Cervidil, Prostin E2 , Prepidil
Classifications: hormones and synthetic substitutes; prostaglandin; oxytocic
Pregnancy Category: C


20 mg suppository; Prepidil 0.5 mg gel; Cervidil 10 mg vaginal insert


Synthetically prepared member of the prostaglandin E2 series that appears to act directly on myometrium and on gastrointestinal, bronchial, and vascular smooth muscle. Stimulation of gravid uterus in early weeks of gestation is more potent than that of oxytocin.

Therapeutic Effects

Contractions are qualitatively similar to those that occur during term labor. Has high success rate when used as abortifacient before twentieth week and for stimulation of labor in cases of intrauterine fetal death.


To terminate pregnancy from twelfth week through second trimester as calculated from first day of last regular menstrual period; to evacuate uterine contents in management of missed abortion or intrauterine fetal death up to 28 wk gestational age; to manage benign hydatidiform mole; cervical ripening prior to labor induction.


Acute pelvic inflammatory disease, history of pelvic surgery, uterine fibroids, cervical stenosis, active cardiac, pulmonary, renal, or hepatic disease, pregnancy (category C).

Cautious Use

History of hypertension, hypotension, asthma, epilepsy, anemia, diabetes mellitus; jaundice, history of hepatic, renal, or cardiovascular disease; cervicitis, acute vaginitis, infected endocervical lesion.

Route & Dosage

Induction of Labor
Adult: Endocervical Place Prepidil 0.5 mg endocervically, may repeat q6h (max: of 1.5 mg); Place Cervidil insert 10-mg transversely in the posterior fornix of the vagina, remove on onset of active labor or 12 h after insertion

Evacuation of Uterus
Adult: Intravaginal Insert suppository high in vagina, repeat q2–5h until abortion occurs or membranes rupture (max: total dose 240 mg)


Endocervical & Intravaginal

Adverse Effects (1%)

CNS: Headache, tremor, tension. CV: Transient hypotension, flushing, cardiac arrhythmias. GI: Nausea, vomiting, diarrhea. Urogenital: Vaginal pain, endometritis, uterine rupture. Respiratory: Dyspnea, cough, hiccups. Body as a Whole: Chills, fever, dehydration, diaphoresis, rash.


Drug: oxytocics used with extreme caution.


Absorption: Slowly absorbed from vagina; Cervidil insert releases approximately 0.3 mg/h. Onset: 10 min. Duration: 2–3 h. Distribution: Widely distributed in body. Metabolism: Rapidly metabolized in lungs, kidneys, spleen, and other tissues. Elimination: Excreted mainly in urine; some excreted in feces.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug