Description

Simple

Clinical

Overview

Gemeprost is a prostaglandin E1 (PGE1) analog and antiprogestogen used for preoperative dilation of the cervix before surgical abortion. It is available as vaginal suppositories and also used in combination with the antiprogestin and mifepristone for termination of 1st- and 2nd-trimester pregnancy [1]. It is not FDA-approved but available in Japan marketed as Preglandin.

Pharmacology

Indication

Indicated for the softening and dilatation of the cervix uteri prior to transcervical, intrauterine operative procedures in the first trimester of pregnancy or facilitating therapeutic termination of pregnancy in patients in the second trimester of gestation.

Pharmacodynamic

Gemeprost softens and dilates of the cervix prior to transcervical intrauterine operative procedures. It is a prostaglandin E1 analog that potently stimulates uterine contractions and causes cervical ripening and relaxation [ Read more

Mechanism of action

As a prostaglandin analog, gemeprost binds to prostaglandin E2 and E3 receptors as an agonist to cause myometrial contractions and progressive cervical dilation via tissue sensitization to oxytocin [ Read more

Absorption

Systemic absorption of gemeprost is limited with about 12-28% of administered dose of gemeprost reaching the systemic circulation [5]. Following vaginal administration, peak plasma concentration is r... Read more

Protein binding

Information currently not available.

Volume of distribution

Information currently not available.

Clearance

Information currently not available.

Half life

Information currently not available.

Route of elimination

About 50% of the dose eliminated as metabolites in the urine during the first 24 hours.

Toxicity

Serious or life-threatening adverse effects include coronary spasms with subsequent myocardial infarctions and uterine rupture following prolonged uterine hypertonia or abnormal uterine pain. More common adverse effects are nausea, vomiting, loose stools, diarrhea, lower abdominal or back pain, head... Read more

Adverse Effects

Contraindications

Information currently not available.

Food Interactions

    Information currently not available.

Interactions

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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
Abacavir
Abacavir may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Acarbose
Acarbose may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Aceclofenac
Aceclofenac may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Acemetacin
Acemetacin may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Acetaminophen
Acetaminophen may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Acetazolamide
Acetazolamide may increase the excretion rate of Gemeprost which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acid
Acetylsalicylic acid may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Aclidinium
Aclidinium may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Acrivastine
Gemeprost may decrease the excretion rate of Acrivastine which could result in a higher serum level.
Acyclovir
Acyclovir may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Adefovir
Adefovir may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Adefovir dipivoxil
Adefovir dipivoxil may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Albutrepenonacog alfa
Gemeprost may decrease the excretion rate of Albutrepenonacog alfa which could result in a higher serum level.
Alclofenac
Alclofenac may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Aldesleukin
Aldesleukin may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Allopurinol
Allopurinol may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Allylestrenol
Allylestrenol may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Almasilate
Gemeprost may decrease the excretion rate of Almasilate which could result in a higher serum level.
Alminoprofen
Alminoprofen may decrease the excretion rate of Gemeprost which could result in a higher serum level.
Almotriptan
Almotriptan may decrease the excretion rate of Gemeprost which could result in a higher serum level.
5 References
  1. 1 . Bygdeman M: Pharmacokinetics of prostaglandins. Best Pract Res Clin Obstet Gynaecol. 2003 Oct;17(5):707-16.PubMed: 12972009
  2. 2 . Bartley J, Baird DT: A randomised study of misoprostol and gemeprost in combination with mifepristone for induction of abortion in the second trimester of pregnancy. BJOG. 2002 Nov;109(11):1290-4.PubMed: 12452468
  3. 3 . Wong KS, Ngai CS, Wong AY, Tang LC, Ho PC: Vaginal misoprostol compared with vaginal gemeprost in termination of second trimester pregnancy. A randomized trial. Contraception. 1998 Oct;58(4):207-10.PubMed: 9866000
  4. 4 . Husslein P: [Causes of labor initiation in man: role of oxytocin and prostaglandins]. Z Geburtshilfe Perinatol. 1985 May-Jun;189(3):95-102.PubMed: 2996248
  5. 5 . CERVAGEM (Gemeprost) Product information Link