E-drug: Association Diclofenac/Misoprostol (cont)
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a) Is there an association like this in your countries?
yes (Canada)
b) If the previous answer is positive: Which are the legal restrictions?
It's a prescription-only drug - otherwise no restrictions.
c) Is there a really necessity for this combination, or there is other
solution to minimize gastrointestinal AE of NSAIDs?
Misoprostol is not the only agent to prophylaxis against NSAID-
induced ulcers. Proton pump inhibitors also provide this protection.
Some clinicians have found the same to be true for high doses of
famotidine. So - is this particular combination "necessary"?
Depends on your desired endpoint. Not everyone develops an ulcer.
Misoprostol reduces the risk.
d) Do you know about the illegal use of this drug in your counties,
i.e. as an abortifacient?
Using misoprostol as an abortifacient is not illegal in Canada. It's
simply not an approved indication in the official monograph.
Therefore this is an off-label use. I've never heard of it being used
alone for this purpose but only in combination with methotrexate -
which is a well-studied use of the drug.
Randy Trinkle, BScPharm BA
Clinical Pharmacist
Prince Rupert Regional Hospital
Prince Rupert, BC
Health Science Links:
http://www.rupert.net/~rtrinkle
mailto:rtrinkle@mail.citytel.net
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