# Misoprostol in Nigeria

Misoprostol has 18 active NAFDAC registrations in our October 2026 copy of the register, from 16 registration holders; 10 further listings have lapsed.

- Source: https://ogbogwu.com/drugs/misoprostol/
- Drug class: Prostaglandin E1 analogue (Reproductive Health)
- Also known as: Cytotec
- Prescription required: yes
- On the WHO Model List of Essential Medicines
- Last updated: October 2026

## Price in Nigeria

Misoprostol has no sampled online price here, and the reason is worth knowing: the registered 200 mcg tablets reach Nigeria through hospital pharmacies, primary health centres and the maternal-health programmes of MSI, the Society for Family Health and DKT, not through open online listings, and a facility usually bills it inside the cost of a delivery or of post-abortion care rather than as a line of its own. A pack offered loose by a street seller, a social-media account or an unregistered shop, at any price, is the pack to refuse — it is outside the only settings equipped to manage the heavy bleeding misoprostol can cause.

## What is Misoprostol?

Misoprostol is a synthetic prostaglandin E1 analogue that is listed on the World Health Organisation's List of Essential Medicines for multiple critical indications. It was originally developed and marketed as Cytotec by Pfizer for the prevention of gastric ulcers in patients taking non-steroidal anti-inflammatory drugs (NSAIDs). However, its ability to stimulate uterine contractions and soften the cervix has made it an invaluable medicine in obstetric and gynaecological care. In Nigeria, misoprostol's most important role is in the prevention and treatment of postpartum haemorrhage (PPH) — excessive bleeding after childbirth — which remains one of the leading causes of maternal death in the country. Nigeria accounts for approximately 23% of all global maternal deaths, and haemorrhage is responsible for an estimated 25-30% of these deaths. Misoprostol is a life-saving medicine that, when used correctly and under appropriate medical guidance, has the potential to significantly reduce maternal mortality in Nigeria.

What makes misoprostol particularly valuable in the Nigerian healthcare context is its stability at room temperature. Unlike oxytocin — the gold standard uterotonic drug for PPH prevention — which requires refrigeration (cold chain), misoprostol remains stable at ambient temperatures found across Nigeria's tropical climate. This makes it suitable for use in rural health centres, primary health care facilities, and community-level distribution points in states like Bayelsa, Kebbi, Jigawa, and Adamawa, where reliable cold chain infrastructure may be lacking. Misoprostol can be administered orally, sublingually (under the tongue), vaginally, or rectally, providing flexible dosing options even in resource-limited settings where intravenous access may not be available. The WHO recommends that where oxytocin is not available, misoprostol 600mcg orally should be administered by a healthcare provider immediately after delivery for the prevention of PPH. Community distribution programmes in several Nigerian states have trained traditional birth attendants and community health extension workers to administer misoprostol during home deliveries, where most maternal deaths from PPH occur.

Beyond its obstetric uses, misoprostol is also prescribed for the prevention of gastric and duodenal ulcers in patients who require long-term NSAID therapy — a common clinical scenario in Nigeria where NSAIDs such as diclofenac and ibuprofen are among the most widely used medicines. For this indication, misoprostol is typically taken at a dose of 200mcg two to four times daily with food. It works by replacing the protective prostaglandins in the stomach lining that are depleted by NSAIDs, thereby reducing the risk of ulcer formation and gastrointestinal bleeding. Misoprostol also has established roles in cervical ripening prior to surgical procedures and in the management of incomplete or missed miscarriage under medical supervision. It is essential that misoprostol is used only under the guidance of qualified healthcare professionals for its approved medical indications. All healthcare providers and patients should be aware that misoprostol is a potent uterotonic drug that causes uterine contractions, and its use requires appropriate clinical oversight to ensure patient safety.

Our October 2026 copy of the NAFDAC register lists 28 misoprostol products, 18 of them with Active registrations and nearly all 200 mcg tablets: Pfizer's Cytotec (B4-0307), MSI Nigeria's Misoclear (A4-6446), the Society for Family Health's Mistol (A4-5922), Jeksam's Jekprostol (B4-5623), Aquatix's Misofree (C4-1140) and Embassy's Cytofix (A4-7182) among them, most made in India for Nigerian holders. Misoprostol is also the second half of the mifepristone-misoprostol combipacks registered for managing a miscarriage that has not completed and for post-abortion care in a facility; those are covered on the mifepristone page. Abortion remains a criminal offence in Nigeria except to save the woman's life. This page describes a registered medicine and its registered uses — stopping bleeding after childbirth above all — under the clinicians who are trained to give it.

## What is Misoprostol used for?

- Prevention of postpartum haemorrhage (PPH) — administered after delivery to reduce excessive bleeding, especially in settings where oxytocin is unavailable
- Treatment of postpartum haemorrhage — used as part of the emergency management of PPH when other uterotonics are insufficient or unavailable
- Prevention of NSAID-induced gastric and duodenal ulcers in patients requiring long-term NSAID therapy
- Cervical ripening and labour induction — used in hospital settings under close obstetric supervision
- Medical management of incomplete miscarriage — used to help expel retained products of conception under medical supervision
- Medical management of missed miscarriage — used as an alternative to surgical evacuation in appropriate clinical settings

## Dosage

Always follow a doctor's or pharmacist's instructions; this is general reference information.

- Adults: For PPH prevention: 600mcg (3 tablets) orally as a single dose, given immediately after delivery of the baby and preferably after delivery of the placenta. For PPH treatment: 800mcg sublingually (under the tongue) as a single dose. For NSAID-induced ulcer prevention: 200mcg two to four times daily, taken with food and at bedtime. For cervical ripening and labour induction: dosing varies and must be individualised by the attending obstetrician — typically 25mcg vaginally every 4-6 hours. For management of incomplete miscarriage: 600mcg orally or 400mcg sublingually as a single dose, under medical supervision. All obstetric uses of misoprostol must be supervised by qualified healthcare professionals.
- Children: Misoprostol is not routinely used in children. Its use in paediatric patients is limited to rare gastroenterological indications and must be prescribed and supervised by a specialist.
- Elderly: For elderly patients taking long-term NSAIDs, misoprostol 200mcg two to four times daily may be prescribed for ulcer prevention. Start with a lower dose (200mcg twice daily) and titrate upward to minimise gastrointestinal side effects. Elderly patients should be monitored for diarrhoea and dehydration.

Misoprostol must be stored at room temperature (below 30°C) in its original foil packaging to protect from moisture. Its heat stability is a major advantage in tropical climates like Nigeria. For ulcer prevention, take misoprostol with food to reduce diarrhoea. Do not take antacids containing magnesium with misoprostol as they may worsen diarrhoea. For all obstetric indications, misoprostol should only be administered by or under the supervision of trained healthcare providers in appropriate clinical settings with the capacity to manage complications.

## Side effects

Common: Diarrhoea — the most common side effect, occurring in up to 30% of patients; usually dose-related and self-limiting; Abdominal pain and cramping — particularly with obstetric use, as the drug stimulates uterine contractions; Nausea and vomiting — more common with higher doses used in obstetric practice; Headache; Flatulence and bloating; Fever and chills — particularly common with sublingual and vaginal administration; usually transient (lasting a few hours).

Serious (seek medical help immediately): Uterine rupture — a rare but life-threatening complication, particularly in women with previous caesarean section scars or uterine surgery. This is why misoprostol for labour induction must only be used in hospital settings with surgical capability.; Excessive uterine bleeding — may occur if used inappropriately, particularly in early pregnancy; Uterine hyperstimulation — excessive uterine contractions that can compromise blood flow to the baby if used during labour; requires immediate medical intervention; Severe diarrhoea with dehydration — particularly at higher doses or in vulnerable patients; Allergic reactions — rare but can include rash, urticaria, and in very rare cases, anaphylaxis; Hypotension (low blood pressure) — can occur particularly with sublingual administration.

When to see a doctor: After delivery, if you are experiencing heavy bleeding that soaks through more than one sanitary pad per hour, passing large blood clots, feeling dizzy or faint, or having a rapid heartbeat, seek emergency medical care immediately — these are signs of postpartum haemorrhage requiring urgent intervention. If you are taking misoprostol for ulcer prevention and develop severe or persistent diarrhoea, bloody stools, or signs of dehydration (excessive thirst, dry mouth, dark urine, dizziness), contact your healthcare provider. In Nigeria, go to the nearest hospital maternity unit or emergency department for any obstetric emergency. Do not delay seeking care — postpartum haemorrhage can become life-threatening within minutes.

## Warnings

Do not take if: Known allergy or hypersensitivity to misoprostol or other prostaglandins; Pregnancy — for the gastric ulcer prevention indication, misoprostol is absolutely contraindicated in pregnant women as it can cause uterine contractions, miscarriage, premature birth, or birth defects. Women of childbearing age must have a negative pregnancy test before starting misoprostol for ulcer prevention.; For labour induction: previous caesarean section or major uterine surgery (risk of uterine rupture); grand multiparity (five or more previous deliveries); suspected cephalopelvic disproportion; abnormal foetal lie; Active cardiovascular disease — prostaglandins can affect blood pressure and cardiac function; Inflammatory bowel disease — misoprostol may worsen diarrhoea in patients with Crohn's disease or ulcerative colitis.

Interactions: Magnesium-containing antacids (such as Maalox) — can worsen misoprostol-associated diarrhoea; use aluminium-based antacids instead if needed; Oxytocin — additive uterotonic effect when used together; combined use requires careful monitoring in hospital settings to avoid uterine hyperstimulation; NSAIDs — while misoprostol is used to prevent NSAID-related ulcers, the combination still carries gastrointestinal risk and patients should be monitored; Dinoprostone (prostaglandin E2) — should not be used together due to risk of uterine hyperstimulation; Alcohol — may increase gastrointestinal side effects including diarrhoea and abdominal pain.

Pregnancy & breastfeeding: Misoprostol has a complex relationship with pregnancy that requires careful understanding. For the gastric ulcer prevention indication, misoprostol is ABSOLUTELY CONTRAINDICATED in pregnancy, as it can cause uterine contractions leading to miscarriage, premature labour, or birth defects. Women of childbearing potential must use effective contraception while taking misoprostol for ulcer prevention and should have a negative pregnancy test before starting therapy. However, in obstetric practice, misoprostol is deliberately used DURING pregnancy and after delivery for specific medical indications — including labour induction, cervical ripening, and PPH prevention and treatment — but only under the supervision of qualified healthcare professionals. Misoprostol is excreted in breast milk in small amounts. For PPH prevention, the single postpartum dose is unlikely to affect the breastfeeding infant. For women taking ongoing misoprostol for ulcer prevention, the small amount in breast milk may cause diarrhoea in the infant; discuss with your healthcare provider.

## Brands in Nigeria

Well-known NAFDAC-registered brands: Cytotec (Pfizer, made in UK); Misoclear (MSI Nigeria Reproductive Choices Ltd/Gte, made in India); Mistol (Society for Family Health, made in India); Jekprostol (Jeksam Pharmaceuticals, made in India); Misofree (Aquatix Pharmaceuticals, made in India); Cytofix (Embassy Pharmaceutical and Chemicals Limited, made in India).
Full searchable brand list: https://ogbogwu.com/drugs/misoprostol/brands/

## How to verify it is genuine

1. Check the NAFDAC registration number on the pack. In our October 2026 copy of the register, Cytotec (B4-0307), Misoclear (A4-6446), Mistol (A4-5922), Jekprostol (B4-5623), Misofree (C4-1140) and Cytofix (A4-7182) are all Active
2. Enter the number in our free NAFDAC checker and confirm the product name, strength and holder match the pack — misoprostol is a counterfeit target precisely because a weak tablet fails silently in an emergency
3. Obtain misoprostol only from NAFDAC-registered pharmacies, hospital pharmacies, or authorised health facilities. Due to its potential for misuse, distribution of misoprostol in Nigeria is more tightly controlled than many other medicines.
4. Check that the tablets are sealed in their original aluminium foil blister packaging — misoprostol is sensitive to moisture and must be protected. Loose or repackaged tablets may have degraded and lost potency.
5. Verify the expiry date and batch number. Do not use expired misoprostol as it may have reduced potency, which could be dangerous in emergency obstetric situations where reliable drug action is critical.
6. If you are a healthcare provider procuring misoprostol for facility use, ensure it is sourced from WHO-prequalified manufacturers or NAFDAC-approved distributors to guarantee quality and potency.

Verify any NAFDAC number free (no login): https://ogbogwu.com/nafdac-checker/

## FAQs

### Is misoprostol NAFDAC approved, and which brands are registered in Nigeria?

Yes. Our October 2026 copy of the NAFDAC register lists 28 misoprostol products, 18 of them with Active registrations, all 200 mcg tablets: Cytotec (Pfizer, B4-0307), Misoclear (MSI Nigeria, A4-6446), Mistol (Society for Family Health, A4-5922), Jekprostol (Jeksam, B4-5623), Misofree (Aquatix, C4-1140) and Cytofix (Embassy, A4-7182) are the names most facilities stock. Check the number printed on your pack against its own record in our NAFDAC checker, and buy only through a pharmacy or health facility.

### How does misoprostol help prevent postpartum haemorrhage, and why is this important in Nigeria?

Postpartum haemorrhage (PPH) — defined as the loss of 500ml or more of blood within 24 hours of childbirth — is the single leading cause of maternal death in Nigeria and globally. In Nigeria, where approximately 58,000 women die from pregnancy-related causes each year, haemorrhage accounts for 25-30% of these deaths, with the highest burden in rural communities where women deliver at home without skilled birth attendants. Misoprostol helps prevent PPH by stimulating the uterus to contract firmly after delivery, which compresses the blood vessels at the placental site and reduces bleeding. When 600mcg of misoprostol is given orally immediately after delivery, it significantly reduces the risk of severe bleeding. Its critical advantage in Nigeria is that, unlike oxytocin (which must be injected and requires refrigeration), misoprostol is a tablet that is stable at room temperature and can be taken by mouth. This makes it suitable for use in home deliveries, rural health posts, and primary health centres across Nigeria where cold chain and injection supplies may not be available.

### How should misoprostol be stored, and why is temperature stability important?

Misoprostol tablets should be stored at room temperature below 30°C, in their original sealed foil blister packaging, protected from moisture. Unlike oxytocin, which must be stored at 2-8°C in a refrigerator and loses potency rapidly when exposed to heat, misoprostol maintains its effectiveness at the ambient temperatures encountered across Nigeria — including in the hot northern states like Borno, Yobe, Sokoto, and Zamfara where daytime temperatures regularly exceed 35°C. This temperature stability is one of misoprostol's most important practical advantages for use in Nigeria's healthcare system, where reliable electricity for refrigeration is not always available, particularly in rural and remote areas. However, misoprostol is sensitive to moisture, which is why it must remain in its sealed aluminium foil packaging until the moment of use. Once removed from the packaging, the tablet should be used promptly. Do not store loose misoprostol tablets in pill boxes, paper envelopes, or plastic bags.

### Can misoprostol be used to prevent stomach ulcers from pain medications?

Yes, misoprostol was originally developed specifically for this purpose. Non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac, ibuprofen, and piroxicam are among the most commonly used medicines in Nigeria for conditions including arthritis, back pain, and general pain relief. However, long-term NSAID use significantly increases the risk of developing gastric (stomach) and duodenal ulcers, which can lead to dangerous gastrointestinal bleeding. Misoprostol prevents NSAID-induced ulcers by replacing the protective prostaglandins in the stomach lining that are depleted by NSAIDs. The recommended dose for ulcer prevention is 200mcg two to four times daily, taken with meals and at bedtime. Diarrhoea is the most common side effect at this dose but can be minimised by starting at a lower dose and gradually increasing. Important: women of childbearing age who are prescribed misoprostol for ulcer prevention MUST use effective contraception, as misoprostol can cause miscarriage if taken during pregnancy. Omeprazole is an alternative gastroprotective option that is often better tolerated.

### Is misoprostol available in pharmacies in Nigeria, and do I need a prescription?

Misoprostol is classified as a prescription-only medicine in Nigeria, and its distribution is subject to stricter oversight compared to many other medicines. It is available at hospital pharmacies, some registered community pharmacies, and through health programmes focused on maternal health. Due to concerns about misuse, NAFDAC and the Pharmacists Council of Nigeria have issued guidance on the responsible dispensing of misoprostol. In practice, availability varies — some pharmacies stock it readily while others may not. For the prevention of postpartum haemorrhage, misoprostol is distributed through maternal health programmes in many Nigerian states, often provided free of charge at primary health centres and through community-based distribution programmes. For gastric ulcer prevention, a doctor's prescription is required. Healthcare providers who prescribe misoprostol for any indication should ensure patients understand the correct use, potential side effects, and the importance of following medical guidance. If you have been prescribed misoprostol and have difficulty finding it, ask your healthcare provider or hospital pharmacy for assistance.

## Sources

- NAFDAC Greenbook (official register of approved products in Nigeria)
- WHO Model List of Essential Medicines
- British National Formulary (BNF)
- Nigerian Standard Treatment Guidelines (Federal Ministry of Health)