Dinoprostone

Therapeutic Group

Uterotonics

Indication Dosage

Dinoprostone is indicated for the medical induction of labour in pregnant women at or near term when there is a medical necessity for initiating contractions and ripening of the cervix.

Induction Of Labour: 

  • Adults: Vaginal Gel: Inserted High Into Posterior Fornix (avoid Administration Into Cervical Canal), 1 Mg Vaginal Gel (unfavourable Primigravida 2 Mg), Followed After 6 Hr By 1-2 Mg Vaginal Gel If Required; Max Gel 3 Mg (unfavourable Primigravida 4 Mg). 

Vaginal Pessary/tab: 

  • Inserted High Into Posterior Fornix; 3 Mg Vaginal Tab/pessary, Followed After 6-8 Hr By 3 Mg Vaginal Tab/pessary If Labour Is Not Established; Max 6 Mg Vaginal Tab/pessary. 

By IV Infusion: 

  • Adult: 1 Mg Inj: See Literature. 

Termination Of Pregnancy: 

By IV Infusion: 

  • Adult: 10 Mg Inj: See Literature.

Content

  • Vaginal Pessary /Tab 3mg /10mg: Dinoprostone (prostaglandin E2) 3mg /10mg.
  • Vaginal Gel 2mg: Per ml: Dinoprostone 800 Mcg; 2.5 ml (2mg).
  • Vaginal Gel 1mg /3gm: Per 3gm: Dinoprostone 1mg;

Pregnancy

Consult with Doctor Or Caution Advised

Stability

  • Prostaglandin

Contra Indications

  • Active Cardiac Disease, Active Pulmonary Disease, Avoid Extra-amniotic Route In Cervicitis Or Vaginitis, Fetal Distress, Fetal Malpresentation, Grand Multiparas, History Of Caesarean Section, History Of Difficult Or Traumatic Delivery, History Of Major Uterine Surgery, Major Cephalopelvic Disproportion, Multiple Pregnancy, Placenta Praevia Or Unexplained Vaginal Bleeding During Pregnancy, Ruptured Membranes, Untreated Pelvic Infection, Avoid In Hepatic Or Renal Impairment

Precautions

  • Active Cardiac Disease, Active Pulmonary Disease, Avoid Extra-amniotic Route In Cervicitis Or Vaginitis, Fetal Distress, Fetal Malpresentation, Grand Multiparas, History Of Caesarean Section, History Of Difficult Or Traumatic Delivery, History Of Major Uterine Surgery, Major Cephalopelvic Disproportion, Multiple Pregnancy, Placenta Praevia Or Unexplained Vaginal Bleeding During Pregnancy, Ruptured Membranes, Untreated Pelvic Infection, Avoid In Hepatic Or Renal Impairment

Lactation

  • Consult with Doctor Or Caution Advised

Side Effects

  • Abruptio Placenta
  • Amniotic Fluid Embolism
  • Backache
  • Bronchospasm
  • Cardiac Arrest
  • Diarrhoea
  • Disseminated Intravascular Coagulation
  • Fetal Distress
  • Fever
  • Low Apgar Scores
  • Maternal Hypertension
  • Nausea
  • Pulmonary Embolism
  • Rapid Cervical Dilation
  • Severe Uterine Contractions
  • Stillbirth Or Neonatal Death
  • Uterine Hypercontractility With Or Without Fetal Bradycardia
  • Uterine Hypertonus
  • Uterine Rupture
  • Vaginal Symptoms (warmth
  • Irritation
  • Pain)
  • Vomiting

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