Résumé : The Brazilian National Institute for Quality Control in Drugs (INCQS) reported in a study by GPUIM, a working group on misuse of drugs, at the University of Ceara and the University Hospital at Fortaleza, Ceara State, that the drug misoprostol (Cytotec) is being abused as an abortifacient. The drug is a "prescription only" drug, but is available over the counter, as is usual in Brazil. Since abortion if illegal, pregnant women ask pharmacists for advice on inducing abortion or uterine bleeding that may qualify them for hospital admission for emergency curettage. In a survey of 102 pharmacists in Fortaleza, 67% gave advice and 83% recommended misoprostol, usually 800 mcg, 2 tablets orally and 2 vaginally. Some suggest up to 46 tablets. At the maternity unit at the University Hospital in Fortaleza in 1988, there were 20 cases, and in 1990 there were 525 cases, 73% of admissions, of misoprostol used as the inducing agent. Complications such as infection were only 15% of these cases, lower than any other drug used locally to induce abortion. German studies on use of misoprostol as a 1st- trimester abortifacient, however, found that less than 50% of women experienced uterine bleeding and <10% complete abortion. There has been incidence of serious fetal abnormalities reported in women who took misoprostol but did not achieve abortion, among them bone lesions, hydrocephalus, cranial suture abnormalities, and abnormal digits. This situation of illegal abortion and uncontrolled drug marketing is unacceptable for women's and children's health.
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