Misoprostol

Misoprostol is a synthetic, oral prostaglandin E1 analog and exists in 1:1 mixture of two diastereoisomers. Misoprostol is used for and is commonly believed to be effective for prevention of gastric and duodenal ulcers secondary to use of nonsteroidal antiinflammatory drugs (NSAIDs), although currently Misoprostol is indicated only for the prevention of gastric ulcers. While Misoprostol is approved for use in preventing NSAID-induced gastric ulcers in high-risk patients and it has been shown to be superior than sucralfate for this condition, uncertainty exists regarding the role of it in patients receiving NSAIDs. Independent of NSAID administration, it has been used as a therapeutic agent in the treatment of active duodenal and gastric ulcers, although Misoprostol is slightly less effective than H-2-antagonists. It was approved by the FDA in December 1988.it inhibits basal and nocturnal gastric acid secretion through a direct action on the parietal cell. Parietal cells contain receptors that have high affinity for prostaglandins of the E series. It can inhibit gastric acid secretion secondary to stimulation from food, alcohol, NSAIDs, histamine, pentagastrin, or caffeine, and this effect appears to be more pronounced with increasing doses. HÁ-antagonists, however, appear to be more potent than it in the ability to inhibit gastric acid output, especially at night.