One of the legal cases presented in the July installment of Medical Verdicts had this heading: “Is misoprostol wrong for induction?” Misoprostol may not be wrong, but the dose sure was.
The plaintiff claimed that hyperstimulation occurred during induction of labor at term due to excessive doses of misoprostol. The case summary stated that 50 mg of misoprostol was given vaginally and a second 50-mg dose was given 3 hours later.
Each of these doses is approximately 1,000 to 2,000 times the recommended dose of 25 to 50 micrograms (μg). However, since the baby was apparently not ejected at escape velocity into a low earth orbit I assume this was just a typographical error!
Bruce Flamm, MD
Riverside, Calif
Correction
Dr. Flamm is correct; the 50-mg figure was a typographical error. The doses should have been 50 micrograms.