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Misoprostol is best taken with or after meals and at bedtime, unless otherwise directed by your doctor. To help prevent loose stools, diarrhea, and abdominal cramping, always take this medicine with food or milk.

Dosing

The dose of misoprostol will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of misoprostol. If your dose is different, do not change it unless your doctor tells you to do so.

• To prevent stomach ulcers in patients taking anti-inflammatory medicines including aspirin:
  • For oral dosage form (tablets):
    • Adults 200 micrograms (mcg) four times a day, with or after meals and at bedtime. Or, your dose may be 400 mcg two times a day with the last dose taken at bedtime. Your doctor may reduce the dose to 100 mcg if you are sensitive to high doses.
    • Children and teenagers Dose must be determined by your doctor.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For misoprostol, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to misoprostol. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Misoprostol must not be used during pregnancy when used to prevent stomach ulcers caused by anti-inflammatory medicines including aspirin. It has been shown to cause contractions and bleeding of the uterus. Misoprostol may also cause miscarriage.

Before starting to take this medicine you must have had a negative pregnancy test within the previous 2 weeks. Also, you must start taking misoprostol only on the second or third day of your next normal menstrual period. In addition, it will be necessary that you use an effective form of birth control while taking this medicine. Be sure that you have discussed this with your doctor before taking this medicine.

Breast-feeding It is not known whether misoprostol passes into breast milk. However, misoprostol is not recommended for use during breast-feeding because it may cause diarrhea in nursing babies.

Children Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of misoprostol in children with use in other age groups.

Older adults This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

• Blood vessel disease Medicines similar to misoprostol have been shown to make this condition worse

• Epilepsy (uncontrolled) Medicines similar to misoprostol have been shown to cause convulsions (seizures)
• Inflammatory bowel disease Misoprostol may worsen diarrhea, which could lead to dehydration