Misoprostol is indicated for-

• reducing the risk of NSAID (nonsteroidal anti-inflammatory drugs, including aspirin) induced gastric ulcers in patients at high risk of complications from gastric ulcer, e.g., the elderly and patients with concomitant debilitating disease
• patients at high risk of developing gastric ulceration, such as patients with a history of ulcer. 

Gastric Ulcer

• Misoprostol 200 mcg four times daily with food is the recommended adult oral dose for reducing the risk of NSAID-induced gastric ulcers. If this dose is not tolerated, a 100 mcg dose can be used.
• Misoprostol should be taken for the duration of the NSAID therapy prescribed by your doctor. Misoprostol should be taken with a meal, and the final dose of the day should be taken before going to bed.

Common side effects associated with the use of misoprostol are-

• diarrhea
• abdominal pain
• aches/pains
• asthenia
• fatigue
• fever

Gynecological side effects:  spotting, cramps, hypermenorrhea, menstrual disorder, dysmenorrhea, Postmenopausal vaginal bleeding.

Diarrhea

Abdominal Pain

Asthenia

Fever

• (Misoprostol) administration to pregnant women can result in birth defects, abortion, premature birth, or uterine rupture.
• When pregnant women were given Misoprostol to induce labor or abortion, uterine rupture was reported. With increasing gestational age and prior uterine surgery, including cesarean delivery, the risk of uterine rupture rises.
• Pregnant women should not take Misoprostol to reduce the risk of ulcers caused by nonsteroidal anti-inflammatory drugs (NSAIDS).
• Women of childbearing potential who use Misoprostol to reduce the risk of NSAID-induced ulcers should be informed that they must not be pregnant when Misoprostol therapy begins and must use an effective contraception method while taking Misoprostol.
• Caution should be employed when administering misoprostol to patients with pre-existing cardiovascular disease.