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What is Misoprostol?

By T. Broderick
Updated May 17, 2024
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Misoprostol is a medication originally developed to prevent stomach ulcers caused by non-steroidal anti-inflammatory drugs (NSAIDs). Yet further testing proved the drug's effectiveness in inducing abortion and treating miscarriages. Misoprostol is also used to induce labor on full-term pregnancies. This last use has caused controversy, as some in the medical community believe that the use of misoprostol increases the chances of possibly fatal complications during labor.

Misoprostol is an effective medication when taken to prevent NSAID-induced stomach ulcers. The medication works by turning off the stomach's parietal cells, stopping the secretion of gastric acid. Though many other prescription medications exist to treat the same condition, the particular effects of NSAIDs make misoprostol the best option for treatment. The drug also has the added benefit of stimulating secretion of the stomach's protective mucus lining. For these reasons, many physicians prescribe the drug at the same time as an NSAID.

Misoprostol is also commonly used to induce abortion in first and second trimester pregnancies. Used correctly, it is a safe medication lacking the possibly adverse side effects of surgical abortion. To raise the chances that abortion is successful, the drug is usually taken in tandem with mifepristone, known in many parts of the world as RU-486. This combination of drugs guarantees an almost 95% success rate. Only in very rare cases does medical abortion using drugs cause any side effects for the woman.

Due to its effectiveness as an abortion medication, misoprostol is also prescribed after a miscarriage. There are a number of reasons a miscarriage can occur in the first and second trimesters of pregnancy. Chromosomal abnormalities, progesterone deficiency and uterine malformation are just a few examples that cause fetal death. As when it is used to induce abortion, the drug safely causes uterine evacuation without any chance of permanent harm to the woman's reproductive system.

A controversial use of misoprostol is its use as a medication to induce labor. Though effective, a debate beginning in 2000 started when some in the medical community linked the drug to amniotic fluid embolism, the fifth leading cause of maternal fatality. As this medical condition is very rare, a double blind study to prove or disprove the drug's involvement is near impossible. Despite the debate, the drug is still widely use to induce labor and carries the approval of both the U.S. Food and Drug Administration and the American College of Obstetricians and Gynecologists.

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