Misoprostol tablets are taken to prevent or treat stomach or duodenal ulcers.
Take the tablets with a meal or snack.
The most common side-effect is diarrhoea. If this happens, drink plenty of water.
|Type of medicine||A prostaglandin analogue anti-ulcer medicine|
|Used for||To help prevent stomach and duodenal ulcers; to treat an existing stomach or duodenal ulcer|
Combination brands containing misoprostol: Arthrotec® (with diclofenac); Masidemen® (with diclofenac); Misofen® (with diclofenac); Napratec® (with naproxen)
Misoprostol is similar to naturally made protective substances in your body, called prostaglandins. Prostaglandins help to protect the lining of your stomach and intestines. Taking misoprostol will help prevent you from getting ulcers in your stomach and the part of your intestines next to your stomach, which is called the duodenum. Ulcers in these areas are often caused by taking painkillers known as non-steroidal anti-inflammatory drugs (or NSAIDs for short). Two common examples of these medicines are diclofenac and naproxen - medicines often taken by people with arthritis. NSAIDs can reduce the natural amount of prostaglandins in your stomach and intestines, which causes indigestion and can lead to ulcers forming. Misoprostol tablets will replace your natural prostaglandins so that you can continue getting benefit from your NSAID painkiller. If you already have an ulcer, misoprostol will help it to heal.
Misoprostol is an ingredient of a number of combination brands of tablet that are sometimes prescribed for people with arthritis (see the list above). Taking a combination brand tablet such as one of these can help to reduce the total number of tablets that you need to take each day.
Occasionally, misoprostol may be prescribed for a use which is not covered by this leaflet. If you have been prescribed misoprostol for a reason other than those listed above, you should ask your doctor if you have any questions about your treatment.
Before taking misoprostol
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking misoprostol it is important that your doctor knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you have ever been told that you have an inflammatory bowel disease, such as ulcerative colitis or Crohn's disease.
- If you have any of the following: heart disease, low or high blood pressure, blood vessel disease.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take misoprostol
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about misoprostol, and will also provide you with a full list of side-effects which you could experience from taking it.
- Take the tablets exactly as your doctor tells you to. You will be asked to take one tablet either two, three or four times a day. Your doctor or pharmacist will tell you which of these doses is right for you, and this information will also be printed on the label of the pack of tablets to remind you about what was said to you. Each time you take a dose, take the tablet just after eating a meal or with a snack.
- If you forget to take a dose, take it as soon as you remember (with a snack). However, if when you remember it is nearly time for your next dose, then leave out the forgotten dose. Do not take two doses together to make up for a missed dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- If you are taking misoprostol because you already have an ulcer then you will be prescribed a course of treatment lasting 4-8 weeks. If you are taking misoprostol to prevent you from getting an ulcer then your treatment is likely to be long-term, especially if you are taking anti-inflammatory medicines regularly. Continue to take misoprostol until your doctor advises you otherwise.
- If you need to take an indigestion remedy, you should choose one that does not contain magnesium. This is because magnesium can increase the risk of diarrhoea as a side-effect. Your pharmacist will be able to give you advice about which antacids and other medicines are suitable for you to buy to take alongside misoprostol.
- It is very important that you do not become pregnant while on misoprostol. This is because misoprostol is harmful to unborn babies. If you have not yet been through the menopause and this is something which could be a concern for you, make sure you ask your doctor about what contraception is suitable for you and your partner before you start taking misoprostol.
Can misoprostol cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains the most common ones associated with misoprostol. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any continue or become troublesome.
|Very common misoprostol side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Diarrhoea||Make sure you take misoprostol tablets after food to minimise this. Drink plenty of water to replace lost fluids. If it continues or becomes severe, speak with your doctor for further advice|
|Rash||If troublesome, speak with your doctor for advice|
|Common misoprostol side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Feeling sick or being sick, tummy (abdominal) pain, indigestion, wind||Make sure you take misoprostol tablets after food. Avoid rich and spicy meals|
|Vaginal bleeding||Speak with your doctor about this|
|Feeling dizzy||If this happens, do not drive or use tools or machines while affected|
|Headache, constipation||If either of these becomes troublesome, ask your pharmacist to recommend a suitable remedy|
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
How to store misoprostol
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you are due to have an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Cytotec® 200 microgram tablets; Pfizer Limited, The electronic Medicines Compendium. Dated June 2018.
British National Formulary; 70th Edition (Sep 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London