoke premature birth.
Pregnant women on NSAIDs are not recommended to use Misoprostol to reduce the risk of peptic ulcer. However, a gynecologist can appoint a woman to the vaginal delivery system Misoprostol to stimulate the maturation of the uterus and cause childbirth.
- Misoprostol vaginal delivery system is a polymer insert with rounded corners that absorbs moisture and swells.
- After insertion into the vagina, the vaginal delivery system contributes to a gradual release of Misoprostol within 24 hours, approximately by 7 mcg/hr.
Misoprostol vaginal delivery system was developed by the pharmaceutical company Ferring with a purpose to ease the use of this drug in pregnant women.
You can get more information about precautionary measures or adverse reactions of Misoprostol from a pharmacist, while buying this medication at a pharmacy. Some online pharmacies that sell Misoprostol provide free online or telephone consultations by healthcare specialists.
The use and sale of Misoprostol in Singapore market were approved on June 15, 1989. Already for more than 25 years, Misoprostol remains one of the best selling in Singapore drugs for reducing the risk of ulcers and labor stimulation.
In Singapore, this antacid is not included in the standard drug list (SDL), so government subsidy schemes (such as Medifund, Medisave or MediShield Life) do not cover the cost of Misoprostol.
Nevertheless, some private pharmacy chains or online pharmacies may offer discounts on Misoprostol to make this medication available to a larger number of Singaporeans.
Today, Misoprostol is available not only in Singapore. This popular antacid is sold under the brand Cytotec in such countries, as the United States, Australia, Britain, Israel, and the New Zealand.
The right for manufacture, supply and wholesale of Misoprostol in the Singapore market belongs to the pharmaceutical companies Pfizer, Ferring Pharmaceuticals and Zyfas Medical.