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Cytotec To Induce Labor Quickly: At What Cost?

Cytotec To Induce Labor

Cytotec To Induce Labor Quickly: At What Cost?

Today we have an extraordinary guest writer. Following our post about Cytotec To Induce Labor, the vice president of Timéo et Les Autres, a French association of users affected by induction with this drug, has contacted us. Thank you very much, Anne!

Are there advantages to using such a dangerous drug?

The answer already appears in the conclusion of Wing’s 1996 study: 

Cytotec is an “effective” induction method. 

By “effective,” it is meant that Cytotec flushes the uterus’ contents. Let us remember that its first use in Gynecology was abortion.

But if we look more closely at the studies that highlight the “efficacy” of Cytotec, we find some arguments such as:

“The time to delivery was lower with misoprostol (22.9 ± 2.5h vs. 27.1 ± 2.6h, p <0.05). However, this difference disappears when only vaginal delivery is considered” 

Cytotec To Induce Labor. Cytotec causes a faster delivery but only in the case of the cesarean section!

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Cytotec To Induce Labor
Cytotec To Induce Labor

If it were a joke, I would be amused … but the authors of this study write it very seriously … Without specifying that when induced labor ends in an emergency cesarean section, it means that the mother and baby are in danger.

The studies that demonstrated superior efficacy of misoprostol over dinoprostone used doses of 50 µg and had unfavorable results in terms of safety. When using a 25µg dose, misoprostol does not save time.

The real reason for the interest in Cytotec is rather practical and inexpensive:

– Unlike dinoprostone, Cytotec does not need freezing (which is “interesting” for countries with limited resources, but since these countries also have no resources to save emergencies caused by Cytotec, it is not difficult to imagine the fate of women receiving this treatment).

– Another critical difference: a Cytotec pill costs 20 euro cents while a dinoprostone tampon costs around 100 euros. (Cytotec To Induce Labor)

It is clear that if one considers the expenses caused by emergency cesarean sections, fetal suffering, bleeding, uterine ruptures … Cytotec is much more expensive than dinoprostone.

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Positions of the health authorities (Cytotec To Induce Labor)

Considering the risks of Cytotec, and comparing them with the supposed financial benefits, only a strong reaction from the authorities can prevent this medicine from being used routinely to induce labor.

– We have already discussed the FDA alert in the United States. Alert that there was quite useless since the FDA has no power over the medical profession.

– In the UK, NICE positioned itself in 2008 and concluded:

It can be considered that these British and French recommendations did have an impact in the medical sphere since, in these countries, the use of Cytotec for induction of labor is now a relatively marginal practice. Which does not mean that we can lower our guard … The two French maternity wards that continue to induce Cytotec deliveries are among the largest countries (with 3,000 and 4,500 deliveries per year). (Cytotec To Induce Labor)

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And in Spain?

I do not know if Cytotec uses in Spain, but there is a drug called MISOFAR that contains misoprostol, like Cytotec, and has been approved in Spain in 2008, with two different dosages:

– 200µg tablets, officially “for dilating the cervix of the non-gravid uterus before hysteroscopy or other gynecological procedures that require access to the uterine cavity.”

– 25µg tablets for induction of labor. (Cytotec To Induce Labor)

How did the BIAL firm obtain the marketing authorization?

Perhaps we will find a response element in this document, which relates the lawsuit that BIAL brought against its concurrent Ferring (who markets Process), a case in which Ferring denounced abusive advertising of MISOFAR, which presented arguments such as: «Now, in the induction of labor … the natural way. »

BIAL  sentence to rectify its advertising and received a financial penalty of thirty thousand (30,000) euros. 

Cytotec To Induce Labor
Cytotec To Induce Labor

From section 7 of this resolution, it can infer that BIAL’s arguments failed to convince the jury … But they accept by the Spanish authorities.

Worse than Cytotec (Cytotec To Induce Labor) … is it possible?

And since we are with bad news, I have to mention the new drug from the Ferring firm (yes, yes, precisely the one that did not appreciate the methods of its concurrent BIAL). In 2013, Ferring obtained European-wide market authorization for its new product MISODEL, a tampon to induce labor, based on… misoprostol.

And the clinical studies for this new product were led by… Deborah Wing!

Clinical studies showing a rate of uterine hyperstimulation never achieved with Cytotec. And when uterine hyperstimulation is the first sign of all the complications above, there is cause for concern. 

I commented on the model in French in this post, which I titled “Chronicle of an announced hecatomb” (Someday, I will translate it into Spanish)

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Here in France, the medicine agency (ANSM) did not oppose the MODEL. Still, the HAS (high health authority) refuses to register the MODEL in the list of medicines reimbursable by social security (because of a benefit / negative risk).

Thus we have in France two authorities (dependent on the same ministry) who are in contradiction in the evaluation of a drug.


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