Can I put Cytotec under the tongue?

When used sublingually (under the tongue), Misoprostol (Cytotec – 200mcg) has an efficacy rate of 95% , and of 93% when used vaginally.

Pharmacokinetic studies comparing oral and vaginal administration (58) showed that the vaginal route of Misoprostol is associated with a slower absorption, lower peaks of plasma levels, and slower clearance. The vaginal route of Misoprostol has also been linked to a higher total exposure to the drug (area under the curve [AUC]) and to larger effects on the cervix and uterus. However, we can observe a wide variation regarding the absorption of Misoprostol through the vaginal epithelium in different women. No clinically significant differences were found between the dry vaginal administration of Misoprostol and the moistened administration with water, saline or acetic acid.

“Pharmacokinetics of different administration routes of Misoprostol,” Hum Reprod. 2002; 17:332-336.

The rectal route of administration shows a similar pattern to the vaginal administration, however, it has a lower AUC, including a significantly reduced concentration than the maximum peak.

The sublingual route of administration (under the tongue) has a similar AUC as the vaginal administration, but it has higher and faster absobency than the peak levels of the vaginal or oral absorption. This represents elevated levels of gastrointestinal side effects. However, the sublingual route also causes uterine contractions at a rate that is equivalent to the vaginal administration and has less variation on its absorption.

The oral route of administration shows a low AUC, a lower peak concentration, and less side effects than the sublingual administration. The oral route has a similar absorption pattern as the vaginal one, but, at the same time, it produces lower serum levels in general. Nevertheless, the oral and vaginal routes of administration have similar effects on the uterine tone and activity.

If you rather introduce the pills into the vagina, then you should use your fingers to push them as far as possible, deep inside right where the uterus begins.

If you experience any complication and happen to live in a country where health care professionals can report you to the police, then pay attention: with your fingers you should carefully check your vagina and confirm that the pills have dissolved completely. Remove all loose pills and find a hospital immediately. It usually takes 4 days for the pills to dissolve completely.

We do not recommend the vaginal use. We strongly advise you to take Cytotec under your tongue.