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Chemical Compound Review

AG-L-66068     methyl7-[(1R,2S,3R)-3- hydroxy-2-(4...

Synonyms: SureCN5956198, CTK8G1129, Misoprostol (SC-29333)
 
 
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Disease relevance of misoprostol

  • Healing rates among patients with duodenal ulcers were higher with either dose of omeprazole than with misoprostol, whereas healing rates among patients with erosions alone were higher with misoprostol [1].
  • The rates of gastric-ulcer healing were significantly higher with 20 mg of omeprazole (but not 40 mg of omeprazole) than with misoprostol [1].
  • Misoprostol for the treatment of peptic ulcer and antiinflammatory-drug-induced gastroduodenal ulceration [2].
  • Certain side effects were more frequent in the women receiving PGE2 than in those receiving misoprostol: pyrexia (63 percent vs. 11 percent; P < 0.001), uterine pain (67 percent vs. 57 percent, P = 0.58), vomiting (33 percent vs. 4 percent, P = 0.005), and diarrhea (30 percent vs. 4 percent, P = 0.012) [3].
  • BACKGROUND: Misoprostol is effective for ulcers associated with the use of nonsteroidal antiinflammatory drugs (NSAIDs) but is often poorly tolerated because of diarrhea and abdominal pain [1].
 

Psychiatry related information on misoprostol

  • The different conclusions reached by five economic evaluations of misoprostol can be explained solely by the assumed absolute risk reduction of symptomatic ulcer, which was more than seven times greater in the studies that concluded that misoprostol was cost-effective than in a study that concluded misoprostol to be costly [4].
  • A double-blind, placebo-controlled trial of diclofenac/misoprostol in Alzheimer's disease [5].
  • Misoprostol is effective in reducing NSAID-induced mucosal damage, but patient compliance is limited by poor tolerance [6].
  • METHOD: Patients who met DSM-IV criteria for alcohol abuse were randomly assigned to treatment with F (40 mg/day) plus misoprostol (M) (500 mg/day) or I (100 mg/day) plus M or placebo (PL) plus M [7].
  • CONCLUSIONS: Immediate labour induction with misoprostol in cases of term PROM shortens the latency period, the total time between recruitment to delivery and the time of maternal hospitalisation, increasing the occurrence of alterations of contractility without any maternal and perinatal outcomes disadvantages [8].
 

High impact information on misoprostol

 

Chemical compound and disease context of misoprostol

 

Biological context of misoprostol

 

Anatomical context of misoprostol

 

Associations of misoprostol with other chemical compounds

 

Gene context of misoprostol

  • M&B-28767, a putative EP3 agonist, and misoprostol, a putative EP2/EP3 agonist, also bound to this receptor with Ki values of 120 nM [27].
  • The actions of PGE2 were mimicked by synthetic PGE2 analogues including misoprostol and butaprost [28].
  • Bay K 8644, a specific activator of L-type Ca2+ channels, stimulated ECL-cell secretion, an effect that was inhibited equally effectively by somatostatin, misoprostol and galanin (75-80% inhibition) [29].
  • Whereas the synthesis of Th1 cytokines (IL-2 and IFN-gamma) was dose-dependently reduced, IL-10 expression was increased at lower misoprostol doses [30].
  • Prior to the introduction of the COX-2 selective inhibitors, patients at high risk were often coprescribed a gastroprotective agent (such as misoprostol or a proton pump inhibitor) with a conventional NSAID [31].
 

Analytical, diagnostic and therapeutic context of misoprostol

References

  1. Omeprazole compared with misoprostol for ulcers associated with nonsteroidal antiinflammatory drugs. Omeprazole versus Misoprostol for NSAID-induced Ulcer Management (OMNIUM) Study Group. Hawkey, C.J., Karrasch, J.A., Szczepañski, L., Walker, D.G., Barkun, A., Swannell, A.J., Yeomans, N.D. N. Engl. J. Med. (1998) [Pubmed]
  2. Misoprostol for the treatment of peptic ulcer and antiinflammatory-drug-induced gastroduodenal ulceration. Walt, R.P. N. Engl. J. Med. (1992) [Pubmed]
  3. A comparison of intravaginal misoprostol with prostaglandin E2 for termination of second-trimester pregnancy. Jain, J.K., Mishell, D.R. N. Engl. J. Med. (1994) [Pubmed]
  4. Is misoprostol cost-effective in the prevention of nonsteroidal anti-inflammatory drug-induced gastropathy in patients with chronic arthritis? A review of conflicting economic evaluations. Stucki, G., Johannesson, M., Liang, M.H. Arch. Intern. Med. (1994) [Pubmed]
  5. A double-blind, placebo-controlled trial of diclofenac/misoprostol in Alzheimer's disease. Scharf, S., Mander, A., Ugoni, A., Vajda, F., Christophidis, N. Neurology (1999) [Pubmed]
  6. Appropriate choice of proton pump inhibitor therapy in the prevention and management of NSAID-related gastrointestinal damage. Singh, G., Triadafilopoulos, G. International journal of clinical practice. (2005) [Pubmed]
  7. Effects of fluoxetine, indomethacine and placebo on 3 alpha, 5 alpha tetrahydroprogesterone (THP) plasma levels in uncomplicated alcohol withdrawal. Romeo, E., Pompili, E., di Michele, F., Pace, M., Rupprecht, R., Bernardi, G., Pasinib, A. World J. Biol. Psychiatry (2000) [Pubmed]
  8. Misoprostol versus expectant management in premature rupture of membranes at term. da Graça Krupa, F., Cecatti, J.G., de Castro Surita, F.G., Milanez, H.M., Parpinelli, M.A. BJOG : an international journal of obstetrics and gynaecology. (2005) [Pubmed]
  9. Use of misoprostol during pregnancy and Möbius' syndrome in infants. Pastuszak, A.L., Schüler, L., Speck-Martins, C.E., Coelho, K.E., Cordello, S.M., Vargas, F., Brunoni, D., Schwarz, I.V., Larrandaburu, M., Safattle, H., Meloni, V.F., Koren, G. N. Engl. J. Med. (1998) [Pubmed]
  10. Use of misoprostol during pregnancy and Möbius' syndrome in infants. Blanchard, K., Winikoff, B., Ellertson, C. N. Engl. J. Med. (1998) [Pubmed]
  11. Uterine contractility and induction of abortion in early pregnancy by misoprostol and mifepristone. Norman, J.E., Thong, K.J., Baird, D.T. Lancet (1991) [Pubmed]
  12. Effect of misoprostol and cimetidine on gastric cell labeling index. Fich, A., Arber, N., Sestieri, M., Zajicek, G., Rachmilewitz, D. Gastroenterology (1985) [Pubmed]
  13. Misoprostol provides a colonic mucosal protective effect during acetic acid-induced colitis in rats. Fedorak, R.N., Empey, L.R., MacArthur, C., Jewell, L.D. Gastroenterology (1990) [Pubmed]
  14. Misoprostol compared with sucralfate in the prevention of nonsteroidal anti-inflammatory drug-induced gastric ulcer. A randomized, controlled trial. Agrawal, N.M., Roth, S., Graham, D.Y., White, R.H., Germain, B., Brown, J.A., Stromatt, S.C. Ann. Intern. Med. (1991) [Pubmed]
  15. Nonsteroidal antiinflammatory drugs for cancer pain: comparison between misoprostol and ranitidine in prevention of upper gastrointestinal damage. Valentini, M., Cannizzaro, R., Poletti, M., Bortolussi, R., Fracasso, A., Testa, V., Sozzi, M., Fornasarig, M., Bortoluzzi, F., Grazioli, I. J. Clin. Oncol. (1995) [Pubmed]
  16. Vaginal misoprostol administered 1, 2, or 3 days after mifepristone for early medical abortion: A randomized trial. Schaff, E.A., Fielding, S.L., Westhoff, C., Ellertson, C., Eisinger, S.H., Stadalius, L.S., Fuller, L. JAMA (2000) [Pubmed]
  17. WHO multicentre randomised trial of misoprostol in the management of the third stage of labour. Gülmezoglu, A.M., Villar, J., Ngoc, N.T., Piaggio, G., Carroli, G., Adetoro, L., Abdel-Aleem, H., Cheng, L., Hofmeyr, G., Lumbiganon, P., Unger, C., Prendiville, W., Pinol, A., Elbourne, D., El-Refaey, H., Schulz, K. Lancet (2001) [Pubmed]
  18. Effects of misoprostol on cell migration and transit in the dog stomach. Goodlad, R.A., Madgwick, A.J., Moffatt, M.R., Levin, S., Allen, J.L., Wright, N.A. Gastroenterology (1990) [Pubmed]
  19. Oral prostaglandin E analogues induce intestinal migrating motor complexes after a meal in dogs. Evidence for a central mechanism. Staumont, G., Fioramonti, J., Frexinos, J., Bueno, L. Gastroenterology (1990) [Pubmed]
  20. Cost-effectiveness of misoprostol for prophylaxis against nonsteroidal anti-inflammatory drug-induced gastrointestinal tract bleeding. Edelson, J.T., Tosteson, A.N., Sax, P. JAMA (1990) [Pubmed]
  21. Cervical priming with prostaglandin E1 analogues, misoprostol and gemeprost. el-Refaey, H., Calder, L., Wheatley, D.N., Templeton, A. Lancet (1994) [Pubmed]
  22. Double-blind, placebo-controlled endoscopic comparison of the mucosal protective effects of misoprostol versus cimetidine on tolmetin-induced mucosal injury to the stomach and duodenum. Lanza, F.L., Aspinall, R.L., Swabb, E.A., Davis, R.E., Rack, M.F., Rubin, A. Gastroenterology (1988) [Pubmed]
  23. Misoprostol reduces gastroduodenal injury from one week of aspirin: an endoscopic study. Jiranek, G.C., Kimmey, M.B., Saunders, D.R., Willson, R.A., Shanahan, W., Silverstein, F.E. Gastroenterology (1989) [Pubmed]
  24. Induction of abortion with mifepristone (RU 486) and oral or vaginal misoprostol. el-Refaey, H., Rajasekar, D., Abdalla, M., Calder, L., Templeton, A. N. Engl. J. Med. (1995) [Pubmed]
  25. Prevention of acute graft rejection by the prostaglandin E1 analogue misoprostol in renal-transplant recipients treated with cyclosporine and prednisone. Moran, M., Mozes, M.F., Maddux, M.S., Veremis, S., Bartkus, C., Ketel, B., Pollak, R., Wallemark, C., Jonasson, O. N. Engl. J. Med. (1990) [Pubmed]
  26. Cerebroventricular calcitonin gene-related peptide inhibits rat duodenal bicarbonate secretion by release of norepinephrine and vasopressin. Lenz, H.J., Brown, M.R. J. Clin. Invest. (1990) [Pubmed]
  27. Ligand binding specificities of the eight types and subtypes of the mouse prostanoid receptors expressed in Chinese hamster ovary cells. Kiriyama, M., Ushikubi, F., Kobayashi, T., Hirata, M., Sugimoto, Y., Narumiya, S. Br. J. Pharmacol. (1997) [Pubmed]
  28. Prostaglandin E2 is a potent regulator of interleukin-12- and interleukin-18-induced natural killer cell interferon-gamma synthesis. Walker, W., Rotondo, D. Immunology (2004) [Pubmed]
  29. Somatostatin, misoprostol and galanin inhibit gastrin- and PACAP-stimulated secretion of histamine and pancreastatin from ECL cells by blocking specific Ca2+ channels. Björkqvist, M., Bernsand, M., Eliasson, L., Håkanson, R., Lindström, E. Regul. Pept. (2005) [Pubmed]
  30. The immunosuppressive potential of misoprostol--efficacy and variability. Waiser, J., Böhler, T., Stoll, J., Schumann, B., Budde, K., Neumayer, H.H. Clin. Immunol. (2003) [Pubmed]
  31. NSAIDs: gastroprotection or selective COX-2 inhibitor? Dickman, A., Ellershaw, J. Palliative medicine. (2004) [Pubmed]
  32. Early termination of pregnancy with mifepristone (RU 486) and the orally active prostaglandin misoprostol. Peyron, R., Aubény, E., Targosz, V., Silvestre, L., Renault, M., Elkik, F., Leclerc, P., Ulmann, A., Baulieu, E.E. N. Engl. J. Med. (1993) [Pubmed]
 
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