Misoprostol Pfizer is misoprostol 200 microgram tablets, listed on the South African register as Misoprostol Pfizer (Cytotec). It is used to prevent stomach ulcers caused by anti-inflammatory medicines, and in obstetrics and gynaecology for a range of uses including managing miscarriage, inducing labour, and treating postpartum haemorrhage.
What is Misoprostol Pfizer?
The South African Medicine Price Registry lists Misoprostol Pfizer (Cytotec) as a Schedule 4 tablet containing misoprostol 200 micrograms.
The registry name carries both the manufacturer and the older brand name, which is why searches for either lead here. It is the same product as Cytotec.
Misoprostol is a synthetic prostaglandin E1 analogue — a manufactured version of one of the body’s own signalling chemicals. Prostaglandins do two quite separate things that matter here, and this is why one small tablet has such different uses.
In the stomach, prostaglandins maintain the protective mucus layer and bicarbonate that stop stomach acid digesting the stomach lining itself. Anti-inflammatory medicines work by blocking prostaglandin production — which is how they relieve pain, and also why they cause ulcers. Misoprostol replaces the missing prostaglandin, restoring the protection.
In the uterus, prostaglandins cause the muscle to contract and the cervix to soften and open. This is the basis of every obstetric and gynaecological use.
The second effect is why the tablet is tightly controlled. Misoprostol causes uterine contractions, and it must not be taken by anyone who is pregnant or might be, unless it is being used deliberately under medical supervision. Taken in pregnancy it can cause miscarriage, premature labour, uterine rupture, and specific birth defects if a pregnancy continues.
Misoprostol is a WHO essential medicine. It is heat-stable, cheap, and needs no refrigeration — which makes it enormously important in settings without reliable cold chains, particularly for treating postpartum haemorrhage, a leading cause of maternal death.
What is Misoprostol Pfizer commonly used for?
Preventing NSAID-induced ulcers — its original licensed use. Prescribed for people who must take anti-inflammatories long term and are at high ulcer risk: older people, those with a previous ulcer, or those also on steroids or blood thinners. Proton pump inhibitors have largely replaced it for this, being better tolerated and taken once daily, but misoprostol remains an option.
In obstetrics and gynaecology, under medical supervision:
- Managing miscarriage — helping the uterus empty after a pregnancy has already ended, avoiding surgery for many women.
- Induction of labour, softening and opening the cervix at term.
- Treating and preventing postpartum haemorrhage — contracting the uterus after delivery to stop bleeding. This use saves lives, particularly where injectable oxytocin cannot be kept cold.
- Termination of pregnancy, usually with mifepristone. In South Africa, termination of pregnancy is legal under the Choice on Termination of Pregnancy Act, and is provided free at designated public health facilities. It is a medical procedure requiring proper assessment, gestational dating, and follow-up.
- Cervical preparation before gynaecological procedures such as hysteroscopy or IUD insertion.
- Treating missed miscarriage and retained products of conception.
This page does not give doses or regimens for any of these uses, and deliberately so. Misoprostol used outside medical supervision carries real risks — incomplete miscarriage, heavy bleeding requiring transfusion, infection, and, in later pregnancy, uterine rupture. Anyone considering it should be assessed by a clinician, and in South Africa that care is available free at public facilities.
If you have taken misoprostol and have heavy bleeding, severe pain or fever, go to an emergency department. You will be treated. Emergency care for bleeding or incomplete miscarriage is the same regardless of how it started, and clinicians are there to treat you, not to question you.
How Misoprostol Pfizer fits into this medicine category
| Group | Examples | Use |
|---|---|---|
| Prostaglandin analogues | Misoprostol, dinoprostone | Stomach protection; uterine contraction |
| Proton pump inhibitors | Pantoprazole, omeprazole | Now first choice for ulcer prevention |
| H2 blockers | Famotidine, cimetidine | Reduce acid; weaker |
| Antiprogestogens | Mifepristone | Used with misoprostol in TOP |
| Uterotonics | Oxytocin, ergometrine | Postpartum haemorrhage |
For other guides here see HP553 and K-Fenak OTC, and the general medicines hub.
What to check before using Misoprostol Pfizer
Do not take it if you are pregnant or might be, unless it has been prescribed for a pregnancy-related reason under supervision. If you are prescribed it for stomach protection and you could become pregnant, you must use effective contraception, and a pregnancy test is usually done before starting.
Tell your doctor if you:
- Could be pregnant, or are trying to conceive.
- Are breastfeeding.
- Have inflammatory bowel disease or another condition causing diarrhoea.
- Have cardiovascular disease or low blood pressure.
- Have epilepsy.
- Have had previous uterine surgery or a caesarean section — relevant to obstetric use, because of rupture risk.
- Have asthma.
- Take magnesium-containing antacids, which worsen the diarrhoea.
Practical points:
- Take it with food for the stomach-protection use, which reduces diarrhoea considerably.
- Keep it out of reach of others, and never share it.
- Do not use it for a pregnancy-related purpose without clinical assessment. Gestational age changes what is appropriate, and it cannot be judged without examination or a scan.
- Know where your nearest emergency department is if it has been prescribed for miscarriage management at home, and have someone with you.
Possible cautions and when to ask a pharmacist or doctor
Diarrhoea is the commonest effect and affects a large minority — usually starting within two weeks and settling. Abdominal pain, cramping, nausea and wind are also common. In obstetric use, cramping, bleeding, fever, chills and shivering are expected effects rather than side effects.
Get emergency help for:
- Heavy vaginal bleeding — soaking two or more pads an hour for two hours, or passing large clots.
- Severe abdominal pain that is not relieved by simple painkillers.
- Fever above 38 °C, particularly beyond 24 hours, or foul-smelling discharge — possible infection.
- Fainting, dizziness or a racing heart.
- Severe diarrhoea with dehydration.
- Swelling of the face, lips or tongue, or difficulty breathing.
Seek prompt advice for:
- Persistent diarrhoea that is not settling.
- Bleeding that continues for more than two weeks, or a pregnancy test still positive after three to four weeks following a pregnancy-related use — this may mean the process is incomplete and needs follow-up.
- Any concern that you may be pregnant while taking it for stomach protection.
Contact your doctor if you have been prescribed it for ulcer prevention and cannot tolerate the diarrhoea — a proton pump inhibitor is usually a straightforward alternative and better tolerated.
A closing point worth stating plainly. Misoprostol appears in a great deal of unreliable online material. The medicine itself is safe and effective when used correctly, and dangerous when used blind — the difference is assessment, dating, and follow-up. In South Africa that assessment is free at designated public facilities, and seeking it is both legal and the safest available route.
Related medicine guides
Frequently asked questions
What is Misoprostol Pfizer 200 mcg used for? Preventing stomach ulcers caused by anti-inflammatory medicines, and — under medical supervision — a range of obstetric and gynaecological uses including managing miscarriage, inducing labour and treating postpartum haemorrhage.
Is it the same as Cytotec? Yes. The registry lists it as Misoprostol Pfizer (Cytotec) — the same product under both names.
Why does one tablet have such different uses? Because prostaglandins do two unrelated jobs: protecting the stomach lining, and making the uterus contract. Misoprostol mimics both.
Can I take it if I might be pregnant? No, unless it has been prescribed for a pregnancy-related reason under supervision. It causes uterine contractions and can cause miscarriage or birth defects.
Why does it cause diarrhoea? Prostaglandins also stimulate the bowel. Taking it with food reduces this considerably, and it usually settles within a couple of weeks.
Is there an alternative for stomach protection? Yes. Proton pump inhibitors such as pantoprazole have largely replaced misoprostol for this — better tolerated, once daily.
Is termination of pregnancy legal in South Africa? Yes, under the Choice on Termination of Pregnancy Act, and it is provided free at designated public health facilities. It requires proper assessment and follow-up.
What if I have heavy bleeding or fever after taking it? Go to an emergency department. You will be treated — emergency care for bleeding or incomplete miscarriage is the same regardless of how it started.