Avertiso: Uses, Dosage, Side Effects and Composition

Description and Composition of Avertiso

Avertiso is a prostaglandin analog used to reduce the risk of pain killers (NSAIDs) related ulcers, manage miscarriages, prevent or treat post partum hemorrhage due to poor contraction of the uterus, and also for first trimester abortions. It contains Misoprostol as its active pharmaceutical ingredient. In addition, it also contains inactive ingredients called excipients in sufficient quantities.

Uses of Avertiso

  1. Avertiso is used to prevent stomach ulcer in people taking pain killers (NSAIDs) regularly and in the elderly.
  2. It is used to treat pain killers induced ulcer (or just normal stomach ulcer).
  3. Pregnancy termination < 13 weeks. Misoprostol is used to cause abortion in pregnancy less than 13 weeks of age
  4. It can be used to induce or support labour in pregnant women at term.
  5. Postpartum hemorrhage prevention and treatment. Misoprostol is used to control bleeding after delivery.
  6. Post abortion care and in the management of miscarriage
  7.  It is used in missed abortion and in intrauterine fetal death. Misoprostol is used when a baby dies in the womb to cause its delivery
  8. It is used to ripen cervix for normal delivery and for cervical preparation for surgical abortion

Dosage of Avertiso

For ulcer:

To protect the stomach from developing ulcer, a tablet of 200 mcg Avertiso is taken 4 times daily.

For abortion and other uses:

As directed by your physician.
Although, the common dose is between 600mcg to 800mcg once per oral or intra vaginally.
You are to adhere to your physician’s prescription as against what is written here as the dose might differ depending on your condition or what he wants to achieve.

Side effects of Avertiso

Some side effects you may experience while on Avertiso include:
  • Diarrhoea
  • Stomach pain and cramps
  • Nausea
  • Vomiting
  • Headache
  • Spotting
  • Increased or irregular menstruation
  • Rupture of womb
  • Constipation
  • Gas
  • Weakness
  • Dizziness
  • Chills
Some people can experience allergic reactions and it could be life threatening. If it occurs, stop your medication immediately and seek emergency medical help.
You may experience other side effects other than those listed above.

How Avertiso works

Mechanism of Action of Avertiso

For Ulcer:

In the treatment and prevention of ulcer, Avertiso forms a protective substance called prostaglandins.
This substance coats the stomach and prevent it from direct acid attack.

For abortion and others uses:

When it is used for abortion, labour induction, cervix ripening, bleeding control after delivery, or in the management of miscarriage, it makes the womb to be contracting.
This contraction would then lead to: expulsion of the fetus, labour, or bleeding control depending on usage.

Interactions: What to avoid while taking Avertiso

You may need to  avoid:
Magnesium antacids

Food Interactions

Take with food. Food decreases incidence of diarrhea.
For a comprehensive list of what to avoid or how best to combine them, please consult your pharmacist or doctor.

Contradictions of Avertiso

Avertiso should not be used for women who have known allergy to misoprostol or prostaglandins.
Additional contraindication for uterine evacuation (pregnancy termination and PAC): known or suspected ectopic pregnancy.

Precautions

If a woman has these specific conditions, the risks, benefits and availability of alternatives must be considered:
  1. serious/unstable health problems including but not limited to hemorrhagic disorders
  2. heart disease and severe anemia or concurrent anticoagulant therapy.
Additional precautions for uterine evacuation:
  • signs of pelvic infection or sepsis (should immediately be referred for surgical evacuation and treatment of infection)
  • IUD in place (remove IUD before use).
  • Women who have had a previous cesarean birth and are greater than 18 weeks gestation and using misoprostol for uterine evacuation should consider a lower dose of misoprostol.

Additional precautions for postpartum hemorrhage:

  • If a woman has had a severe reaction (pyrexia or severe shivering) and needs a second dose of misoprostol for treatment, consider use of oxytocin as an alternative as the uterotonic if available, if not available treat PPH with misoprostol and if bleeding continues after provision of uterotonics, causes of PPH other than atony should be considered and other steps to stop the bleeding should be explored.

Is Avertiso Used in Pregnancy

This depends.
No if the intention is to use it to treat stomach ulcer or to protect the stomach from developing ulcer in  people using pain killers.
Yes if it for abortion, labour induction, bleeding control purposes.

Is Avertiso Used while Breast feeding

It enters breast milk. Use not advised.

Additional considerations for pregnancy termination, post abortion care, missed abortion, and intrauterine fetal death

Expected effects

Cramping/vaginal bleeding: bleeding typically lasts an average of 5-8 days.

Possible complications

Complications associated with Avertiso are uncommon.
  • Uterine rupture is a rare complication. The risk of uterine rupture increases with advancing gestational age and with prior uterine surgery including cesarean birth.
  • Retained products or ongoing pregnancy may require another dose of misoprostol or surgical completion. Tell her to seek care immediately if she experiences any of the warning signs of possible complications.
  • Excessive blood loss; more than 2 maxi pads per hour for more than 2 hours – especially if accompanied by prolonged dizziness, lightheadedness and increasing fatigue.
  • Signs of infection: High fever that occurs any day after the day misoprostol is taken: 38 degrees Celsius or higher for more than 24 hours.
  • Severe pain for more than a few hours, abdominal cramping that continues for more than 1 day after taking tablets, or abdominal pain that is severe.
  • Feeling very sick, with or without fever, and persistent severe nausea or vomiting after the day misoprostol is used.
  • Unusual or bad-smelling vaginal discharge, especially if accompanied by severe cramps or abdominal pain.

Note

This write up is not a prescription, medical advice or a substitute of anything. You are therefore advised to strictly rely and  adhere to your doctor’s prescription.
Remember not to take any drug without consulting your health care provider first.
Self medication can be very deadly.

Where to Buy Avertiso in Nigeria

To order, health facilities including Hospitals, Pharmacies, Clinics should contact:

Pharm Charles Ogomola

Tel:+234 706 762 0802

Email: [email protected]

References 

  1. Drug Bank
  2. Wikipedia
  3. Avertiso leaflet
  4. ncbi

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