Cervidil
Cervidil (dinoprostone) is inserted into your vagina to start labor. It's only given in the hospital by your labor and delivery healthcare team. Your providers will need to review your medical history carefully before using it, since there are many medical conditions that make it unsafe to use.
What is Cervidil (dinoprostone)?
What is Cervidil (dinoprostone) used for?
Activating labor (labor induction)
How Cervidil (dinoprostone) works
Cervidil (dinoprostone) is a type of prostaglandin that's found naturally in the body. During pregnancy, the placenta and other tissues in the uterus release dinoprostone. This activates labor at the end of pregnancy. Dinoprostone also helps relax and widen the cervix (an opening connecting your uterus to your vagina), so your baby can be delivered.
Drug Facts
What are the side effects of Cervidil (dinoprostone)?
Common Side Effects
- Frequent or prolonged contractions that don’t cause changes in your baby’s heart rate (2-5%)
- Changes in your baby’s heart rate not caused by frequent or prolonged contractions (3-4%)
- Frequent or prolonged contractions that cause changes in your baby’s heart rate (3%)
Other Side Effects
- Fever
- Nausea
- Vomiting
- Diarrhea
- Stomach pain
- Headache
- Low blood pressure
Serious Side Effects
- Blood clots
- Excessive bleeding
- Amniotic fluid embolism syndrome: seizures, coma, low blood pressure, low oxygen, trouble breathing, excessive bleeding
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common or rare
Chills or shivering
flushing
headache
swelling of the genital area (vulva)
tender or mildly bloated abdomen or stomach
This procedure may still result in some effects, which occur after the procedure is completed, that need medical attention. Check with your doctor if any of the following side effects occur:
Chills or shivering (continuing)
fever (continuing)
foul-smelling vaginal discharge
pain in lower abdomen
unusual increase in bleeding of the uterus
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Cervidil (dinoprostone)
Pros
Works well at starting labor
Can speed up labor and delivery by several hours
Only inserted once per delivery for it to work
Doesn't require any needles or injections
Side effects are rare
Cons
Must be given at a hospital by the labor and delivery team
Can cause a drop in your baby's heart rate (fetal distress)
Can't use if you've had uterine surgeries of any kind before, including a previous Cesarean-section (C-section)
Can't use if you've had 6 or more pregnancies that lasted about 40 weeks (term pregnancy)
Pharmacist tips for Cervidil (dinoprostone)
Cervidil (dinoprostone) can only be inserted into your vagina by the labor and delivery team while you're at a hospital.
There are several medical conditions that might make using Cervidil (dinoprostone) unsafe for you. These conditions include a past C-section and major surgeries of your uterus. Make sure your providers know about any previous major surgeries you've had.
After Cervidil (dinoprostone) is inserted into your vagina, you must remain lying down for the next 2 hours.
If needed, use water-based lubricants to help insert Cervidil (dinoprostone). Use just enough lubricant, since excess lubricant can block the insert from releasing the medication. Don't use any other types of lubricants.
If you need to use the restroom after administration, be sure to blot instead of wipe.
If you feel any discomfort, irritation, or if you feel that the insert
has moved out of place, tell your provider or nurse.
Frequently asked questions about Cervidil (dinoprostone)
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What are the risks and warnings for Cervidil (dinoprostone)?
Cervidil (dinoprostone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Problems with blood clotting
Risk factors: Age 30 years and older | Complications during pregnancy | More than 40 weeks pregnant before labor
The induction of labor, naturally or with help from medications like Cervidil (dinoprostone), can raise your risk of dangerous blood clots or blood clotting problems right after you give birth. You're at higher risk if you're 30 years or older, if you've had complications during pregnancy, or if you're more than 40 weeks pregnant at the time of delivery. If you use this medication, your providers might have to run blood tests and will watch you closely to make sure you don't develop any bleeding problems or blood clots. You might need additional medication to help prevent or treat these problems.
Amniotic fluid embolism syndrome
Cervidil (dinoprostone) can cause tissues in the amniotic fluid in your uterus to clump together and enter into your bloodstream. This can lead to the development of a rare but life-threatening condition called amniotic fluid embolism syndrome. This condition must be recognized and treated as soon as possible. Providers should monitor you for signs and symptoms of seizures, coma, low blood pressure, low oxygen, trouble breathing or inability to breathe, and blood clotting problems (e.g., blood clots, bleeding).
Frequent or prolonged contractions
Cervidil (dinoprostone) can cause frequent or prolonged contractions of your uterus. Sometimes, excessive contractions can drop your baby's heart rate. To make sure your baby is healthy, your providers will monitor your contractions, your cervical dilation, and your baby's heart rate. If they suspect something is wrong, your providers will remove Cervidil (dinoprostone) right away.
Cervidil (dinoprostone) should not be used if you've had a previous major surgery to your uterus, including a C-section, because there is a risk of serious delivery complications, including the tearing of the uterus wall (uterine rupture) or the death of your baby.
Glaucoma
Prostaglandins, including Cervidil (dinoprostone), can cause the pressure in your eyes to rise and the pupils of your eyes to narrow. If you have an eye problem called glaucoma, Cervidil (dinoprostone) can worsen this condition. Let your providers know if you have glaucoma so that they can decide if they should use alternative medications to prepare your cervix for delivery and induce labor.
Interactions with oxytocin
Risk factors: Oxytocin use
Cervidil (dinoprostone) can interfere with oxytocin medications. Oxytocin is a natural hormone that helps promote contractions. Cervidil (dinoprostone) itself makes the uterus more sensitive to oxytocin, so it can enhance the activity of oxytocin medications when used together. Because of this, Cervidil (dinoprostone) can't be used if your providers are already using oxytocin medications to help start labor. Your providers should be keeping track of which medications are being used to induce labor. If your providers decide to use oxytocin after Cervidil (dinoprostone) has been inserted, they will remove it before starting oxytocin.
Cervidil (dinoprostone) dosage forms
Typical dosing for Cervidil (dinoprostone)
Cervidil (dinoprostone) must be given by a healthcare provider in the hospital. Cervidil (dinoprostone) is inserted into your vagina for up to 12 hours. The insert releases 0.3 mg of dinoprostone every hour.
Interactions between Cervidil (dinoprostone) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Cervidil (dinoprostone) contraindications
Known allergy to other prostaglandins
Known or suspected drop in your baby's heart rate when the time for delivery is not near
Unexplained vaginal bleeding during the current pregnancy
Known or suspected that the baby's head or body is too big to fit through the mother's pelvis (cephalopelvic disproportion, CPD)
Conditions where labor shouldn't be induced
Conditions where oxytocin medications shouldn't be used
Previous C-section or other major surgery to your uterus
Conditions where prolonged contractions can harm the baby
Using intravenous (IV) oxytocin medications at the same time
Having 6 or more term pregnancies in the past
Cervidil (dinoprostone) images
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