Misoprostol
CLINICAL USE
Benign gastric and duodenal ulceration and NSAID associated ulcerationProphylaxis of NSAID induced ulceration
DOSE IN NORMAL RENAL FUNCTION
Treatment: 800 mcg daily in 2 or 4 divided dosesProphylaxis: 200 mcg 2–4 times daily
PHARMACOKINETICS
Molecular weight                           :382.5 %Protein binding                           :<90 (as misoprostol acid) %Excreted unchanged in urine     : <1 Volume of distribution (L/kg)       :858 litreshalf-life – normal/ESRD (hrs)      :20–40 minutes/ 40–80 minutes (as misoprostol acid) DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20 to 50     : Dose as in normal renal function 10 to 20     : Dose as in normal renal function <10           : Dose as in normal renal function DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Unlikely to be dialysed. Dose as in normal renal function HD                     :Unlikely to be dialysed. Dose as in normal renal functionHDF/high flux   :Unknown dialysability. Dose as in normal renal functionCAV/VVHD      :Unlikely to be dialysed. Dose as in normal renal function IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsNone known ADMINISTRATION
Reconstition
– Route
Oral Rate of Administration
–Comments
– OTHER INFORMATION
Plasma concentrations of misoprostol are generally undetectable due to its rapid metabolic conversion to misoprostol acidDosage adjustment is not usually necessary in patients with varying degrees of renal impairment, even though there is an approximate doubling of half-life, maximum plasma concentration and area under the curve. If renal patients are unable to tolerate it, the dose can be reduced.
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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