Pharmacokinetic Analysis of Hourly Oral Misoprostol Administration A Pilot Study
- *Corresponding Author:
- Tzu-Min Chan
Department of Medical Education and Research
China Medical University Beigang Hospital
123 Shin Der Road, Beigang
Yun Lin 651, Taiwan, ROC
Tel: 886-5-7837901, Ext. 1213
E-mail: [email protected]
Received Date: August 11, 2015 Accepted Date: September 11, 2015 Published Date: September 14, 2015
Citation: Cheng SY, Hung CH, Lee MR, Chan TM (2015) Pharmacokinetic Analysis of Hourly Oral Misoprostol Administration – A Pilot Study. Pharm Anal Acta 6:415. doi: 10.4172/21532435.1000415
Copyright: © 2015 Cheng SY, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: To conduct a pilot study of optimal misoprostol dosing to induce moderate labor among woman and to understand the pharmacokinetic parameters of moderate labor induction or augmentation. Methods: We administered high doses of oral misoprostol (200 μg) hourly to nine mid-trimester pregnant women who had requested termination of gestation to determine whether misoprostol metabolites (misoprostol acid, MPA) accumulated in the blood plasma. We then chose five pregnant women at term to receive individual hourly oral misoprostol administration program and measured plasma concentrations of MPA at various stages of labor including the beginning of misoprostol solution administration, the initial response of regular uterine contractions, and full cervical dilation. Results: The concentration of MPA, which is responsible for misoprostol’s clinical activity and toxicity, had no obvious accumulation after high-dose hourly oral misoprostol administration. Furthermore, the five moderate dosing programs of hourly oral misoprostol administration ripened the cervix with very low concentrations of MPA detected in the plasma. Conclusions: The preliminary results show that the five defined programs in labor induction or augmentation are promising dosing regimens that avoid uterine hyperstimulation, shorten the labor course, and prevent the risk of potential toxicity from excess MPA.