Trade Names:Cervidil- Vaginal insert 10 mg
Trade Names:Prepidil- Gel 0.5 mg
Trade Names:Prostin E2- Vaginal suppository 20 mg
Stimulates gravid uterus to contract; also stimulates smooth muscle of GI tract.
T max is 0.5 to 0.75 h (gel). C max approximately 484 pg/mL (gel).
Rapidly metabolized in the local tissue. Systemically absorbed drug is extensively metabolized in the lungs, liver, and kidney.
t ½ is 2.5 to 5 min. Metabolites excreted in the urine.
Cervical ripening in pregnant women at or near term with need for labor induction.Vaginal suppositories
Termination of pregnancy from 12 to 20 wk.
Hypersensitivity to prostaglandins; patients in whom oxytocic drugs are contraindicated or when prolonged contractions of uterus are considered inappropriate; ruptured membranes; placenta previa; unexplained vaginal bleeding during current pregnancy; when vaginal delivery is not indicated; acute pelvic inflammatory disease; active cardiac, pulmonary, renal or hepatic disease.
Intravaginal Gel 0.5 mg (contents of one syringe); may repeat dose 6 h later if necessary (max dose 1.5 mg (3 syringes/24 h).
Intravaginal Insert 10 mg (1 insert). Releases approximately 0.3 mg/h over 12 h. Remove insert upon onset of active labor or 12 h after insertion.Termination of PregnancyAdults
Intravaginal 1 suppository (20 mg) high into vagina. Repeat at 3 to 5 h intervals until abortion occurs. Do not give continuously for longer than 2 days.
Store suppository and insert in freezer. Store gel in refrigerator. Bring both to room temperature just prior to use, do not use external sources of heat (eg, hot water bath, microwave oven) to decrease warming time.
May augment effect of other oxytocic agents; avoid concomitant use.
None well documented.
Transient fall in BP; syncope; dizziness; arrhythmias.
Headache; flushing; anxiety; tension; hot flashes; paresthesia; weakness.
Blurred vision; eye pain.
Anorexia; nausea; vomiting; diarrhea.
Uterine contractile abnormality; endometritis; uterine rupture; uterine pain; amnionitis; premature rupture of membranes; vaginal pain; warm feeling in vagina.
Bronchospasm; coughing; dyspnea; wheezing.
Back pain; muscular cramps; fever; chills; joint inflammation; breast tenderness; diaphoresis; rash; leg cramps; dehydration. Fetal effects: Fetal heart rate abnormalities; bradycardia; deceleration; sepsis; depression (1 min Apgar less than 7); acidosis.
WarningsExperienced physician/equipped facility
Use only with strict adherence to recommended dosages by medically trained personnel that can provide immediate intensive care in acute surgical facilities.
Perform physical assessment to determine baseline vital signs and fetopelvic relationships. Perform careful uterine and fetal monitoring throughout use of dinoprostone. Wait at least 6 to 12 h after administration of gel before using IV oxytocin, a dosing interval of at least 30 min is recommended after removal of insert. Monitor patient closely for adverse reactions including nausea, vomiting, or diarrhea. Monitor vital signs frequently during administration, noting especially any increase in temperature and hypertension or hypotension. Monitor for hypersensitivity reactions such as bronchospasms, cardiac arrhythmias or seizures.
Category C . Contraindicated if fetus in utero has reached viability stage except when cervical ripening is indicated.
Use with caution in patients with asthma, glaucoma, or raised IOP, hypotension or hypertension, cardiovascular or renal or hepatic function impairment, anemia, jaundice, diabetes, epilepsy, compromised uterus, infected endocervical lesions; acute vaginitis.
Uterine hypercontractility, uterine hypertonus.
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