Re: Oral Cytotec
From: Douglas Krell MD (djkrell@ix.netcom.com)
Thu Nov 2 05:19:37 2000
I too have been using the 100mcg dose orally with great success.
Occasionally patients have required multiple doses or ultimately oxytocin
was administered after an 8 hour washout. Obviously head to head comparison
trials are needed to determine optimal dosing strategies. In my practice
the advantage of oral dosing is that the patient can be given the medication
by the nursing staff. The nurses will not administer vaginal meds.
--
Douglas Krell MD
>----- Original Message -----
From: Dr. Lynn Montgomery <lmontgomery@communitymed.org>
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.medispecialty.com>
Sent: Wednesday, November 01, 2000 8:55 AM
Subject: Re: Oral Cytotec
> All the patients I induced with misoprostol over the last four years must
> have just been going into spontaneous labor then cause it works fine for
me?
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Luis
> Sanchez-Ramos, MD
> Sent: Tuesday, October 31, 2000 7:35 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: Re: Oral Cytotec
>
> I hate to disagree, but 25-50 mcg of orally administered misoprostol is
> not an effective method for labor induction (unless your definition of
> success is different than what is in the literature). In fact, oral
> doses of 100 mcg have not been very effective and are only so when
> compared to 25 mcg vaginally. It seems that the proper dose is closer
> to 200 mcg orally. We see no benefit to using it orally. It is easier
> to remove from the vagina when given by that route, if need be. I
> discuss the issue of oral vs vaginal in my systematic review in Clin
> Obstet Gynecol Sept 2000.
> My good friend from Spain, Jose Luis Bartha, published a nice paper in
> the september issue of the green journal and he used a single dose of
> 200 mcg effectively.
> For those who feel necessary to use the oral route I would recommend 100
> mcg. There may be a patient here and there that could respond to 25
> mcg!
>
> LSR
>
> At Tue, 31 Oct 2000, Dr. Lynn Montgomery wrote:
> >
> >Rick,
> >Have been using in orally for about 4 years. Early in my experience with
> >it, I used it on a rather obese patient (350+) and she just sat there and
> >smiled all day long-nothing happened. Because I could not really be sure
> >about the pharmacokenetics (where the cytotec was hiding), I switched to
> >oral and have used it ever since. I only use it with inpatients. I use
> the
> >same doses (25-50 mcg) and get what seems to be an excellent response and
> >have never had tachysytole/hyperstim.
> >Lynn
> > -----Original Message-----
> > From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of
Richard
> >Chudacoff, MD
> > Sent: Tuesday, October 31, 2000 3:56 PM
> > To: Multiple recipients of list OB-GYN-L
> > Subject: Oral Cytotec
> >
> > Anyone using oral Cytotec for induction of labor? In patient or office
> >with monitoring? I read the article in the Green Journal in June by Debra
> >Wing, comparing the efficacy of oral v. vaginal, and have just induced
my
> >second patient orally. Zero-to-Q-2 minute contractions in two hours, one
a
> >multip and the other primip. Both delivered within 14 hours by SVD.
> >
> > Rick
> >
> > Richard Chudacoff, MD
> >
> > Chudacoff Obstetrics & Gynecology, PLLC
> >
> > 15200 Southwest Freeway, #270
> >
> > Sugar Land, TX 77478
> >
> > Tel: 281-277-3900
> >
> > Fax: 281-277-3901
> >
> > rchudacoff@mylinuxisp.com
> >
> > Richard.Chudacoff@obgyn.net
> >
> > **********************************************************************
> >
> >--
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> >
> > can be guaranteed following transmission on the Internet.
> >
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> >
>
