Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android


misoprostol (mye-soe-prost-ole)



Therapeutic: antiulcer agents, cytoprotective agents

Pharmacologic: prostaglandins


Prevention of gastric mucosal injury from NSAIDs, including aspirin, in high-risk patients (geriatric patients, debilitated patients, or those with a history of ulcers). With mifepristone for termination of pregnancy. Unlabeled Use: Treatment of duodenal ulcers.


Acts as a prostaglandin analogue, decreasing gastric acid secretion (antisecretory effect) and increasing the production of protective mucus (cytoprotective effect). Causes uterine contractions. Therapeutic Effects: Prevention of gastric ulceration from NSAIDs. With mifepristone terminates pregnancy of less than 49 days.

Adverse Reactions/Side Effects

CNS: headache. GI: abdominal pain, diarrhea, constipation, dyspepsia, flatulence, nausea, vomiting. GU: miscarriage, menstrual disorders.


Examination and Evaluation

  • Monitor improvements in GI symptoms (gastritis, heartburn, and so forth) to help document whether drug therapy is successful in preventing gastric damage or duodenal ulcers.


  • In cases of NSAID-induced gastritis, implement appropriate manual therapy techniques, physical agents, and therapeutic exercises to reduce musculoskeletal pain and decrease the need for aspirin and other NSAIDs.

Patient/Client-Related Instruction

  • Advise patient to avoid alcohol and foods that may cause an increase in GI irritation.

  • Inform patient that misoprostol will cause spontaneous abortion. Women of childbearing age must be informed of this effect through verbal and written information and must use contraception throughout drug treatment. If pregnancy is suspected, the woman should stop taking misoprostol and notify her health care professional immediately.

  • If used with mifepristone to terminate pregnancy, inform patient that vaginal bleeding and uterine cramping will probably occur. Bleeding or spotting occurs for an average of 9–16 days, but may continue for more than 30 days. Instruct patient to report any severe or unusual cramping, bleeding, or pelvic pain that extends beyond the expected time periods.

  • Instruct patient to report bothersome side effects, including severe or prolonged headache, menstrual irregularities, or GI problems (nausea, diarrhea, vomiting, constipation, heartburn, flatulence, abdominal pain).


Absorption: Well absorbed following oral administration and rapidly converted to its active form (misoprostol acid).

Distribution: Unknown.

Protein Binding: 85%.

Metabolism and Excretion: Undergoes some metabolism and is then excreted by the kidneys.

Half-life: 20–40 min.

|Download (.pdf)|Print

TIME/ACTION PROFILE (effect on gastric acid secretion)

PO 30 min unknown 3–6 hr


Contraindicated in: Hypersensitivity to prostaglandins; Pregnancy or lactation (when used to prevent NSAID-induced gastric injury).

Use Cautiously in: Patients with childbearing potential; Children ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.