Cytotec (Misoprostol) - Oral

Warning:

Cytotec (misoprostol) can cause birth defects, abortion, premature birth, or uterine rupture. Do not use this medication to reduce the risk of nonsteroidal anti-inflammatory drug (NSAID)-induced ulcers if you are pregnant. If you become pregnant while taking misoprostol for this reason, stop the medication immediately and contact your healthcare provider.

What Is Cytotec?

Cytotec (misoprostol) is a prescription medication used to prevent stomach ulcers in people taking non-steroidal anti-inflammatory drugs (NSAIDs). Although labeled as an ulcer medication, misoprostol is also commonly used in combination with Mifeprex (mifepristone) to end an early pregnancy (abortion).

Cytotec is a synthetic prostaglandin. Prostaglandin is a protective chemical naturally released in the body. NSAIDs can reduce the natural amount of prostaglandins in the stomach and intestines, leading to indigestion and ulcers if used long-term.

Misoprostol tablets replace the natural prostaglandins in the body to help reduce the risk of NSAID-induced ulcers and serious ulcer complications, such as bleeding. If you already have an ulcer, Cytotec will also help heal it.

Cytotec is a prescription medicine available as a tablet.

Drug Facts

Generic Name: Misoprostol

Brand Name(s): Cytotec

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Prostaglandin

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Misoprostol

Dosage Form(s): Tablet

What Is Cytotec Used For?

The Food and Drug Administration (FDA) approved misoprostol to prevent or treat stomach ulcers due to NSAIDs (e.g., aspirin), especially in people at risk for developing ulcers and related complications. Prolonged use of NSAIDs, especially at higher doses, can lead to these kinds of ulcers. People may take NSAIDs long-term to treat chronic pain associated with arthritis or other inflammatory conditions.

Cytotec has not been shown to reduce the risk of duodenal ulcers (ulcers in the duodenum) in people taking NSAIDs.

Misoprostol is also widely used in combination with another drug called mifepristone to end an early pregnancy (abortion).

How to Take Cytotec

Ulcer Prevention

To reduce the risk of NSAID-induced gastric ulcers, take misoprostol for the duration of NSAID therapy. You will usually be prescribed to take misoprostol four times daily with meals. Take the last dose of the day before going to bed.

The dose of medicine is based on your medical condition and response to therapy. Tell your healthcare provider if you experience side effects, as they may lower your dose.

Abortion

The FDA approved misoprostol and mifepristone for use through 70 days gestation (10 weeks or less since the first day of the person's last menstrual period) for abortion. Generally, misoprostol is taken 24 to 48 hours after mifepristone. The pregnancy will pass within two to 24 hours after taking the misoprostol tablets.

Misoprostol may be given to you in a healthcare provider's office or taken home.

The following are general instructions for taking misoprostol to end a pregnancy:

  • Take four misoprostol tablets 24 to 48 hours after taking mifepristone
  • When taking misoprostol, place two tablets in each cheek pouch (the area between the teeth and cheek) for 30 minutes. After 30 minutes, swallow what's leftover with water or another liquid.
  • Make sure to take it at least 24 hours after mifepristone and no later than 48 hours after. Otherwise, it might not work as well.

Vaginal bleeding and cramping after taking mifepristone and misoprostol are expected, so don't worry if you notice this. This usually means the treatment is working. You may bleed or spot for about nine to 16 days, but it can last up to 30 days. Keep an eye on these side effects and report to your healthcare provider if you have heavy bleeding that is concerning or lasts longer than expected.

Visit your healthcare provider about one to two weeks after taking misoprostol for a follow-up appointment. They will check that the pregnancy has passed from the uterus.

Storage

Keep Cytotec tablets in their original container. Store it at or below room temperature (77 degrees F) in a dry area, away from direct light and moisture. Do not store medications in the bathroom. Keep all medicines locked away from the sight and reach of children.

Do not keep unwanted or expired medicines with you. Do not throw the unwanted drugs in the waste bin, pour them into a drain, or flush them down the toilet unless directed. The right way to discard the medications is to return them through a medicine take-back program.  Ask your pharmacist or local waste disposal company about how to discard the drugs safely.

Off-Label Uses

Healthcare providers may prescribe misoprostol for off-label uses, meaning for conditions not specifically indicated by the FDA.

Misoprostol is widely used off-label for several indications in the obstetrics and gynecology practice, including:

How Long Does Cytotec Take to Work?

For ulcers, the initial treatment requires at least four weeks, even if symptomatic relief has been achieved earlier. In most people, ulcers will heal in four weeks, but treatment may be continued for up to eight weeks if required. If the ulcer relapses, further treatment courses may be needed.

For abortion, pregnancy will pass within two to 24 hours after taking the misoprostol tablets.

What Are the Side Effects of Cytotec?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Some common side effects of Cytotec are:

The following side effects are also common when taking misoprostol in combination with mifepristone for abortion:

  • Vaginal bleeding: Bleeding may be similar to or heavier than your normal period.
  • Cramping
  • Nausea or vomiting
  • Weakness
  • Fever and chills
  • Dizziness

Consult your healthcare provider if any of these symptoms do not go away or worsen.

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects can include the following:

  • Severe ongoing stomach discomfort or diarrhea
  • Dehydration symptoms such as feeling very thirsty or very hot, unable to urinate, or heavy sweating
  • Vomiting blood
  • Bloody, black, or tarry stools

A severe allergic reaction to Cytotec is unlikely. But seek immediate medical attention if you notice symptoms of a severe allergic reaction, such as:

  • Rash or itching
  • Swelling of the face, tongue, or throat
  • Severe dizziness
  • Difficulty breathing

If using misoprostol for abortion, contact your healthcare provider if you experience any of the following:

  • Heavy bleeding (bleeding enough to soak two, thick full-size sanitary pads per hour or heavy bleeding for two hours or more)
  • Stomach pain or discomfort for more than 24 hours
  • Fever: A fever of 100.4 F that lasts more than four hours

Report Side Effects

Cytotec may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Cytotec Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • To prevent stomach ulcers in patients taking NSAIDs:
      • Adults—200 micrograms (mcg) four times a day with food. Other patients may need 100 mcg four times a day with food. Take the last dose of the day at bedtime.
      • Children—Use and dose must be determined by your doctor.

Modifications

Evidence suggests no dose modifications (changes) are required in people 65 and older or in those with liver or kidney impairment.

However, your healthcare provider may prescribe a lower dose if you do not tolerate Cytotec well.

Missed Dose

Take the missed dose as soon as you remember. If it is nearly the time for the next dose, skip the missed dose. Take your following doses at the usual time. Never take a double dose to catch up.

Overdose: What Happens If I Take Too Much Cytotec?

Signs of an overdose may include:

What Happens If I Overdose on Cytotec?

If you think you or someone else may have overdosed on Cytotec, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Cytotec, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

Do not use this medicine if you are pregnant or planning to become pregnant. This medicine can cause miscarriage, premature birth, or birth defects if taken during pregnancy. You will need to have a negative pregnancy test within 2 weeks before you start using this medicine. Continue to use birth control for at least 1 month after you stop using this medicine. Tell your doctor right away if you become pregnant.

Begin using this medicine on the 2nd or 3rd day of your next monthly period. This is to make sure you are not pregnant.

This medicine may cause diarrhea, stomach cramps, or nausea in some people. These effects will usually disappear within a few days as your body adjusts to the medicine. However, check with your doctor if the diarrhea, cramps, or nausea is severe and/or does not stop after a week. Your doctor may have to lower the dose of misoprostol you are taking.

What Are Reasons I Shouldn’t Take Cytotec?

Misoprostol should not be used to treat or prevent ulcers in:

  • People who can become pregnant who are not using effective contraception
  • Pregnant people, those planning to become pregnant, or people who have not had a negative pregnancy test before taking the drug: Misoprostol increases uterine contractions in pregnancy, causing miscarriage, premature birth, or congenital disabilities (birth defects).
  • Breastfeeding people: Misoprostol is rapidly metabolized into misoprostol acid, which is biologically active and excreted in breast milk. Therefore, it can cause diarrhea in nursing infants.
  • Those with a known hypersensitivity to misoprostol, any other component of the medicine, or other prostaglandins

Intrauterine devices (IUDs) must be removed before taking misoprostol and mifepristone for abortion.

It is also only approved for use to end pregnancy up to 70 days (10 weeks) and no later.

What Other Medications Interact With Cytotec?

You can take Cytotec safely with most other drugs.

However, Cytotec may interact with the following:

  • Magnesium-containing antacids: Avoid using magnesium-containing antacids during treatment with misoprostol, as it may worsen misoprostol-induced diarrhea.
  • Oxytocic agents (drugs used to stimulate uterine activity and induce labor): Do not use Cytotec with these medications. An example of an oxytocic agent is Pitocin (oxytocin).

Always consult your healthcare provider about all prescription, non-prescription, and herbal or supplement products you take before starting Cytotec.

What Medications Are Similar?

Arthrotec (diclofenac and misoprostol) is a medication containing misoprostol that helps reduce pain, swelling, and joint stiffness in arthritis.

This combination drug treats the signs and symptoms of osteoarthritis or rheumatoid arthritis in people at high risk of getting gastric ulcers and complications from the ulcers.

Frequently Asked Questions

  • What is Cytotec used for?

    Cytotec is used to treat or prevent duodenal and gastric ulcers, including those caused by nonsteroidal anti-inflammatory drugs (NSAIDs). Misoprostol is also used in combination with mifepristone to end a pregnancy (abortion).

  • How does Cytotec work?

    Cytotec reduces the amount of acid in contact with the gastric lining. Misoprostol is also used in combination with mifepristone to end a pregnancy. Mifepristone causes the pregnancy to end by blocking the hormone progesterone, which breaks down the uterus lining. Misoprostol then causes the uterus to contract and empty.

  • What drugs should not be taken with Cytotec?

    Avoid taking magnesium-containing antacids during treatment with misoprostol, as it may worsen misoprostol-induced diarrhea.

    Cytotec should be given along with oxytocic agents, such as Pitocin (oxytocin). Oxytocic drugs are used to stimulate uterine activity.

  • How long does it take for Cytotec to work?

    Cytotec is used as a preventive medication for gastric ulcers caused by NSAIDs in people who are at high risk of ulcers and ulcer-related complications. Therefore, you should take it for as long as you are on NSAID therapy.

    If you are taking misoprostol for abortion, the pregnancy will pass within two to 24 hours after taking the misoprostol tablets. You must follow up with your healthcare provider about one to two weeks after to make sure you are well and confirm the pregnancy has passed from the uterus.

  • What are the side effects of Cytotec?

    Some common side effects of Cytotec are:

    • Headache
    • Stomach pain or distress (an upset stomach)
    • Bloating
    • Diarrhea
    • Vomiting
    • Constipation

    If you are taking misoprostol for abortion, you will likely experience bleeding and cramping as the pregnancy passes.

  • Can I drive while taking Cytotec?

    You may feel nausea and tiredness after taking misoprostol. However, these side effects will improve after one to two days of taking the tablet. Be careful while driving and operating machinery unless you know how the drug affects you.

How Can I Stay Healthy While Taking Cytotec?

Whether you have been prescribed misoprostol to prevent ulcers or end a pregnancy, it is important to take it exactly as your healthcare provider instructs.

To effectively prevent ulcers, continue taking Cytotec for as long as you are on NSAID therapy. Risk factors for NSAID-induced ulcers include:

  • Older age
  • Taking multiple NSAIDs
  • Taking blood thinners, such as Jantoven (warfarin)
  • Taking corticosteroids
  • Smoking and alcohol use
  • Previous history of stomach ulcers

Misoprostol as part of the abortion pill regimen (mifepristone plus misoprostol) has been widely, safely, and effectively used for some time. However, on June 24, 2022, the Supreme Court overturned Roe v. Wade—ending the constitutional right to abortion. Since that ruling, some states have enforced bans or severe restrictions on abortion, whereas others continue to protect the right to choose under state law.

Before undergoing an abortion, talk to your healthcare provider about what to expect. This can help put you more at ease when managing the side effects.

Consider the following tips to aid in your recovery after an abortion:

  • Set aside time to rest for the first few days after your abortion.
  • Do not engage in strenuous activity for the first week after the abortion.
  • Avoid stimulating the nipples. Stimulating your nipples can cause breast discharge.
  • Bleeding can occur for up to a week or more, so it can be helpful to have pads, tampons, and other menstrual supplies on hand.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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