Misoprostol
Misoprostol.JPG

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 litres
  • half-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 function
  • HDF/high flux   :Unknown dialysability. Dose as in normal renal function
  • CAV/VVHD      :Unlikely to be dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • None 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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