Cytomis 200

Indications for Cytomis

Cytomis is prescribed for the following conditions:

• Prevention of Gastric and Duodenal Ulcers: For individuals at high risk of complications from NSAID-induced gastric ulcers, such as the elderly, those with serious comorbidities, and individuals with a history of ulcers.
• Healing of NSAID-Induced Gastric and Duodenal Damage: Effective for restoring health to the gastrointestinal tract following NSAID use.
• Treatment of Non-NSAID Related Gastric and Duodenal Ulcers: Aids in the recovery from ulcers not associated with NSAID treatment.
• Labor Induction: Facilitates the onset of labor when medically indicated.
• Postpartum Hemorrhage Management: Provides both prevention and treatment of excessive bleeding after childbirth.

Always use under the guidance of a registered healthcare professional.

Pharmacology

Misoprostol, the active ingredient in Cytomis, is well absorbed and quickly converted to its active form, Misoprostol acid, which is crucial for its therapeutic effects. Notably, when taken with food or certain antacids, its effectiveness may be reduced. Misoprostol possesses both antisecretory properties (reducing gastric acid production) and mucosal protective characteristics. NSAIDs can impair the production of prostaglandins, leading to decreased secretion of bicarbonate and mucus, thus causing mucosal injury. Misoprostol can enhance bicarbonate and mucus production, particularly at doses of 200 mcg or higher, though it remains unclear whether its ulcer prevention effects stem from antisecretory or mucosal protection mechanisms—or both.

Dosage & Administration

For Benign Gastric and Duodenal Ulceration & NSAID-Associated Ulceration:
Administer 800 mcg daily, divided into 2-4 doses, taken with meals and at bedtime. Continue treatment for at least 4 weeks, extendable to 8 weeks if necessary.

For NSAID-Induced Ulcer Prophylaxis:
Take 200 mcg 2-4 times daily alongside NSAID treatment. If this dosage is intolerable, 100 mcg can be considered. Misoprostol should be used for the entire duration of NSAID therapy as directed by a physician.

For Labor Induction:
Insert 25 mcg into the posterior vaginal fornix, repeating every 6 hours as needed until a total of 200 mcg is reached. Monitor fetal heart rate and uterine contractions. Alternatively, administer 100 mcg orally, with further doses of 100-200 mcg every 4 hours until labor is established (Bishop score ≥7), with a maximum of 6 doses. Notify a physician for signs of fetal distress or prolonged uterine contractions. Oral administration should be supervised by a physician.

For Postpartum Hemorrhage Prevention:
600 mcg orally immediately after delivery.

For Postpartum Hemorrhage Treatment:
Administer 600 mcg orally or 1000 mcg rectally.

Always consult with a registered healthcare professional before use.

Interactions

Cytomis exhibits no clinically significant interactions with cardiac, pulmonary, or CNS medications, as well as NSAIDs. However, its bioavailability may decrease with high doses of antacids.

Contraindications

Misoprostol is contraindicated for individuals with a known allergy to prostaglandins and should not be used during pregnancy.

Side Effects

Cytomis is generally well tolerated. Common adverse effects may include gastrointestinal disturbances such as diarrhea, abdominal pain, dyspepsia, flatulence, nausea, vomiting, rashes, and dizziness. To minimize diarrhea, it is advisable to take the medication after meals and at bedtime, avoiding magnesium-containing or other laxative antacids concurrently.

Pregnancy & Lactation

Due to its abortifacient properties, Misoprostol is contraindicated for pregnant women. It should only be used by women of childbearing potential who require NSAID therapy and are at a heightened risk of gastric or duodenal ulcers, provided they meet the following criteria:

• A negative serum pregnancy test within 2 weeks before treatment.
• Adherence to effective contraceptive measures.
• Receipt of comprehensive warnings regarding the risks associated with Misoprostol and potential contraceptive failure.
• Initiation of treatment only on the second or third day of the next menstrual period.

The transfer of Misoprostol into breast milk is possible, although unstudied; thus, it is not recommended for nursing mothers due to potential risks to breastfeeding infants.

Precautions & Warnings

In the context of NSAID-induced ulcer prevention and treatment, Cytomis is contraindicated for pregnant women and should be used cautiously in women of childbearing potential. They must ensure pregnancy does not occur during treatment and must employ effective contraception.

For labor induction, ensure the pregnancy has reached at least 38 weeks of gestation (or 36 weeks with medical indication). Avoid use in cases of acute fetal distress, placenta previa, abruptio placenta, or unexplained vaginal bleeding, and confirm that the fetus is in a vertex presentation.

Special Populations

Children: The safety and efficacy of Cytomis in individuals under 18 have not been established.

Overdose Effects

The specific toxic dose of Cytomis in humans has not been defined. Symptoms of overdose may include sedation, tremors, convulsions, dyspnea, abdominal pain, diarrhea, and fever. Supportive care is recommended for symptom management.

Therapeutic Class

Prostaglandin analogues acting on the uterus.

Storage Conditions

Store in a cool, dry place, shielded from light and moisture. Keep out of reach of children.