Drug reference

Dinoprostone

Vasodilator · Labour induction, Cervical ripening

Also known as PROPESS, PROSTIN E2 VAGINAL GEL, PROSTIN E2 VAGINAL TABLETS

VasodilatorLabour induction, Cervical ripening

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

5 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 6 →

ErgometrineSevereDatabaseDDInter
MethylergometrineSevereDatabaseDDInter
MifepristoneSevereDatabaseDDInter
OxytocinSevereDatabaseDDInter

Mechanism

Prostaglandins induce uterine contractions. Dinoprostone is used to induce abortion or induce or augment labour and to minimise blood loss from the placental site.

Indications

Cervical ripening and induction of labour at term (PROPESS®)Induction of labour (PROSTIN E2® VAGINAL GEL)Induction of labour (unfavourable primigravida) (PROSTIN E2® VAGINAL GEL)Induction of labour (PROSTIN E2® VAGINAL TABLETS)facilitation of labor (cervical ripening)treatment of postpartum hemorrhageInduction/augmentation of labourMidterm abortionCervical priming (ripening)

Dosing

Adult: PROPESS® (Cervical ripening and induction of labour at term): 1 pessary, insert high into posterior fornix and remove when cervical ripening adequate; if oxytocin necessary, remove 30 minutes before oxytocin infusion; remove if cervical ripening inadequate after 24 hours (dose not to be repeated).…
Renal adjustment: Manufacturers advise avoid.
Hepatic adjustment: Manufacturer advises avoid.
Max dose: PROSTIN E2® VAGINAL GEL (Induction of labour): Maximum 3 mg per course. PROSTIN E2® VAGINAL GEL (Induction of labour, unfavourable primigravida): Maximum 4 mg per course. PROSTIN E2® VAGINAL TABLETS (Induction of labour): Maximum 6 mg per course. PROPESS®: Dose not to be repeated after 24 hours.

Pharmacokinetics

Bioavailability

Prostin E2 Vaginal tablets and Vaginal Gel are not bioequivalent.

Contraindications

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 pregnancies
history of asthma
glaucoma
myocardial infarction

Side effects

Common

Amniotic cavity infectionFebrile disordersHeadacheHyperbilirubinaemia neonatalHypotensionPruritusUterine atonyVaginal burningAbdominal painDiarrhoeaGenital oedemaNauseaVomitingWatery diarrhoeaUterine crampsUnduly forceful uterine contractionsVaginal bleedingFlushingShiveringFeverMalaiseFall in BPTachycardiaChest pain

Serious