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Precautions and Warnings With Dinoprostone Vaginal Gel

Specific Dinoprostone Vaginal Gel Precautions and Warnings

Some warnings and precautions to be aware of prior to receiving this medication include the following:
  • Dinoprostone vaginal gel should only be administered by a trained healthcare provider in a hospital setting, where intensive care and emergency surgery can be provided if needed.
  • This medication may increase the risk for a blood clotting disorder that can cause serious bleeding after childbirth. Women who are 30 years of age or older, who had complications during pregnancy, or who have been pregnant for longer than 40 weeks may have a higher risk and should be carefully monitored after delivery.
  • Dinoprostone vaginal gel has been associated with a rare but dangerous condition known as anaphylactoid syndrome of pregnancy (sometimes called amniotic fluid embolism). This condition occurs when amniotic fluid enters the bloodstream through the placenta and causes an allergic response, which can lead to heart and lung collapse and bleeding.
  • Your healthcare provider will closely monitor you and your unborn baby during dinoprostone vaginal gel use to make sure serious problems do not occur. Monitoring will include checking your cervix and the strength and frequency of your contractions. Let your healthcare provider know if you have contractions that are unusually strong, long, or frequent.
  • Your healthcare provider may choose to monitor you more closely if you have abnormal uterine contractions, kidney or liver disease, asthma (or have ever had asthma), or increased eye pressure (such as glaucoma). These conditions may increase your risk for problems with dinoprostone vaginal gel.
  • It is unknown whether dinoprostone vaginal gel is safe for use in women who have had ruptured membranes ("water breaking"). The drug should be used with caution in such women.
  • Dinoprostone vaginal gel is a pregnancy Category C medication. This means the medicine may not be safe for use during pregnancy (see Prepidil and Pregnancy), although obviously it is intended for use only during pregnancy.
  • It is unknown whether dinoprostone vaginal gel passes through breast milk, although it is unlikely to do so. If you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving the drug (see Prepidil and Breastfeeding).
Last reviewed by: Kristi Monson, PharmD
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