Gemeprost pessary
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Vaginal pessary containing gemeprost.
Drugs List
Therapeutic Indications
Uses
Induction of abortion in 2nd trimester following intrauterine foetal death
Therapeutic termination of pregnancy during the second trimester
Transcervical surgery in 1st trimester: adjunctive treatment
Softening and dilation of the cervix to facilitate transcervical intrauterine operative procedures in the first trimester of pregnancy.
Termination of pregnancy during the second trimester of pregnancy.
Induction of abortion in the second trimester of pregnancy following intrauterine foetal death.
Gemeprost is not indicated in labour induction or in cervical dilatation at term as the effects of gemeprost on the foetus have not been studied.
Dosage
Adults
Softening and dilation of the cervix
One pessary (1mg gemeprost) to be inserted into the posterior vaginal fornix 3 hours before surgery.
Termination of pregnancy during the second trimester of pregnancy
One pessary (1mg gemeprost) to be inserted into the posterior vaginal fornix every three hours for a maximum of 5 administrations.
A second course of treatment may be started 24 hours after the initial commencement of treatment.
If abortion is not well established after the administration of 10 pessaries, further courses of gemeprost are not recommended and alternative treatments should be considered.
Induction of abortion following intrauterine foetal death
One pessary (1mg gemeprost) to be inserted into the posterior vaginal fornix every three hours for a maximum of 5 administrations.
Contraindications
Placenta praevia
Renal impairment
Undiagnosed uterine bleeding
Precautions and Warnings
Cervicitis
Multiparae with over three previous term pregnancies
Cardiovascular disorder
History of uterine surgery
Obstructive pulmonary disease
Raised intra-ocular pressure
Vaginitis
Monitor cardiovascular function
Monitor coagulation values
Termination of pregnancy must be confirmed at follow-up visit
When used for cervical dilatation and surgery is postponed beyond the 3 hours after gemeprost administration, patients should be closely monitored. This is because spontaneous abortion may occur.
Pregnancy and Lactation
Pregnancy
Gemeprost is used to facilitate termination of pregnancy.
Lactation
Gemeprost is used to facilitate termination of pregnancy.
At the time of writing, there are no data on the effect of gemeprost on the lactation process or on a breastfed infant.
Side Effects
Backache
Chest pain
Chills
Coronary vasospasm
Diarrhoea
Dizziness
Dyspnoea
Flushing
Headache
Muscle weakness
Myocardial infarction
Nausea
Palpitations
Pyrexia
Severe hypotension
Uterine pain
Uterine rupture
Vaginal bleeding
Vomiting
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: March 2019
Reference Sources
Summary of Product Characteristics: Cervagem 1mg Pessary. Sanofi. Revised January 2014.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 08 March 2019
Specialist Pharmacy Service (SPS)
Available at: https://www.sps.nhs.uk/
Can mothers breastfeed after a medical termination of pregnancy? Last revised: 03 May 2018
Last accessed: 08 March 2019
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