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Cytotec: Doses
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Cytotec's sole appeal is price. Cytotec costs pennies per induction, whereas Prepidil and Cervidil cost close to $100 per dose, and more than one dose may be needed (3). Cytotec ... reduces the need for intravenous oxytocin (Pitocin), the hormone that stimulates contractions, another savings.
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Because of managed care, capitation and the closing of hospitals due to lack of financial stability, the cost of Cytotec is certainly something that needs to be addressed. At an average of 52 cents per tablet, Cytotec administration may be only ¼ to ½ tablet per person per induction. This is tragically compared to the other prostaglandin agents and Pitocin (costing hundreds of dollars) that cost more. Bucal pitocin was discontinued because of the inability to regulate contractions. Yet Cytotec is being used without known side effects such as hypertonic uterus, effects on uteri with previous scarring from cesarean sections or uterine rupture. Those that prepare Cytotec for administration in a woman's vaginal must cut the tablet with a knife into little pieces - making exact dosage and certain placement impossible.
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Ask your health care provider if Cytotec may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
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The most common side effect associated with Cytotec® therapy in clinical trials was diarrhoea, which is a natural response to the intestinal smooth muscles to the increased level of Prostaglandin’s. In clinical trials, diarrhoea occurred in approximately one tenth of patients. It was usually mild and self-limiting, resolving within a few days despite continued therapy. Cytotec® is to be dosed with meals and at bedtime, which will minimise this side effect.
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The results of clinical studies indicate that Cytotec does not produce hypotension at dosages effective in promoting the healing of gastric and duodenal ulcers. Nevertheless, Cytotec should be used with caution in the presence of disease states where hypotension might precipitate severe complications, e.g., cerebrovascular disease, coronary artery disease or severe peripheral vascular disease including hypertension.
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Whatever the truth, both parties agree that over the next several hours the nurse-midwife gave Holly three 25-microgram doses of Cytotec. (Because of legal considerations, both parties requested anonymity.) What Holly didn't know and the midwife never told her was that it was an unapproved drug with potentially disastrous side effects.
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