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Misoprostol: a prostaglandin E1 analogue.
1Albany Veterans Administration Medical Center, NY.
Clinical Pharmacy
|September 1, 1989
Summary
Misoprostol effectively prevents nonsteroidal anti-inflammatory drug (NSAID)-induced gastropathy, showing superiority over placebo and other agents. However, it offers no significant advantage over H2-receptor antagonists for treating existing gastric or duodenal ulcers.
Area of Science:
- Pharmacology and Therapeutics
- Gastroenterology
Background:
- Misoprostol is a synthetic prostaglandin E1 analogue.
- It inhibits gastric acid and pepsin secretion, enhancing mucosal resistance.
- Its pharmacology, pharmacokinetics, efficacy, and safety are reviewed.
Purpose of the Study:
- To review the pharmacology, pharmacokinetics, clinical efficacy, contraindications, adverse effects, dosage, and cost of misoprostol.
- To evaluate misoprostol's role in ulcer treatment and prevention.
Main Methods:
- Review of pharmacology and pharmacokinetics.
- Analysis of clinical trial data for ulcer healing and prevention.
- Comparison with placebo, H2-receptor antagonists, and sucralfate.
Main Results:
- Misoprostol demonstrated 60-80% healing rates for duodenal ulcers, comparable to H2-receptor antagonists.
- Gastric ulcer healing rates were lower than for duodenal ulcers.
- Misoprostol was superior to placebo, cimetidine, and sucralfate in preventing NSAID-induced gastropathy.
Conclusions:
- Misoprostol is effective in preventing NSAID-induced gastric ulcers.
- It offers no clinical advantage over H2-receptor antagonists for treating gastric or duodenal ulcers.
- Contraindicated in pregnancy due to abortifacient properties; diarrhea is a common side effect.