18 November 2004
If you pop open a package of Cytotec® (misoprostol tablets), you'll get the following information [link requires Adobe Reader]:
Cytotec (misoprostol) is being prescribed by your doctor to decrease the chance of getting stomach ulcers related to the arthritis/pain medication that you take.
Do not take Cytotec to reduce the risk of NSAID induced ulcers if you are pregnant. Cytotec can cause abortion (sometimes incomplete which could lead to dangerous bleeding and require hospitalization and surgery), premature birth, or birth defects. It is also important to avoid pregnancy while taking this medication and for at least one month or through one menstrual cycle after you stop taking it. Cytotec has been reported to cause the uterus to rupture (tear) when given after the eighth week of pregnancy. Rupture (tearing) of the uterus can result in severe bleeding, hysterectomy, and/or maternal or fetal death.
Scene: A conference room at Planned Parenthood. ROESENCRANTZ and WADENSTERN are at opposite sides of the table. Each is thumbing through a copy of the Physician's Desk Reference. There is no sound but the occasional "Hmmm..." from one or the other. And then....
This sounds promising.
ROESENCRANTZ: What've you got?
WADENSTERN [reading]: "Can cause abortion, sometimes incomplete, yadda, yadda, yadda... can result in...." Yes! Here it is! "Fetal death!"
ROESENCRANTZ: Outstanding. Let's get Women on Waves on the horn. And see if we can't get some of this stuff for the home office.
A personal note: I have actually taken this drug, which is also sold combined with an anti-inflammatory drug (diclofenac sodium) under the brand name Arthrotec®. Once. It made me violently ill. I decided I'd rather take my chances with the ulcers.
(Via the ever-alert Dawn Eden.)
Posted at 7:47 AM to Life and/or Death
» Somethin' that made me queasy to the core from Read My Lips
C.G. Hill (Dustbury) and I often seem to share the same eye for details, although our interests vary extensively. I jes' ain't sure I could have blogged 'bout this 'fore breakfast. At least my stomach stopped growlin' as it filled......[read more]
Recursive medication. Take Pill A to relieve your actual problem. Take Pill B to relieve side effects from Pill A. Take Pill C to relieve side effects from Pill B...
"And what was your actual problem for which you were taking Pill A?"
I have no idea why I'm so skeptical of the Medicare prescription drug benefit.
My issue with NSAIDs has always been that similar drugs produce dissimilar results. After Celebrex did very little for me, I was given a sample of Arthrotec, which produced trigonometric emesis (the liquid path follows a parabolic curve).
Interestingly, my NSAID of choice now is Bextra, which is very much like Celebrex (and like Vioxx, recently pulled from the market by Merck). I limit my consumption rather strictly, though.
I've taken Cytotec numerous times whenever I've had to take several days worth of NSAIDs, and I've always been helped. So there.
I have to assume that this stuff works for some people or they wouldn't be selling it at all. And sometimes the results aren't predictable: Bextra works for me, but Celebrex didn't, yet they're designed to do almost exactly the same thing.
My problem with Cytotec, the standalone product, has nothing to do with the drug itself, but with people pushing it for uses beyond (and in this case, contrary to) the manufacturer's recommendation.
Cytotec is also used for induction of labor--by OBs...and I understand that its use is common though controversial for that.
My mom had to go off Vioxx with the recent recall, and is now back on an older anti-inflammatory to relieve her severe arthritis. She was given Cytotec (or a generic) and did some Googling to find out what was up with it, other than the stomach protection. She told me about the abortifacient activity it can cause, and I was creeped out. She is obviously well beyond childbearing years, and the drug is safe for what she is using it for, but I immediately thought of organizations like PP getting their hands on it. Or the British government for that matter, given what I've read lately about one MPs suggestion that girls over the age of 14 get Depo-Provera injections. It's mind-boggling.
Speaking of fetal effects, thalidomide is making a comeback. (I wrote about it here.) It, too, is "safe," by the usual definition, so long as you follow the extremely-strict specifications of the manufacturer.
But we all know what happens otherwise.