Guidelines for Safe Use of Misoprostol in Sri Lanka

    Misoprostol, a synthetic analogue of prostaglandin E1, is a crucial medication used in obstetrics and gynaecology. SLCOG emphasizes the importance of adhering to specific guidelines when prescribing Misoprostol tablets to ensure proper and safe usage.

    Definition – Synthetic analogue of prostaglandin E1.

    How to Buy Misoprostol in Sri Lanka

    In Sri Lanka, Misoprostol, a medicine approved by WHO and FDA, faces complications due to strict laws against abortion. Despite its global approval, using Misoprostol for abortion purposes is illegal in Sri Lanka. This creates difficulties for individuals seeking the medication.

    Because of Misoprostol‘s restricted status, it’s hard to find, and some pharmacies sell it at high prices due to its scarcity. This not only makes it financially challenging for those who need it but also raises concerns about the safety of obtaining the medication from unofficial sources.

    It’s important to note that this information is for educational purposes only and doesn’t support any illegal activities. If you’re dealing with reproductive health issues in Sri Lanka, it’s best to consult with healthcare professionals or organizations specializing in women’s health. The challenges surrounding Misoprostol highlight the need for informed decisions and legal compliance to ensure the well-being of those seeking help.

    How to Use Misoprostol in a Safe Way

    Mechanism of Action – Induces contractions of smooth muscle fibers in the myometrium. – Facilitates cervical dilation and evacuation of intrauterine contents.

    1. Preparation:

    • 200mcg tablet

    2. Contraindications:

    a. Known hypersensitivity to misoprostol or any prostaglandin. b. Coagulation disorders and during anticoagulant treatment. c. Uncertainty about pregnancy viability. d. Suspected ectopic pregnancy.

    3. Precautions:

    a. Avoid if intrauterine contraceptive device is present; remove it first. b. Lower dosage in the second and third trimester to prevent hyperstimulation. c. Caution in women with cardiovascular risk factors. d. Consideration in patients with a history of epilepsy or asthma.

    4. Teratogenicity:

    • Associated with birth defects; caution advised.

    5. Use During Lactation:

    • Not recommended due to potential adverse effects on breastfeeding infants.

    6. Adverse Effects:

    • Gastrointestinal and reproductive system disorders.
    • General disorders like headache, dizziness, and chills with fever.

    7. Use in First and Second Trimesters:

    • Advantages over alternatives; effective with fewer side effects.
    • Confirm non-viable pregnancy before use.

    8. Use in the Third Trimester:

    • Extensive use with caution; recommended for death in utero.
    • Contraindicated in the presence of a uterine scar.

    9. Procedure for Use of Misoprostol:

    a. Decision and responsibility with the consultant Obstetrician and Gynaecologist. b. Dosage and route of administration per consultant’s instructions, documented clearly. c. Informed choice after counseling and obtaining written consent. d. Record keeping, reporting adverse effects, and monitoring drug supply.

    10. Recommended Dosages (See Table Below):

    • Includes indications, dosages, and notes for different conditions and trimesters.

    The SLCOG emphasizes the significance of following these guidelines for the proper and safe use of Misoprostol tablets. Adherence to these recommendations ensures the optimal use of this medication in obstetric and gynaecological practices, promoting the well-being of patients.

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