Cytotec is misoprostol 200 mcg, a prescription tablet. It was developed to protect the stomach lining from anti-inflammatory damage, but most of its use today is in obstetrics and gynaecology — inducing labour, managing bleeding after childbirth, treating miscarriage, and in medical termination of pregnancy. It is a Schedule 4 medicine and is not safe to use unsupervised.
What is Cytotec?
The South African Medicine Price Registry lists it as Misoprostol Pfizer (Cytotec), a Schedule 4 tablet containing misoprostol 200 micrograms.
Misoprostol is a synthetic prostaglandin E1 analogue — a manufactured version of one of the body’s own signalling chemicals. Prostaglandins do two relevant things: they protect the stomach lining by promoting mucus and bicarbonate and reducing acid, and they cause the muscle of the uterus to contract and the cervix to soften.
Both effects come from the same molecule, which is why one medicine has two entirely separate lives. The stomach effect is what it was designed for. The uterine effect is what it is mostly used for now.
Because of that second effect, misoprostol carries an absolute rule: it must not be taken by anyone who is pregnant unless a doctor has prescribed it for a specific obstetric purpose. Taken in pregnancy for its stomach effect, it can cause miscarriage, premature labour and serious birth defects.
The same medicine is sold in South Africa under other names, covered in the guide to misoprostol.
What is Cytotec commonly used for?
Its registered original use:
- Preventing stomach and duodenal ulcers in people taking long-term anti-inflammatories (NSAIDs) who are at high risk of them. Proton pump inhibitors such as omeprazole have largely displaced it here, being better tolerated and easier to take.
Its obstetric and gynaecological uses, which are the bulk of its use today and always take place under medical supervision:
- Inducing labour, and ripening the cervix before induction.
- Preventing and treating postpartum haemorrhage — heavy bleeding after childbirth. Misoprostol is on the World Health Organization’s list of essential medicines partly for this reason: it is effective, cheap and does not need refrigeration, which matters enormously where those constraints are real.
- Managing miscarriage — helping the uterus empty after a pregnancy has ended, avoiding surgery in many cases.
- Medical termination of pregnancy, usually following mifepristone.
- Preparing the cervix before gynaecological procedures such as an IUD insertion or a hysteroscopy.
A great many searches for this medicine are about the pregnancy uses, so the following is worth stating plainly rather than skirting.
These uses are legitimate, established medicine. They are recommended by the World Health Organization and used in hospitals and clinics worldwide, including throughout South Africa.
They are also not safe to attempt alone. Serious complications occur — heavy bleeding, incomplete emptying of the uterus needing surgery, infection, and in later pregnancy rupture of the uterus. These are survivable when someone is monitoring for them and dangerous when nobody is. The gestation of the pregnancy changes the risk substantially, and that cannot be judged without an examination or a scan.
In South Africa, termination of pregnancy is legal under the Choice on Termination of Pregnancy Act, and is provided free of charge at designated public health facilities. Anyone considering it can go directly to a public clinic or hospital, or contact a provincial health department helpline, without a referral and without payment. That route is confidential, and it is far safer than tablets bought from a street trader, a social media seller or an unregistered website — where the pills are frequently counterfeit, the wrong dose, or not misoprostol at all, and where there is no one to call if something goes wrong.
How Cytotec fits into this medicine category
| Group | Examples | What it does |
|---|---|---|
| Prostaglandin analogues | Misoprostol (Cytotec), dinoprostone | Protects stomach lining; contracts the uterus |
| Proton pump inhibitors | Omeprazole, lansoprazole, pantoprazole | Now the standard for preventing NSAID ulcers |
| H2 blockers | Famotidine, cimetidine | Reduce stomach acid |
| Uterotonics | Oxytocin, ergometrine | Contract the uterus after childbirth |
| Anti-progestogens | Mifepristone | Used with misoprostol in medical termination |
| NSAIDs | Diclofenac (K-Fenak OTC), ibuprofen | The medicines whose stomach damage misoprostol was meant to prevent |
See the general medicines hub, which also covers compound remedies such as HP553.
What to check before using Cytotec
It must not be used in pregnancy except where a doctor has prescribed it for a specific obstetric indication.
If it is prescribed for stomach protection:
- Pregnancy must be excluded, and effective contraception used throughout treatment. Many prescribers require a negative pregnancy test before starting.
- Do not use it if you are breastfeeding without specific advice.
- Tell your doctor if you have inflammatory bowel disease or a condition causing diarrhoea, which misoprostol commonly worsens.
- Tell your doctor about heart, kidney or liver disease.
- Take it with food to reduce diarrhoea and cramping.
- Never share it, and keep it well away from anyone who might be pregnant.
If it is prescribed for an obstetric or gynaecological purpose, follow the instructions of the clinician who prescribed it exactly — including the route of administration, which differs by indication and is not interchangeable. Make sure before you leave that you know what bleeding is expected, what is too much, who to call, and where to go.
This page does not give doses or regimens for any use. Those decisions depend on the indication, the gestation and the individual, and they belong with a clinician.
Possible cautions and when to ask a pharmacist or doctor
The most common effects are diarrhoea, abdominal cramping, nausea, vomiting, wind and headache. Diarrhoea is very common and is dose-related.
With obstetric use, cramping, pain and bleeding are expected — they are the medicine working. What matters is knowing where the boundary is.
Get emergency help immediately for:
- Very heavy bleeding — soaking through two full-size pads an hour for two hours or more, or passing large clots persistently.
- Fainting, dizziness on standing, a racing heart, or feeling cold and clammy — signs of significant blood loss.
- Fever, chills, severe abdominal pain, or foul-smelling discharge — signs of infection, which can become life-threatening quickly.
- Severe, unrelenting abdominal pain, especially in later pregnancy.
- Vomiting that prevents you keeping anything down, or signs of dehydration.
- Swelling of the face, lips or tongue, or difficulty breathing.
Contact a doctor if diarrhoea persists more than a week or is severe, if stomach pain continues, if bleeding does not settle within the expected time, if a pregnancy test remains positive weeks after a termination or miscarriage, or if you feel unwell in any way you did not expect.
If you have taken tablets obtained outside a health facility and something feels wrong, go to a clinic or hospital. Emergency care for bleeding, incomplete miscarriage and infection is provided regardless of how the situation arose, and delay is what causes harm.
Related medicine guides
Frequently asked questions
What are Cytotec 200 mcg tablets used for? Originally, preventing stomach ulcers caused by anti-inflammatory medicines. Today, mostly obstetric and gynaecological uses — inducing labour, treating postpartum bleeding, managing miscarriage, and medical termination of pregnancy.
What are Cytotec pills used for in pregnancy? Under medical supervision: ripening the cervix and inducing labour, controlling bleeding after childbirth, managing miscarriage, and medical termination. All of these require a clinician, because the risks depend on gestation and need monitoring.
Can I take it for stomach pain if I might be pregnant? No. It can cause miscarriage, premature labour and birth defects. Pregnancy must be excluded first.
Is it legal in South Africa? Yes. It is a registered Schedule 4 medicine, and termination of pregnancy is legal here under the Choice on Termination of Pregnancy Act.
Where can I get safe care? Designated public health facilities provide termination of pregnancy free of charge, and provincial health departments run helplines. Care for miscarriage and bleeding is available at any clinic or hospital.
Is it safe to use tablets bought online or from a trader? No. Products sold that way are frequently counterfeit or the wrong medicine, there is no assessment of how far along a pregnancy is, and there is nobody monitoring for bleeding or infection.
What side effects should I expect? Diarrhoea, cramping, nausea and headache are common. With obstetric use, cramping and bleeding are expected — but very heavy bleeding, fever or severe pain need emergency care.