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Comparative Bioavailability Study of Two Misoprostol Formulations

Phase 1
Completed
Conditions
Labour, Induced
Interventions
Drug: Angusta™
Registration Number
NCT02516631
Lead Sponsor
Region Skane
Brief Summary

The purpose of this study is to compare pharmacokinetics of two formulations of misoprostol following single dose administration in adult women being given misoprostol for cervical ripening and induction of labour.

Detailed Description

Prostaglandin E2 (dinoprostone) given vaginally or intra-cervically, and oxytocin have been the most commonly used preparations for induction of labour. Misoprostol is a synthetic prostaglandin E1 analogue. Misoprostol has anti-secretory and mucosal protective properties and was originally developed in the 1970s for the prevention of nonsteroidal anti-inflammatory drug (NSAID)-induced peptic ulcers. It is now used much more widely for 'off-label' indications like medication abortion, medical management of miscarriage, cervical ripening before surgical procedures, treatment of postpartum hemorrhage, and induction of labour. The lack of a specific license for Cytotec® to be used in obstetrics and gynecology has led to a number of problems regarding correct dose and dose regime.

The study is an open-label, randomized, single-dose, comparative, parallel design, bioavailability study followed by repeat dosing of of two formulations misoprostol in healthy adult females being induced to go into labour.

The drug shall be administered orally or sublingually.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
72
Inclusion Criteria
  • Adult females
  • Women wanting to participate and having given informed consent
  • Known to have reached week 37 + 0 days to week 42 + 2 days of gestation
  • With a viable fetus in a vertex position
  • Age above or equal to 18 years old
  • Women opting for vaginal delivery
  • BMI between 20 and 30 kg/m2
Exclusion Criteria
  • Women with known allergy to misoprostol or other prostaglandins
  • Women with prior caesarean section
  • Women with dead or anomalous fetus
  • Women with twin pregnancy
  • Women with known liver or renal dysfunction

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Oral (A)Cytotec®One tablet of Angusta™ (25 µg) or 1/8 of a tablet of Cytotec® (25 µg).
Oral (B)Cytotec®Two tablets of Angusta™ 25 µg or ¼ of a tablet of Cytotec®.
Sublingual (C)Cytotec®Two tablets of Angusta™ (total dose of 50 µg) or ¼ of a tablet of Cytotec® (50 µg.
Oral (A)Angusta™One tablet of Angusta™ (25 µg) or 1/8 of a tablet of Cytotec® (25 µg).
Oral (B)Angusta™Two tablets of Angusta™ 25 µg or ¼ of a tablet of Cytotec®.
Sublingual (C)Angusta™Two tablets of Angusta™ (total dose of 50 µg) or ¼ of a tablet of Cytotec® (50 µg.
Primary Outcome Measures
NameTimeMethod
AUC (area under the curve) 0-t misoprostolFor 2 hours regime: pre-dose, 5, 10, 20, 30, 40, 50, 75, 100 and 120 min post-dose. For 4-hours regime at pre-dose, 5, 10, 20, 30, 40, 50, 75, 100,120, 180 and 240 min post-dose
AUC (area under the curve) 0-inf of misoprostolFor 2 hours regime: pre-dose, 5, 10, 20, 30, 40, 50, 75, 100 and 120 min post-dose. For 4-hours regime at pre-dose, 5, 10, 20, 30, 40, 50, 75, 100,120, 180 and 240 min post-dose
Secondary Outcome Measures
NameTimeMethod
t max (Time to maximum) of misoprostolFor 2 hours regime: pre-dose, 5, 10, 20, 30, 40, 50, 75, 100 and 120 min post-dose. For 4-hours regime at pre-dose, 5, 10, 20, 30, 40, 50, 75, 100,120, 180 and 240 min post-dose
t 1/2 (Elimination half-life) of misoprostolFor 2 hours regime: pre-dose, 5, 10, 20, 30, 40, 50, 75, 100 and 120 min post-dose. For 4-hours regime at pre-dose, 5, 10, 20, 30, 40, 50, 75, 100,120, 180 and 240 min post-dose
APGAR score of infantAt time of birth
Adverse event / Serious Adverse event profile.From screening and until 7 days post treatment.
Cardiotochographic (CTG) monitoring.During labour

Trial Locations

Locations (1)

Skåne University Hospital Lund

🇸🇪

Lund, Sweden

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