Cyprostol tablets

Cyprostol

  • Active Ingredient: Misoprostol
  • 200mcg, 100mcg
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What is Cyprostol?

The active ingredient of Cyprostol brand is misoprostol. Misoprostol reduces stomach acid and helps protect the stomach from damage that can be caused by taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

Used for

Cyprostol is used to treat diseases such as: Abortion, Cervical Ripening, Duodenal Ulcer, Gynecological Conditions, Labor Induction, NSAID-Induced Ulcer Prophylaxis, Postpartum Bleeding, Stomach Ulcer.

Side Effect

Possible side effects of Cyprostol include: puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue; cough; headache; sweating; paleness of the skin.

How to Buy Cyprostol tablets online?

To purchase Cyprostol online - just click on the "Buy Now" button from the top and follow on to our store. Order and payment takes a few minutes, and all measures are obvious. We do not require a medical prescription and also we have many procedures of payment. Considering all the details of fast delivery and confidentiality, you can read on the applicable pages on the hyperlinks from the navigation menu.

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What is the most important information I should know about Cyprostol (Cytotec)?

Cyprostol can cause birth defects, premature birth, uterine rupture, miscarriage, or incomplete miscarriage and dangerous uterine bleeding. Do not use Cyprostol if you are pregnant.

If you are able to become pregnant, you will need to have a negative pregnancy test before starting this treatment. You will also need to use effective birth control to prevent pregnancy during treatment.

INTENDED EFFECTS AND SIDE EFFECTS OF MISOPROSTOL

Bleeding and uterine contractions (cramping) are the intended effects of using Cyprostol for inducing an abortion. 1,4,5 Cramping will be stronger than for an ordinary menstrual period and may be painful. Nonsteroid anti-inflammatory pain medication such as ibuprofen may be taken without interfering with the Cyprostol. Bleeding will be heavier and more prolonged than for a normal period: up to a week, in most cases, often with continued spotting until menstruation resumes in four to six weeks. These effects will be more pronounced in pregnancies of longer duration.

Chills and fever are common side effects but are transient. High fever is less common, but can occur and usually disappears within a few hours, as do nausea, vomiting, and diarrhea.

Women should seek medical attention if they experience any of the following side effects after taking Cyprostol:

  • very heavy bleeding (soaking more than two large-sized thick sanitary pads each hour for more than two consecutive hours);
  • continuous bleeding for several days resulting in dizziness or light-headedness;
  • bleeding that stops but is followed two weeks or later by a sudden onset of extremely heavy bleeding, which may require manual vacuum aspiration or D&C;
  • scant bleeding or no bleeding at all in the first seven days after using Cyprostol, which may suggest that no abortion has occurred and require a repeat round of Cyprostol or surgical termination;
  • chills and fever lasting more than 24 hours after the last dose of Cyprostol, which suggest that an infection may be present requiring treatment with antibiotics; or
  • severe abdominal pain that lasts more than 24 hours after the last dose of Cyprostol.

Women should not take Cyprostol if they have a known allergy to Cyprostol.

Medication Abortion

In 2000, the FDA approved medication abortion using 600 mg of oral mifepristone, a progesterone antagonist, with 400 µg of oral Cyprostol 48 hours later for pregnancies up to 49 days of gestation. 21 However, there is excellent evidence of efficacy up to 63 days of gestation using the regimens of 200 mg of mifepristone orally followed by home administration of either 800 µg of buccal Cyprostol in 24 to 36 hours or 800 µg of vaginal Cyprostol in 6 to 48 hours. 22 , 23 Women then return 4 to 14 days later for a clinical evaluation to document complete abortion. Success rates for these regimens range from 95% to 98%, with failure due to ongoing pregnancy in approximately 1%. 21 In the United States, most women undergo ultrasound for pregnancy dating and confirmation of complete abortion. However, serial serum β-human chorionic gonadotropin (βhCG) levels can also be used to confirm complete abortion. 24 , 25

Candidates for medication abortion must be able to adhere to the treatment regimen as well as have access to a telephone and transportation to a medical facility in case of emergency. Multiple gestation is not a contraindication to medication abortion provided that the pregnancy is no more than 49 to 63 days, depending on the regimen being used. 22 Contraindications to mifepristone medication abortion include hemorrhagic disorder; concurrent anticoagulant therapy; inherited porphyrias; chronic adrenal failure; concurrent long-term systemic corticosteroid use; confirmed or suspected ectopic or molar pregnancy; allergy to mifepristone, Cyprostol, or other prostaglandin; and unwillingness to undergo a vacuum aspiration if needed. 26 If the woman has an intrauterine device in place, it must be removed before treatment. Women with serious systemic illnesses (eg, severe cardiac, renal, or liver disease or severe anemia) should be evaluated individually to determine which method of abortion is safest. Rhesus (Rh)-negative women typically receive Rh immune globulin on the day of mifepristone administration. 22

Medication abortion necessarily involves heavy bleeding and cramping as the pregnancy is expelled. Other transient side effects from Cyprostol include nausea, vomiting, diarrhea, fever, and chills. 21 At the follow-up visit, ongoing pregnancies are most commonly treated with suction curettage because of the risk of congenital anomalies. Women with persistent nonviable pregnancies may opt for expectant management, a repeat dose of Cyprostol, or suction curettage. 27 Mifepristone medication abortion is safe with an estimated complication rate of 2.2 per 1000 women. 28 The most frequent complications are heavy bleeding requiring curettage and/or transfusion and infection. The estimated mortality rate for mifepristone abortion is 1 per 100,000 women, most commonly due to fatal sepsis. 28 Where mifepristone is not available, medication abortion can be accomplished with methotrexate and Cyprostol or Cyprostol alone. 29

Cyprostol

A synthetic PGE1 analogue administered vaginally with mifepristone (RU 486) as an abortifacient. It is also used to prevent NSAID-induced gastric ulcers and in patients with a history of GI bleeding. Cyprostol may be of use in reducing acute rejection of renal allografts, a phenomenon partially due to ischaemic damage of kidneys that occurs between the time of “harvesting” and re-establishment of the blood flow; Cyprostol-treated group subjects suffered acute rejection one-half as often as the placebo group.

When compared to PGE2, Cyprostol induces complete abortion (i.e., passage of foetus and placenta simultaneously) more often (43% vs 32% for PGE2), was more convenient (insertion of two 100-µg tablets at 12 hours vs insertion of 20 mg suppository every 3 hours, plus antidiarrhoeal, antiemetic and antipyretic medication required for PGE2 therapy), was associated with fewer side effects, including fever (11% vs 63%), vomiting (4% vs 33%) and diarrhoea (4% vs 30%), and is less expensive (USD $0.97 vs $315.30).

Cyprostol ADMINISTRATION TO WOMEN WHO ARE PREGNANT CAN CAUSE BIRTH DEFECTS, ABORTION, OR PREMATURE BIRTH. UTERINE RUPTURE HAS BEEN REPORTED WHEN Cyprostol TABLETS WERE ADMINISTERED IN PREGNANT WOMEN TO INDUCE LABOR OR TO INDUCE ABORTION BEYOND THE EIGHTH WEEK OF PREGNANCY (see also PRECAUTIONS and LABOR AND DELIVERY ). Cyprostol TABLETS SHOULD NOT BE TAKEN BY PREGNANT WOMEN TO REDUCE THE RISK OF ULCERS INDUCED BY NONSTERO >CONTRAINDICATIONS, WARNINGS , and PRECAUTIONS ).

PATIENTS MUST BE ADVISED OF THE ABORTIFACIENT PROPERTY AND WARNED NOT TO GIVE THE DRUG TO OTHERS.

Cyprostol Tablets should not be used for reducing the risk of NSAID-induced ulcers in women of childbearing potential unless the patient is at high risk of complications from gastric ulcers associated with use of the NSAID, or is at high risk of developing gastric ulceration. In such patients, Cyprostol Tablets may be prescribed if the patient

  • has had a negative serum pregnancy test within 2 weeks prior to beginning therapy.
  • is capable of complying with effective contraceptive measures.
  • has received both oral and written warnings of the hazards of Cyprostol Tablets, the risk of possible contraception failure, and the danger to other women of childbearing potential should the drug be taken by mistake.
  • will begin Cyprostol Tablets only on the second or third day of the next normal menstrual period.

INDICACIONES PARA LA INDUCCIÓN DEL ABORTO MEDIANTE EL USO DE MISOPROSTOL

Normalmente, el Cyprostol se vende en farmacias, en tabletas de 200 mcg. Se recomiendan cuatro tabletas para iniciar un aborto temprano. Se pueden requerir cuatro más (o, en casos poco frecuentes, ocho) para completarlo. Es mejor utilizar el Cyprostol dentro de las nueve semanas contadas a partir de la última menstruación –es decir, antes de 63 días contados desde el primer día del último periodo regular. Cuanto más temprana la etapa del embarazo en la que se administre el Cyprostol, mejor, porque es más seguro, más efectivo y menos doloroso. El Cyprostol puede utilizarse en etapas más avanzadas del embarazo, pero los riesgos de complicaciones son mayores (ver más adelante). Las mujeres con un dispositivo anticonceptivo intrauterino insertado deben hacerlo extraer antes de utilizar el Cyprostol.

WARNINGS

For hospital use only if Cyprostol were to be used for cervical ripening, induction of labor, or for the treatment of serious post-partum hemorrhage, which are outside of the approved indication.

See BOXED WARNINGS. Congenital anomalies sometimes associated with fetal death have been reported subsequent to the unsuccessful use of Cyprostol as an abortifacient, but the drug's teratogenic mechanism has not been demonstrated. Several reports in the literature associate the use of Cyprostol during the first trimester of pregnancy with skull defects, cranial nerve palsies, facial malformations, and limb defects.

Cytotec is not fetotoxic or teratogenic in rats and rabbits at doses 625 and 63 times the human dose, respectively.

Acid-reducing drugs

Using acid-reducing drugs that contain magnesium with diclofenac-Cyprostol isn’t recommended. Combining these drugs may reduce the ability of diclofenac-Cyprostol to work as well as it should. It can also increase your risk of diarrhea.

Mifepristone and Cyprostol Dosage

– For women under 9 weeks pregnant, you will need 1 pill of Mifepristone and 4 pills of Cyprostol, and it is recommended to have an extra 4 pills of Cyprostol (a total of 8 pills of Cyprostol).

– For women between 9-11 weeks pregnant , you will need 1 pill of Mifepristone and 4 pills of Cyprostol, and it is highlyrecommended to have an extra 4 pills of Cyprostol (a total of 8 pills of Cyprostol).

The Mifepristone pill should be 200 mg (or the equivalent to 200 mg) and each Cyprostol pill should be 200 mcg.

If the pills you are getting have different dosages of mg and/or mcg, you will need to recalculate the total number of pills so you can use the correct amount of medication.

If you have any questions, please do not hesitate to contact us. We are here to support you throughout your abortion process.

A simplified dosage chart for non-doctors is available here.

This independent site has been set up to distribute dosage guidelines for the use of Cyprostol in obstetrics and gynaecology. The correct dosage varies greatly according to gestation, indication and route of administration – using the correct dosage is vital for success and to prevent complications.

These dosage guidelines are produced by FIGO and WHO. They are based on those originally produced by the Bellagio group in 2007 but updated regularly since. The most recent 2017 guidelines were publshed in the Int J Gynecol Obstet.

Recommended doses of Cyprostol (Cytotec®) are provided in this site along with instructions for use. The table below can be downloaded as a free A4 wallchart , compact easy reference cards, gestational calendars and in various languages .

Gynuity have a wide range of useful resources available regarding Cyprostol use which can be found here.

A full pictorial guide on how to safely make up a 200ml batch of a 1 microgram per ml solution of Cyprostol for oral administration can be found here. A 2015 study found that Cyprostol tablets degenerate if they are exposed to air and moisture (5% less Cyprostol content after 2 days), so keep them in their foil packets until needed!

What is Cyprostol (Cytotec)?

Cyprostol reduces stomach acid and helps protect the stomach from damage that can be caused by taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

Cyprostol is used to prevent stomach ulcers during treatment with aspirin or an NSAID.

Cyprostol may also be used for purposes not listed in this medication guide.

clinical studies

In a series of small short-term (about 1 week) placebo-controlled studies in healthy human volunteers, doses of Cyprostol were evaluated for their ability to reduce the risk of NSAID-induced mucosal injury. Studies of 200 mcg q.i.d. of Cyprostol with tolmetin and naproxen, and of 100 and 200 mcg q.i.d. with ibuprofen, all showed reduction of the rate of significant endoscopic injury from about 70 to 75% on placebo to 10 to 30% on Cyprostol. Doses of 25 to 200 mcg q.i.d. reduced aspirin-induced mucosal injury and bleeding.

Animal toxicology

A reversible increase in the number of normal surface gastric epithelial cells occurred in the dog, rat, and mouse. No such increase has been observed in humans administered Cyprostol Tablets for up to 1 year.

An apparent response of the female mouse to Cyprostol Tablets in long-term studies at 100 to 1000 times the human dose was hyperostosis, mainly of the medulla of sternebrae. Hyperostosis did not occur in long-term studies in the dog and rat and has not been seen in humans treated with Cyprostol Tablets.

Main Points

Cyprostol is a prostaglandin E1 analogue that causes cervical softening and dilation and uterine contractions. Routes of administration include oral, vaginal, rectal, buccal, and sublingual.

Medication abortion with 200 mg of mifepristone and 800 µg of buccal or vaginal Cyprostol is 95% to 98% effective with evidence-based regimens.

Cyprostol is an effective cervical ripening agent prior to first-trimester surgical abortion. It is recommended especially for women between 12 and 14 weeks of gestation, adolescents, and for women in whom cervical dilation is expected to be difficult either due to patient factors or provider inexperience.

Cyprostol for cervical ripening as a substitute for laminaria prior to second trimester dilation and evacuation is only recommended under 16 weeks of gestation.

Cyprostol is an effective cervical ripening agent in premenopausal women prior to hysteroscopy. The greatest benefit is seen in nulliparous women and for operative hysteroscopy. Whether the routine use of Cyprostol prior to hysteroscopy is beneficial is still unknown.

Cyprostol for cervical ripening prior to gynecologic procedures in postmenopausal women has not been found to be effective.

Cyprostol is an option for the management of early pregnancy failure and incomplete abortion in women who are hemodynamically stable without signs of infection. A single dose of 800 µg vaginally is typically used.

Cyprostol is a proven induction agent in the second trimester for termination of pregnancy or fetal death. One regimen is 400 µg vaginally every 6 hours up to 48 hours.

For cervical ripening and induction of labor for a viable fetus, 25 µg of vaginal Cyprostol every 4 to 6 hours is recommended.

Cyprostol has not been shown to be as effective as injectable uterotonics (oxytocin and methylergotomine) for the prevention and treatment of postpartum hemorrhage. However, it is a valid option when these are not available or fail.

Warnings

For hospital use only if Cyprostol were to be used for cervical ripening, induction of labor, or for the treatment of serious post-partum hemorrhage, which are outside of the approved indication.

Contraindications

See boxed WARNINGS .

Cyprostol Tablets should not be taken by pregnant women to reduce the risk of ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs).

Cyprostol Tablets should not be taken by anyone with a history of allergy to prostaglandins.

Conclusions

Cyprostol has many applications in the practice of obstetrics and gynecology. Off-label use of approved medications is supported by the FDA as long as it is based on sound medical evidence. Researchers and providers must continue to work to further refine the indications for Cyprostol in many areas. However, several indications are already supported by high-quality evidence. Given its low cost and ease of use, Cyprostol has the potential to improve women’s health worldwide.


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