Dinoprostone
- Atc Codes:G02AD02
- CAS Codes:363-24-6
- PHARMGKB ID:363-24-6
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Prepidil, Propess, Prostin E2; Belgium: Prepidil, Prostin E2; Bulgaria: Prepidil, Prostin E2; Cyprus: Prepidil, Prostin E2; Czech Republic: Prepidil, Prostin E2; Denmark: Minprostin, Propess; Estonia: Prostenoon; France: Prepidil, Propess, Prostine E2; Germany: Cerviprost, Dinoproston, Minprostin E2, Prepidil, Propess; Greece: Propess, Prostin E2; Hungary: Prepidil, Prostin E2; Ireland: Prostin E2; Italy: Prepidil, Propess; Latvia: Prostenoon; Luxembourg: Prepidil, Prostin E2; Malta: Propess, Prostin E2; Netherlands: Prepidil, Propess, Prostin E2; Poland: Prepidil, Prostin E2; Portugal: Propess, Prostin E2; Romania: Propess; Slovakia: Prepidil, Prostin E2; Spain: Prepidil, Propess, Prostaglandina E2; Sweden: Minprostin, Propess; UK: Propess, Prostin E2.
North America
Canada: Cervidil, Prepidil, Prostin E2; USA: Cervidil, Prepidil, Prostin E2.
Latin America
Argentina: Prolisina E2, Propess; Mexico: Propess.
Asia
Japan: Prostaglandin E2, Prostarmon E.
Drug combinations
Chemistry
Dinoprostone: C~20~H~32~O~5~. Mw: 352.47. (1) Prosta-5,13-dien-1-oic acid, 11,15-dihydroxy-9-oxo-, (5Z,11α,13E,15S)-; (2)(E,Z)-(1R,2R,3R)-7-[3-Hydroxy-2-[(3S)-(3-hydroxy-1-octenyl)]-5-oxocyclopentyl]-5-heptenoic acid; (3) Prostaglandin E~2~. CAS-363-24-6 (1971).
Pharmacologic Category
Oxytocics. Abortifacient. Prostaglandin. (ATC-Code: G02AD02).
Mechanism of action
A synthetic prostaglandin E~2~ abortifacient that stimulates uterine smooth muscle and also produces cervical dilation and softening.
Therapeutic use
Termination of intrauterine pregnancy during the second trimester. Labor induction (cervical «ripening»). Evacuation of uterine contents in cases of missed abortion, intrauterine fetal death up to 28 weeks of gestational age, or nonmetastatic gestational trophoblastic disease (benign hydatidiform mole).
Pregnancy and lactiation implications
Animal studies indicate that prostaglandins may be teratogenic. Vaginal suppositories should not be used in a woman at term pregnancy. Endogenous PGE~2~ can be detected in breast milk. High levels have been associated with diarrhea in nursing infants.
Unlabeled use
Has been used in the management of postpartum hemorrhage.
Contraindications
Hypersensitivity to prostaglandins or any component of the formulation. Fetal distress (suspicion or clinical evidence unless delivery is imminent). Unexplained vaginal bleeding during pregnancy. Strong suspicion of marked cephalopelvic disproportion. Patients in whom oxytocic drugs are contraindicated or when prolonged contraction of the uterus may be detrimental to fetal safety or uterine integrity (including previous cesarean section or major uterine surgery). >6 previous term pregnancies. Patients already receiving oxytocic drugs. Hyperactive or hypotonic uterine patterns. When vaginal delivery is not indicated. Obstetrical emergencies when surgical intervention would be favorable. Acute pelvic inflammatory disease. Active cardiac, pulmonary, renal or hepatic disease.
Warnings and precautions
Use caution with ruptured membranes, nonvertex or nonsingleton pregnancy, previous uterine hypertony, glaucoma, or history of asthma. Transient pyrexia and decreased blood pressure may occur (suppository). Use caution with history of asthma, hypotension or hypertension, cardiovascular, renal/hepatic disease, anemia, jaundice, diabetes, epilepsy, compromised uteri, cervicitis, endocervical infections or acute vaginitis. Do not use for cervical ripening or other indications in term pregnancy.