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Misoprostol oral 25 microgram


Oral formulation of misoprostol 25 micrograms.

Drugs List

  • ANGUSTA 25microgram tablets
  • misoprostol 25microgram tablets
  • Therapeutic Indications


    Labour - induction of



    25 micrograms every 2 hours. Alternatively, 50 micrograms every 4 hours.

    Maximum dose is 200 micrograms over 24 hours.


    Congenital abnormality of the uterus
    Foetal distress
    Foetal malpresentation
    Placenta praevia
    Renal impairment - eGFR below 15ml/minute/1.73m sq
    Scarred uterus
    Undiagnosed vaginal bleeding during current pregnancy

    Precautions and Warnings

    Children under 18 years
    Gestational age below 37 weeks
    Hepatic impairment
    Hypertonic uterine contractions
    Modified bishop score greater than 6
    Multiple pregnancy
    Renal impairment
    Ruptured amniotic membranes
    Severe pre-eclampsia

    Allow at least a 4 hour interval before using oxytocin if necessary
    Treatment to be administered by or under supervision of specialist
    Monitor uterine contractions and foetal heart rate
    Pregnancy: Monitor for disseminated intravascular coagulation postpartum
    Withhold treatment if excessive or prolonged uterine contractions occur
    Consider dose reduction in hepatic impairment
    Consider dose reduction in renal impairment

    Chorioamnionitis may result in fast delivery. It is up to the physician with regards to use of antibiotic treatment, induction of labour or caesarean section.

    Pregnancy and Lactation


    Misoprostol 25 micrograms tablet is indicated for induction of labour at full-time pregnancy.

    The manufacturer states that there is no risk of foetal malformations if used following the recommended dosing schedules. Misoprostol 25 micrograms tablet should only be used prior to 37 weeks of gestation if clinically indicated. Pregnancies exposed to misoprostol in the first trimester have been reported to have a threefold increase in the risk of foetal malformation including Moebius syndrome, amniotic band syndrome and central nervous system anomalies.


    Use Misoprostol with caution during breastfeeding.

    The manufacturer states that misoprostol has been detected in human milk following oral administration. Breastfeeding can start 4 hours after the last dose of misoprostol 25 micrograms tablet is administered. LactMed suggests that due to low levels of misoprostol in breast milk, no adverse effects are expected in breastfed infants.

    Side Effects

    Altered foetal heart rate patterns
    Foetal acidosis
    Low Apgar score in newborn
    Meconium in amniotic fluid
    Neonatal asphyxia
    Neonatal convulsion
    Neonatal cyanosis
    Postpartum haemorrhage
    Premature separation of placenta
    Pruritic rash
    Uterine hyperstimulation
    Uterine rupture


    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 ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: April 2021

    Reference Sources

    Summary of Product Characteristics: Angusta 25 microgram tablets. Norgine Limited. Revised September 2020.

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Misoprostol. Last revised: 17 March 2021
    Last accessed: 12 April 2021

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