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Pharmacology · Drugs and Prescriptions

Dinoprostone

Dinoprostone

Dinoprostone is a synthetic analogue of endogenous prostaglandin E2 (PGE2). The drug has a potent stimulating effect on the myometrium and promotes cervical ripening, which is why it is widely used for labor induction and medical termination of pregnancy at any gestational age.

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Trade namesThe drug is available under the brand names Prostenon and Prostin E2.
Ultra-fast metabolism97% of the intravenously administered drug disappears from blood plasma in just 90 seconds.
Effect on the bronchiUnlike dinoprost, dinoprostone dilates the bronchial lumen and pulmonary blood vessels.
HemodynamicsIt exerts a hypotensive effect, lowering systemic blood pressure.
How to write a prescription
Rp.: Tab. Dinoprostoni 0,0005
D.t.d. N 10
S. Внутрь по 1 таблетке каждый час до развития родовой деятельности (для индукции родов)

Alternative notation: Tabulettas Dinoprostoni 0.0005; Sol. Dinoprostoni 1% - 5 ml

Dosage form
Tab. 0.0005 g; amp. sol. 1% - 5 ml (0.01 g - 1 ml)
Administration
Orally 0.0005 g. For labor induction, intravenously 0.00000025 g per min for 30 min; 0.9% NaCl or 5% glucose solution is used to prepare the infusion solution
Group
Drugs affecting the myometrium
3 min readFor medical studentsUpdated 09/24/2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesReviewed by medical editor: Aulov A. A., general practitioner · 09/24/2026

Mechanism of action on the myometrium and cervix

Dinoprostone belongs to the group of agents that primarily stimulate rhythmic uterine contractions. Unlike oxytocin preparations, which are characterized by strict dependence on the gestational age, prostaglandins have a universal effect. The sensitivity of the myometrium to dinoprostone is maintained at all stages of pregnancy, making it the drug of choice for both labor induction and pregnancy termination.

In addition, the drug solves an important clinical task of the first stage of labor: synchronization of contractile activity and dilation of the birth canal. In case of delayed cervical dilation (rigidity, dystocia), dinoprostone promotes its "ripening": it relaxes the tissues and accelerates cervical effacement and dilation.

Systemic effects and impact on metabolism

Prostaglandin preparations have a systemic effect on the body. A comparative analysis with dinoprost ($PGF_{2\alpha}$) reveals a number of important features of dinoprostone:

  • Respiratory and cardiovascular systems: The drug dilates the bronchial lumen and pulmonary circulation vessels (pulmonary vessels), and also has a hypotensive effect (lowers blood pressure).
  • Gastrointestinal tract: Similar to dinoprost, the drug actively stimulates the motility of smooth muscle in the intestines.
  • Renal effects and electrolytes: $PGE_2$ inhibits sodium reabsorption in the renal tubules, enhancing the diuretic effect. It is known that loop diuretics (furosemide, ethacrynic acid) exert part of their initial hemodynamic action (pulmonary artery vasodilation) precisely by stimulating COX-2 expression and increasing prostaglandin E2 synthesis. Meanwhile, prolonged use of dinoprostone itself provokes the development of hypomagnesemia. It is important to note that the efficacy of the drug does not depend on fluctuations in the blood acid-base balance.
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Clinical use and pharmacokinetics

In clinical practice, dinoprostone is used to address two main obstetric objectives:

  1. Labor induction. The drug is prescribed orally, via intravenous infusion, or intravaginally (in the form of a special gel).
  2. Medical abortion. Intravenous infusion is generally used for pregnancy termination.

A key pharmacokinetic feature of dinoprostone is its rapid inactivation. The drug is metabolized in the pulmonary vessels, as well as in the tissues of the kidneys, spleen, intestines, and adipose tissue. The rate of degradation is so high that the half-life is only 90 seconds (precisely during this time, 97% of the intravenously administered active substance disappears from the plasma).

Specific side effects

The high biological activity of prostaglandins causes a wide range of potential adverse reactions:

  • Gastrointestinal disorders: Due to the stimulation of motility, patients frequently complain of nausea, vomiting, and diarrhea.
  • Thermoregulatory disorders: Dinoprostone has the ability to stimulate the thermoregulatory center located in the hypothalamus. Clinically, this manifests as fever and chills.
  • Vascular and neurological reactions: Severe headache and marked hypotension may develop, requiring monitoring of the patient's condition during therapy.

Briefly: answers to topical questions

What are the routes of administration and dosage forms of dinoprostone in obstetric practice?

In obstetric practice, dinoprostone is used orally, intravenously, and intravaginally. The following routes of administration and dosage forms of the drug exist:

  • Orally — used for labor induction.
  • Intravenous infusion — used both for labor induction and for medical abortion.
  • Intravaginally — administered as a gel (Prostin $E_2$) for labor induction, and also used in the form of a vaginal therapeutic system.
How to memorize

To easily remember the difference in safety profiles: dinoprostON — Opens the bronchi (bronchodilation), while dinoprost — puts a "STop" to them (causes bronchospasm).

Class and exam questions

How does dinoprostone differ from oxytocin in its effect on the uterus?

The sensitivity of the myometrium to oxytocin strictly depends on the gestational age, whereas dinoprostone effectively stimulates the uterus at any stage of pregnancy and additionally promotes cervical dilation ("ripening").

Why might body temperature rise during the use of dinoprostone?

The drug directly stimulates the thermoregulatory center in the hypothalamus, leading to fever and chills.

How does dinoprostone affect blood pressure?

Unlike some other prostaglandins, dinoprostone has a hypotensive effect, meaning it helps lower blood pressure.

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What else to study on this topic

  • Peculiarities of oxytocin preparations (Syntocinon, Demoxytocin) and the dose-dependence of their effects.
  • Comparative characteristics of dinoprost (prostaglandin F2α): indications and spectrum of side effects.
  • Ergot alkaloids (ergometrine) and their role in managing postpartum hypotensive hemorrhage.
  • Mechanism of action of loop diuretics via stimulation of prostaglandin E2 synthesis.
  • Drugs used for the correction of cervical dystocia (rigidity).

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