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Indications and Dosage
Vaginal
Intrauterine fetal death Adult: As pessary: 1 mg 3 hrly. Max 5 mg for 1 course. Vaginal Cervical ripening before surgical termination of pregnancy in the first trimester Adult: As pessary: 1 mg 3 hr before surgery. Vaginal Pregnancy termination in the 2nd trimester Adult: As pessary: 1 mg 3 hrly up to 5 mg per course. May give another course 24 hr after the beginning of 1st course, if necessary.
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Contraindications
Uterine fragility related to uterine scarring (e.g. previous caesarean section or major uterine surgery), placenta praevia, unexplained vag bleeding, untreated pelvic infection.
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Special Precautions
Patient w/ COPD, asthma, CV insufficiency, elevated intraocular pressure, cervicitis or vaginitis, cervical stenosis, multiparity and twin pregnancy. May induce spontaneous abortion. Not intended for induction of labour or cervical softening at term. Severe hepatic impairment.
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Adverse Reactions
Significant: Uterine rupture, spontaneous abortion, vag bleeding and mild uterine pain.
Nervous: Headache, dizziness, weakness. CV: Palpitations, severe hypotension, chest pain, tachycardia, flushing. GI: Nausea, epigastric pain, vomiting, diarrhoea. Resp: Dyspnoea, bronchoconstriction. Genitourinary: Hypercontractility, hypertonus. Musculoskeletal: Back pain. Ophthalmologic: Blurred vision. Others: Chills, mild fever. Potentially Fatal: Serious CV accidents (e.g. MI, coronary artery spasm, severe hypotension, severe cardiogenic shock, vasospasm, stroke, ventricular standstill), uterine rupture during prolonged uterine hypotonia. |
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Monitoring Parameters
Monitor BP, pulse rate and bleeding occurrences.
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Overdosage
Symptoms: Sedation, tremor, convulsion, dyspnoea, abdominal pain and bloody diarrhoea, palpitations and bradycardia. Management: Symptomatic and supportive treatment.
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Drug Interactions
May potentiate effect of oxytocin and other labour inducers/accelerators.
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Action
Description: Gemeprost is an alprostadil (prostaglandin E1) analogue. It softens and dilates the cervix and induce uterine contractions. It is believed that gemeprost mimics the process of cervical ripening initiated by prostaglandins during childbirth.
Onset: W/in 3 hr. Pharmacokinetics: Absorption: Bioavailability: 12-28%. Excretion: Via urine (50% as metabolites). |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. Gemeprost, CID=5282237, https://pubchem.ncbi.nlm.nih.gov/compound/Gemeprost (accessed on Jan. 22, 2020) |
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Storage
Store below -10°C.
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MIMS Class
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ATC Classification
G02AD03 - gemeprost ; Belongs to the class of prostaglandins. Used to induce abortion or augment labour and to minimize blood loss from the placental site.
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References
Buckingham R (ed). Gemeprost. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 31/05/2017. Joint Formulary Committee. Gemeprost. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 31/05/2017.
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