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GENITO URINARY SYSTEM AND SEX HORMONES › OTHER GYNECOLOGICALS › UTEROTONICS › Prostaglandins
gemeprost
G02AD03
Adult Dosing
- Termination of pregnancy (first and second trimester): 1 mg inserted into the posterior fornix of the vagina 3 hours before surgery, up to a maximum of 3 mg per day.
- Softening of the cervix prior to surgical termination: 1 mg vaginally 3 hours prior to the procedure.
Pediatric Dosing
- Safety and efficacy in pediatric populations have not been established, though used in adolescent pregnancies under specialist supervision.
Indications
- Medical termination of pregnancy in the first and second trimesters
- Pre-operative cervical dilatation/softening prior to surgical abortion
Mechanism of Action
- Synthetic analogue of prostaglandin E1 (PGE1)
- Binds to prostanoid receptors, causing myometrial contractions and softening/dilatation of the cervix
- Facilitates expulsion of the uterine contents
Contraindications
- Known hypersensitivity to gemeprost or other prostaglandins
- Active pelvic inflammatory disease
- Severe cardiovascular, hepatic, or renal disease
- Asthma or history of bronchospasm
- Known or suspected uterine scar from previous major uterine surgery
- Multiple pregnancy or grand multiparity due to risk of uterine rupture
Adverse Reactions
- Uterine pain and abdominal cramps
- Nausea, vomiting, and diarrhea
- Vaginal bleeding and uterine hemorrhage
- Headache, dizziness, and flushing
- Pyrexia and chills
- Rare: uterine rupture (especially with scarred uterus or high parity)
Drug Interactions
- Oxytocin and other uterotonic agents: concomitant use may enhance uterine-stimulating effects and increase risk of uterine rupture
- Nonsteroidal anti-inflammatory drugs (NSAIDs): may theoretically reduce the efficacy of prostaglandins due to inhibition of prostaglandin synthesis
Curated Content: Needs Vetting Before Put to Clinical Use