Buccal Misoprostol Prompts Sustained Uterine Contractions

Oral epithelial route may be suitable alternative to vaginal administration

FRIDAY, Sept. 8 (HealthDay News) -- Buccal administration of misoprostol produces similar effects on uterine tone and activity compared to vaginal administration and may serve as an alternative epithelial route for misoprostol delivery, according to a report in the September issue of Obstetrics & Gynecology.

Karen R. Meckstroth, M.D., M.P.H., of the University of California San Francisco, and colleagues measured misoprostol absorption and uterine response in 40 women seeking elective abortion. The drug was administration by one of four epithelial routes: vaginal, vaginal moistened, buccal and rectal.

While vaginal and vaginal moistened administration produced higher peak serum levels than buccal and rectal routes (1,025.0 and 1279.4 compared with 519.6 and 312.5 pg-hr/mL), uterine tone and activity were similar for vaginal and buccal routes and sustained for up to five hours. Rectal administration produced earlier serum misoprostol peaks and weaker effects on vaginal tone.

The authors also found that serum levels of misoprostol dropped gradually after administration through both vaginal and buccal routes and suggest the latter may be preferred in some situations due to its sustained effect on uterine contraction, low interindividual variability, and higher acceptance among patients.

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