Doc Ira: What is ARTHROTEC? SYTOTEC?

[KATKAT]

I helped my friend clean her pad. I just could not help but notice the many empty packs of these two medicines - ARTHROTEC and SYTOTEC. I asked her what those were and she just said they were pain relievers. Is this true? I am concerned bout her. If it were true, are these medicines really OK? I mean wala bang side-effects? Kasi she is pregnant and di ba masama ang basta na lang umiinom ng gamot pag pregnant ka?

[Ira]

Arthrotec is diclofenac sodium + misoprostol. While diclofenac is a pain reliever, misoprostol is an antiulcerant which is also widely used as an abortifacient. It is a strictly regulated drug in all legal drugstores (you can't buy it without a prescription), and no doctor in his right mind will prescribe that to her. So I assume she got it via black market. There are other diclofenac preparations in the market that don't have misoprostol, so I don't think she's taking arthrotec, which is much harder to buy, purely for its analgesic properties.

Cytotec (I think this is what you mean) is, on the other hand, pure misoprostol. It is a banned drug now I believe, and the only place I know that sells that is at the back of Quiapo Church.

I would safely assume that your friend is having an unwanted pregnancy and is trying very hard to lose the baby. The only analgesic doctors routinely prescribe to pregnant women is paracetamol.

[KATKAT]

Thanks doc for the info. Now since I already know what those medicines are, Im scared of the possible things that may happen to her. I think she already took a lot (based on the empty wrappers of the meds.). What are the possible side-effects or better yet what should I be expecting? I always go to her place kasi. Im just scared something might just come up so if you could tell me what to expect it would be much better. I think you are right when you said she is trying to abort it. Remember before I posted a topic regarding abortion? This is her. Actually we talked about it before and she agreed to keep the baby. But after what you said, I think she just told me that so I would not worry too much. Thanks again Doc Ira! Hoping to hear from you soon! :)

[Ira]

Misoprostol per se is a pretty safe medication; the only bad side effect would be on pregnant women, because it induces uterine contraction/early labor. If she took the medications orally, there might be a chance that it didn't work, since you get the side effect pretty much within the 1st 24 hours or so. If she placed the tablets intravaginally, then that would be another matter. Things to watch out for would be basically abdominal pains and bleeding. If she experiences that, bring her to the nearest ER.

[Ira]

By the way...don't ask her, "Ininom mo ba o pinasok mo ba sa vagina mo?" It might give her ideas. :)

[KATKAT]

Oh ok I won't ask her that. So ibig sabihin if she took it intravaginally it would be worse? She keeps on telling me nga that her abdomen is aching pero wala naman bleeding syang sinasabi. Anyway, thank you so much Doc Ira! You did help me a lot! At least di na ako magpapanic kung sakali.

[Ira]

I don't know how much she took, but even if she just took one tablet of misoprostol orally, and with her complaints of abdominal pain (is it crampy?), I would strongly suggest you bring her to see her ob-gyn. One thing about misoprostol, it is a pretty effective pill. She may or may not be having threatened abortion, and it won't hurt to check. Bleeding is already a late sign of threatened abortion. And yes, if she put it intravaginally, we probably won't even be talking here anymore, and she'd be in a hospital.

[NEWYORKER363]

[b]May I derriere in... I mean... may I butt in, please.

Dr. Ira, above, you mentioned "cytotec".


Cytotec (I think this is what you mean) is, on the other hand, pure misoprostol. It is a banned drug now I believe, and the only place I know that sells that is at the back of Quiapo Church.

Piques my interest because my doc once prescribed that to me, as a supplement whenever I took such ahtritic (spell!) pain relievers like Naproxen and the like. To ease the tummy pain daw. Yet you said that was a banned drug in Pinas? Was it bad?

Thanks once again.


NewYorker363

[Ira]

Misoprostol is a good anti-ulcer drug, but unfortunately, here in this country, people buy it not for its antiulcer properties, but due to its side effect of causing abortion. Because of bad drug regulation and dispensation here, they had to ban it from the market. Abortionists and desperate women were the ones buying it in bulk. Otherwise, it's safe on males and non-pregnant women.

[KATKAT]

OK. Is it possible that she already had bleeding and still can manage to move normally without being hospitalized or even going to the doc? I suspect that she already had bleeding based on what you said. I counted the empty wrappers and it totalled to 7. Her belly is always crampy daw but whenever I tell her that we go to a doctor she refuses. Anyway, I'll be watching her closely and tell you further what I have observed. Thanks again, Doc! :)

[Ira]

Yes, it is possible that she's starting to abort the fetus. Misoprostol acts to contract the uterus, forcing it to "spit out" the baby. Whether her abdominal pains are misoprostol-induced or not, she might have to get admitted to the hospital and given uterine relaxants like intravenous Duvadilan in order to reverse the uterine contraction. Katkat, do bring her to the ER. It is still possible to reverse the contractions, if she just experiences it intermittently. It's not normal to have regular crampy abdominal pains until you're about to deliver.