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Prepidil
Prepidil (generic name: dinoprostone) is a cervical ripening agent used to prepare the cervix for labor and delivery in pregnant women. It is a synthetic version of prostaglandin E2 (PGE2), a naturally occurring hormone that helps soften and dilate the cervix, making it easier for the baby to pass through the birth canal. Prepidil is typically used in women at or near term who need assistance with the initiation of labor.
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Frequently Asked Questions
How long does it take for Prepidil to work?
Prepidil typically begins to soften and dilate the cervix within a few hours of administration, but the time to labor progression can vary between individuals.
Can Prepidil be used at home?
No, Prepidil should only be administered in a hospital or clinical setting under the supervision of healthcare professionals due to the risk of uterine hyperstimulation and fetal distress.
What happens if Prepidil does not induce labor?
If Prepidil does not sufficiently ripen the cervix or induce labor, your healthcare provider may consider other options, such as oxytocin or mechanical methods like a Foley catheter.
Is Prepidil safe for use in all pregnancies?
Prepidil is generally safe when used in pregnancies at or near term, but it is not recommended for women with previous uterine surgeries or conditions that increase the risk of complications.
Can Prepidil cause contractions?
Yes, Prepidil may cause uterine contractions, which is part of its role in preparing the cervix for labor. However, excessive contractions should be reported to your healthcare provider.
Comprehensive Drug Guide
How Does Prepidil Work?
Prepidil contains dinoprostone, which mimics the natural action of prostaglandin E2. When applied to the cervix, it promotes the breakdown of collagen fibers in the cervical tissue, softening and dilating the cervix. This prepares the cervix for labor and facilitates the progression of contractions and delivery.
Common Dosages
- 0.5 mg of dinoprostone per syringe
Typical Dosing
- The typical dose of Prepidil is 0.5 mg administered intracervically. If needed, a repeat dose may be administered after 6 hours, but no more than 1.5 mg (three doses) should be given within a 24-hour period.
- A healthcare provider administers this medication in a hospital or clinical setting.
Typical Dosing
FDA Approved Indications
- Cervical ripening before labor induction in pregnant women at term.
- Cervical ripening in certain conditions where labor needs to be induced for medical reasons (e.g., overdue pregnancy, preeclampsia).
Who Shouldn't Take Prepidil?
- Hypersensitivity to dinoprostone or prostaglandins.
- Unexplained vaginal bleeding during pregnancy.
- Previous cesarean section or major uterine surgery.
- Fetal distress or abnormal fetal heart rate patterns.
- Active infections in the cervix or vagina.
Advice From The Pharmacist
- Prepidil should only be administered by a trained healthcare professional in a hospital setting.
- After receiving Prepidil, you will be closely monitored for uterine contractions and fetal heart rate to ensure safe labor progression.
- Inform your healthcare provider if you experience severe contractions, excessive bleeding, or fever after administration.
- Avoid using other uterine stimulants (e.g., oxytocin) immediately after Prepidil, unless advised by your healthcare provider.
Side Effects of Prepidil
Common Side Effects
- Uterine contractions (excessive or prolonged)
- Nausea
- Vomiting
- Diarrhea
- Fever
Uncommon/Severe Side Effects
- Uterine hyperstimulation (excessively strong or frequent contractions)
- Fetal distress
- Severe allergic reactions (swelling, rash, difficulty breathing)
Risks and Warnings of Prepidil
- Uterine Hyperstimulation: Prepidil may cause excessive uterine contractions, which can be dangerous for both mother and baby. Close monitoring is required to ensure safe labor progression.
- Fetal Distress: In some cases, Prepidil may cause changes in the fetal heart rate, indicating fetal distress. Immediate medical intervention may be necessary.
- Infection Risk: Women with active genital infections should avoid Prepidil as it may exacerbate the infection.
Interactions with Prepidil
Common Drug Interactions
- Oxytocin: Caution should be used when administering oxytocin soon after Prepidil, as it can increase the risk of uterine hyperstimulation.
- Other prostaglandins: Using multiple prostaglandin-based medications can increase the risk of side effects, including excessive uterine contractions.
Alternatives to Prepidil
- Misoprostol (Cytotec®): Another prostaglandin analog used for cervical ripening and labor induction.
- Oxytocin (Pitocin®): A hormone used to stimulate uterine contractions and induce labor.
- Foley catheter: A mechanical method for cervical ripening, used as an alternative to medication-based methods.
