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July 1st, 2012, 02:06 PM
Join Date: Jun 2012
Cytotec has an interesting history. It was originally made as a drug to protect against ulcers while taking NSAIDs like Ibuprofen. It was noted that if used in pregnant women it would induce labor. This is why the FDA in the US had Searle put the big scary warning "not for pregnant women". And you certainly should not use this in pregnancy to prevent ulcers.
Researches began studying its labor inducing properties and found that it is the most effective medication available for induction of labor. This happened after the drug went off patent so there was no financial incentive for Searle to ask the FDA to change the indications and warnings.
Early on the best dose was not known and most people were using 50 mcg in the vagina. At this dose it sometimes caused too many contractions and hyperstimulation. Now people use 25 mcg and hyperstimulation is uncommon. There were also some problems early on with uterine ruptures in women with previous c-section.
Cervadil is the competing drug and it is still on patent. That means it is very expensive and drug companies are still making lots of money off of it. Cytotec costs less then 1% of cervadil, no one is making money off of it and therefore there is no voice to defend its use.
To make matters worse, when Ru486, the abortion pill was introduced in the US cytotec was part of the protocol to induce first trimester abortions. Searle was afraid of the bad publicity and went very public warning everyone not to use cytotec in pregnant women as it is contraindicated. This included Letters to every physician in the US.
It definitely works better for induction then any other agent. When dosed properly the risk of hyperstimulation is very small. It should not be used in VBAC induction and maybe not in IUGR. In most other cases it is probably the best choice.
It is unfortunate how politics and money effect the public perception of medications. Cytotec is safe and effective for induction and in many cases the first choice.
Labor induction information
Last edited by joelsmom; July 7th, 2012 at
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