Pregnancy & Baby Index: Pregnancy - Birth: Labor and Delivery: Labor Induction: What is Cytotec?
What is Cytotec?
David Barrere, MD
Though not approved by the Food and Drug Administration as a labor-inducing agent, doctors frequently use Cytotec to induce labor. Obstetrician/Gynecologist David Barrere explains how it works.
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What is Cytotec?
The expert answers
Many of the labor induction methods currently available involve either the use of or release of chemicals called prostaglandins (PGs), especially PGE1, PGE2 and PGF2-alpha. These chemicals can induce structural changes in the cervix, resulting in softening and dilation -- and sometimes, contractions.
Used primarily to treat gastric (stomach) ulcers, Misoprostol (Cytotec) is a synthetic PGE1 analogue. PGE1 tends to have fewer side effects than PGE2, which at high doses can cause fever, diarrhea and nausea. Cytotec comes in tablet form and is placed next to the cervix in doses of 25, 50 or 100 micrograms at various frequencies; the most common regimen is 25 micrograms every three or four hours until labor ensues.
Currently, the FDA has not approved Cytotec for use as a labor-inducing agent. While it has been studied and seems to be effective for select patients, some hospital pharmacies are refusing to dispense Cytotec for obstetrical use. Discussion between the FDA and the American College of Obstetricians and Gynecologists (ACOG) on the use and safety of Cytotec continues.
Editor's note: The safety of Cytotec for use in labor induction is very controversial (See Cytotec: Dangerous experiment or panacea? at Salon.com). Not only has this drug not been approved for this use by the FDA, but the manufacturer also discourages it. (Click here to see a copy of a letter from Cytotec manufacturer Searle related to use of this medication on pregnant women.)