Drug Interaction Report

ADJUST DOSING INTERVAL: Prostaglandins, especially those of the E type such as misoprostol, may potentiate the uterine response to oxytocin and increase the risk of uterine hyperstimulation and rupture. The mechanism of interaction is unknown.

MANAGEMENT: In the countries where it is indicated for the induction of labor or termination of pregnancy, the use of misoprostol in combination with oxytocin and other oxytocic agents is considered contraindicated (GB). Infusion of oxytocin should not be started until at least 4 hours after the last dose of misoprostol oral tablet or at least 6 to 12 hours after the insertion of a misoprostol vaginal tablet. Recommended time intervals vary by brand and manufacturer. It is recommended to refer to local guidelines or drug product labeling. As cervical trauma can occur without remarkable symptomatology, each patient should also be carefully examined postabortion.

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.