Misoprostol added to the WHO Model List of Essential Medicines for the Treatment of PPH

Misoprostol for the treatment of postpartum hemorrhage (PPH) has been added to the World Health Organisation’s 19th Model List of Essential Medicines (EML). This decision was reached by the 20th Expert Committee on the Selection and Use of Essential Medicines when in April 2015 it met at the WHO Headquarters in Geneva to revise and update the EML for both adults and children. The new edition of the EML recommends the use of misoprostol for the “Prevention and treatment of postpartum haemorrhage where oxytocin is not available or cannot be safely used.”

A proposal for the inclusion of misoprostol for the treatment of PPH was submitted by Gynuity Health Projects for consideration by the Expert Committee. Research has demonstrated that a single sublingual dose of 800mcg (200mcg x 4 tablets) of misoprostol is a safe and effective uterotonic for the treatment of PPH: nine out of ten women who receive misoprostol after PPH diagnosis will have bleeding controlled (Winikoff 2010; Blum 2010). For further information, see here.

Misoprostol is already included on the EML’s core list because of its proven safety and efficacy for the prevention of PPH, medical abortion (following mifepristone), management of incomplete abortion/miscarriage, and induction of labor.