Prostaglandins gemeprost

Gemeprost (73 16.16-dimethvl-trans-A -prostaglandin-E]) is dramatically more potent on a dosage basis as an abortifacient than prostaglandin E2 itself and has fewer side effects. The gem-dimethyl groups at C-16 protect the alcohol moiety at C-15 from rapid metabolic oxidation. 

Thong KJ, Robertson AJ, Baird DT. A retrospective study of 932 second trimester terminations using gemeprost (16,16 dimethyl-trans delta 2 PGE1 methyl ester). Prostaglandins 1992 44(l) 65-74. 

The author commented that the myocardial ischemia experienced by both of these patients was thought to be due to prostaglandin-induced coronary spasm. It would be prudent to monitor every woman treated with gemeprost during the course of an abortion. 

Misoprostol, an analogue of PGE1 is licensed for use in the management of gastroduodenal ulceration. It is an effective myometrial stimulant of the pregnant uterus and is used for the induction of labor and as abortifacient, both alone and in combination with other substances (for example mifepristone). It provides an effective alternative to gemeprost, the most widely used prostaglandin pessaries in combination with mifepristone. 

Gemeprost (prostaglandin Ej analogue) (Cervagem) is used intravaginally to soften the cervix before operative procedures in the first trimester of pregnancy and for abortion, alone and in combination with an antiprogestogen (mifepristone, p. 720). 

Clinically important, potentially hazardous interactions with cyclopropane, gemeprost, halothane, prostaglandins... 

Side effects following intravaginally administered gemeprost are generally relatively mild, with systemic effects such as nausea and diarrhea reported. The effects of this drug on the fetus are not known, but once a prostaglandin has been used to initiate termination of pregnancy, if it is found to be unsuccessful, termination must be completed by another means. 

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