Misoprostol
Synthetic prostaglandin E1 analog
También conocido como: Cytotec · Arthotec · Arthrotec · Artotec · Artrenac Pro · Condrotec · Corrigast · Cyprostol · Cytolog · Diclotec · Glefos · Menpros · Misodex · Misofenac · Napratec · Normulen · Oxaprost · Symbol · SC-29333 · Misoprostolum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia de dosis v13 auditada
Evidencia estructurada para el cálculoPrevention of aspirin-induced gastric injury (extra-label)
- q8-12h
NA
Contexto clínico obligatorio (4)
- ■ Give this medicine with food if stomach upset occurs or to prevent stomach upset.
- ■ Common side effects include diarrhea, abdominal/stomach pain, vomiting, and flatulence (ie, gas). These effects may only last a few days, and giving the drug with food may help, but if any of these effects are severe, get worse, or continue to be a problem, contact your veterinarian.
- ■ This medicine is considered to be a hazardous drug because it may affect the reproductive ability of males or females actively trying to conceive, women who are pregnant or may become pregnant, as it can cause miscarriage, and women who are breastfeeding. It is recommended that you wear gloves when administering this medicine to your animal and wash your hands thoroughly afterwards. If you have questions about this medicine’s hazards, please speak with your veterinarian or pharmacist.
- Misoprostol tablets should be stored in well-closed containers at room temperature of 25°C (77°F) or less.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El misoprostol es un análogo sintético de la prostaglandina E1 (PGE1) utilizado principalmente en medicina veterinaria para prevenir y tratar la ulceración gástrica, particularmente aquellas inducidas por fármacos antiinflamatorios no esteroideos (AINEs).
Los AINEs inhiben las enzimas ciclooxigenasa (COX), lo que agota las prostaglandinas protectoras en la mucosa gástrica; el misoprostol reemplaza eficazmente estas prostaglandinas agotadas para restaurar las defensas de la mucosa.
Más allá de sus aplicaciones gastrointestinales, el misoprostol posee potentes propiedades uterotónicas. Aumenta la contractilidad uterina e induce la relajación cervical, lo que lo convierte en una terapia coadyuvante valiosa para indicaciones reproductivas tales como la terminación de la gestación, el manejo de piómetra/metritis y protocolos post-cópula no deseada.
Perla clínica: Aunque se ha investigado para la dermatitis atópica y la nefrotoxicidad inducida por ciclosporina, su uso para estas condiciones es generalmente secundario debido a una eficacia modesta y a la prevalencia de efectos secundarios gastrointestinales.
Mecanismo de acción
Misoprostol exerts its effects through multiple prostaglandin (EP) receptors across different organ systems:
- Gastric Acid Suppression: Binds directly to EP3 receptors on gastric parietal cells → inhibits adenylate cyclase → decreases intracellular cAMP → reduces the activity of the apical H+/K+ ATPase proton pump → decreased basal and stimulated gastric acid secretion.
- Gastric Cytoprotection: Binds to EP receptors on superficial foveolar epithelial cells → stimulates the secretion of protective mucin and bicarbonate. It also increases mucosal blood flow and accelerates epithelial cell turnover, enhancing the overall mucosal barrier and healing capacity.
- Reproductive Tract: Binds to EP receptors in the myometrium → increases intracellular calcium concentrations → increases the amplitude and frequency of uterine contractions. It also induces collagen breakdown in the cervix, leading to cervical softening and dilation.
Seguridad y advertencias
Contraindicaciones
- Pregnancy (unless being used specifically as an abortifacient)
- Nursing mothers (can cause severe diarrhea in nursing offspring)
- Known sensitivity to prostaglandins or prostaglandin analogs
- Pregnant animals (unless being used specifically to induce abortion)
Efectos adversos
- Diarrhea
- Abdominal pain
- Vomiting
- Flatulence
- Uterine contractions (in females)
- Vaginal bleeding (in females)
- Diarrhoea
- Nausea
- Abortion
Precauciones
WARNING FOR PREGNANT WOMEN: Misoprostol is a potent abortifacient. Pregnant women or women who may become pregnant should handle this drug with extreme caution (e.g., wearing gloves or avoiding handling altogether).
- Use with caution in patients with cerebral or coronary vascular disease. While not explicitly reported with misoprostol, other prostaglandins have precipitated seizures in epileptic patients and caused hypotension.
- Adverse GI effects are common but often transient; they can be minimized by adjusting the dose or administering the drug with food.
Interacciones farmacológicas
May aggravate misoprostol-induced diarrhea. If an antacid is required, an aluminum-only antacid is preferred.
May exacerbate renal dysfunction
Human combination products (misoprostol + diclofenac) are highly toxic to small animals due to different NSAID pharmacokinetics
Monitorización
- Clinical efficacy (resolution of ulcer signs, successful pregnancy termination, etc.)
- Adverse effects (GI distress, diarrhea, vomiting)
- Vaginal bleeding or discharge (if used in females)
- Resolution of clinical signs of gastric ulceration (e.g., vomiting, melena, anorexia)
- Monitoring for adverse GI effects (diarrhoea, abdominal pain)
Farmacocinética
Vida media
Absorción
Approximately 88% of an oral dose is rapidly absorbed from the GI tract. The presence of food and antacids will delay absorption. Undergoes significant first-pass metabolism.
Distribución
Both misoprostol and its active acid metabolite are highly bound to plasma proteins (approximately 90%). It is unlikely that misoprostol enters maternal milk, but it is unknown if the active acid metabolite does.
Metabolismo
Rapidly de-esterified in the liver to its primary active metabolite, misoprostol acid. Misoprostol acid is further biotransformed via oxidative mechanisms to pharmacologically inactive metabolites.
Eliminación
Metabolites, free acid, and small amounts of unchanged drug are principally excreted into the urine.
Sobredosis
Information on acute toxicity is limited. Overdoses in laboratory animals have produced:
- Diarrhea and emesis
- GI lesions
- Tremors and seizures
- Focal cardiac, hepatic, or renal tubular necrosis
- Hypotension
Treatment: Overdoses should be treated seriously. Employ standard gut-emptying techniques (e.g., emesis induction, activated charcoal) when applicable and safe. Treat resultant toxicity symptomatically with supportive care (e.g., IV fluids for hypotension and GI fluid loss).
Productos disponibles
Formulaciones
- Compounded cream
- Vaginal suppository (compounded/off-label use of tablets)
- Oral: 200 μg tablet
Etiquetado para humanos
- Misoprostol Tablets: 100 micrograms & 200 micrograms (Cytotec, generic)
- Cytotec 200 μg tablets
Estado regulador
POM (Prescription Only Medicine). Human product used under the cascade.
POM (Prescription Only Medicine). Human product used under the cascade.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Misoprostol tablets should be stored in well-closed containers at room temperature. After manufacture, misoprostol has an expiration date of 18 months.
Información para el cliente
ADVERTENCIA CRÍTICA PARA MUJERES EMBARAZADAS: Este medicamento puede causar contracciones uterinas y aborto espontáneo. Las mujeres embarazadas, o aquellas que intentan concebir, no deben manipular este medicamento. Si la manipulación es absolutamente necesaria, se deben tomar precauciones estrictas (como el uso de guantes desechables).
- Malestar gastrointestinal: Los efectos secundarios más comunes son diarrea, cólicos abdominales y vómitos. Estos suelen ser temporales y se resuelven en pocos días a medida que el cuerpo de su mascota se ajusta al medicamento.
- Administración: Administrar este medicamento con comida puede ayudar a minimizar el malestar estomacal y la diarrea.
- Cuándo llamar al veterinario: Si la diarrea se vuelve severa, persiste por más de unos pocos días, o si su mascota se muestra letárgica, contacte a su veterinario. Es posible que necesiten ajustar la dosis o recomendar un antiácido específico (evite los antiácidos que contienen magnesio, ya que empeoran la diarrea).
- Mascotas hembras: Si se administra a una perra intacta, puede notar sangrado o secreción vaginal debido al efecto del fármaco sobre el útero.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.