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Metabolicglycosuriagoutincreased nitrogenincreased alkaline phosphatase.

Prostaglandins such as Cytotec may augment the activity of oxytocic agentsespecially when given less than 4 hours prior to initiating oxytocin treatmentConcomitant use is not recommended.

See BOXED WARNINGSCongenital anomalies sometimes associated with fetal death have been reported subsequent to the unsuccessful use of misoprostol as an abortifacientbut the drug’s teratogenic mechanism has not been demonstratedSeveral reports in the literature associate the use of misoprostol during the first trimester of pregnancy with skull defectscranial nerve palsiesfacial malformationsand limb defects.

Maximum plasma concentrations of misoprostol acid are diminished when the dose is taken with food and total availability of misoprostol acid is reduced by use of concomitant antacidClinical trials were conducted with concomitant antacidhoweverso this effect does not appear to be clinically important.

Women of childbearing potential must be informed about the risk of teratogenicity prior to treatment with CytotecTreatment must not be initiated until pregnancy is excludedand women should be fully counselled on the importance of adequate contraception while undergoing treatmentIf pregnancy is suspectedtreatment must be immediately discontinuedsee sections 4.3 and 4.4

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Cytotec SHOULD NOT BE TAKEN BY PREGNANT WOMEN TO REDUCE THE RISK OF ULCERS INDUCED BY NONSTEROIDAL ANTI-INFLAMMATORY DRUGSNSAIDssee CONTRAINDICATIONSWARNINGSand PRECAUTIONS

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Take with food200mcg 4 times daily with mealslast dose at bedtimeMay reduce dose if not tolerated.

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