DINOPROSTONE
10 mg Vaginal Delivery System
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or nurse.
- If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. See section 4
- DINOPROSTONE should only be used under the supervision of an appropriate specialist
1. What DINOPROSTONE is and what it is used for
2. What you need to know before you are given DINOPROSTONE
3. How you are given DINOPROSTONE
4. Possible side effects
5. How to store DINOPROSTONE
6. Contents of the pack and other information
DINOPROSTONE contains 10 mg of the active substance dinoprostone and is used to help start the birth process provided that 37 weeks of pregnancy have been completed. The dinoprostone opens the part of the birth canal known as the cervix, to allow the baby through. There can be several reasons why you might need help starting this process. Ask your doctor if you would like to know more.
You must not be given DINOPROSTONE:
- if the size of your baby’s head may cause any problem during delivery
- if your baby is not in the correct position in the womb, to be born naturally
- if your baby is not in good health and/or is distressed
- if you have had previous major surgery or rupture of the cervix
- if you have untreated pelvic inflammatory disease (an infection in the womb, ovaries, tubes and/or cervix)
- if the placenta is obstructing the birth canal
- if you have or have had any unexplained vaginal bleeding during this pregnancy
- if you have had previous womb surgery including a previous Caesarean birth for any previous babies
- if you are hypersensitive (allergic) to dinoprostone or any of the other ingredients of DINOPROSTONE (listed in section 6).
The doctor or nurse will not give you DINOPROSTONE or will remove it after it has been given to you:
- once labour starts
- if you need to be given a drug e.g. an oxytocic to help your labour progress
- if your contractions are too strong or prolonged
- if your baby becomes distressed
- if you get side effects (see 4. Possible side effects).
There is limited experience of using DINOPROSTONE if your waters have been broken. Your doctor or nurse will remove DINOPROSTONE after it has been given to you if your waters break or are going to be broken by the doctor or nurse.
Before you are given DINOPROSTONE, please inform your doctor or nurse if any of the following apply to you:
- if you have or have ever had asthma (breathing difficulty) or glaucoma (an eye condition)
- if you have suffered from contractions that were too strong or prolonged in a previous pregnancy
- if you have lung, liver or kidney disease
- if you are having more than one baby
- if you have had more than three full term deliveries
- if you are taking a medicine for pain and/or inflammation, containing non-steroidal anti-inflammatory drugs (also known as NSAIDs) e.g. aspirin
- if you are aged 35 or over, if you have had complications during pregnancy, such as diabetes, high blood pressure and low level of thyroid hormones (hypothyroidism), or if the pregnancy is above 40 weeks because of the increased risk of developing disseminated intravascular coagulation (DIC), a rare condition which affects blood clotting.
The use of DINOPROSTONE in children and adolescents less than 18 years has not been investigated.
Tell your doctor or nurse if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
DINOPROSTONE can make you more sensitive to medicines belonging to the class of oxytocic drugs which is used to strengthen contractions. It is not recommended to administrate these medicines together with DINOPROSTONE.
DINOPROSTONE is used to help starting the birth process at term. DINOPROSTONE should not be used at any other time during pregnancy.
The use of DINOPROSTONE during breast-feeding has not been investigated. DINOPROSTONE may be excreted in breastmilk but the amount and duration is expected to be limited and should not hinder breastfeeding. No effects on the breastfed newborns have been observed.
Not relevant as DINOPROSTONE is to be used in connection with delivery only.
DINOPROSTONE will be given to you by a trained professional in a hospital or clinic where facilities for monitoring you and your baby are available.
The doctor or nurse will place one vaginal delivery system next to the cervix in your vagina. You should not do this yourself. Your doctor or nurse will coat the vaginal delivery system with a small amount of lubricating jelly before putting it in place. Sufficient tape will be left outside the vagina, to facilitate the removal of the vaginal delivery system when needed.
You should be lying down during this procedure and you will have to stay that way for about 20-30 minutes after insertion of DINOPROSTONE.
When placed in position, the vaginal delivery system takes up some of the moisture there. This allows the dinoprostone to slowly being released.
Whilst the vaginal delivery system is in place helping to start your labour, you will be examined regularly amongst other things for:
- opening of your cervix
- uterine contractions
- labour pains and the continuing health of your baby
The doctor or nurse will decide how long DINOPROSTONE needs to be kept in place, depending on your progress. DINOPROSTONE can be left in place for a maximum of 24 hours.
On removal of the product from the vagina the vaginal delivery system will have swollen to 2-3 times of its original size and be pliable.
If you have been given DINOPROSTONE for a longer time than you should it may lead to increased contractions or the baby may become distressed. The DINOPROSTONE vaginal delivery system will then be taken out immediately.
Like all medicines, DINOPROSTONE can cause side effects, although not everybody gets them.
Common: may affect up to 1 in 10 people
- Increased contractions of the womb which may or may not affect the baby.
- The baby may become distressed and/or its heart rate could become faster or slower than normal.
- Discoloured amniotic fluid.
Uncommon: may affect up to 1 in 100 people
- Headache
- Decrease in blood pressure
- The newborn baby has difficulty breathing immediately after birth
- The newborn baby has high blood levels of bilirubin, a breakdown product of red blood cells, which can cause yellowing of the skin and eyes.
- Itching
- Heavy vaginal bleeding following delivery
- The placenta detaches from the wall of the womb before the baby is delivered
- Overall newborn condition depressed immediately after birth
- Slow progress in the birth process
- Inflammation of the membranes that are lining the inside of the womb
- The mother’s uterus does not shrink after delivery due to lack of normal uterine contractions
- Feeling of burning in the genital area
- Fever
Not known: frequency cannot be estimated from the available data
- Fetal death, stillbirth and death of the newborn baby (neonatal death); especially following serious events such as tearing of the womb
- Disseminated Intravascular Coagulation (DIC), a rare condition which affects blood clotting. This can cause blood clots to form and may increase the risk of bleeding.
- The fluid that surrounds the baby during pregnancy can enter the mother’s bloodstream during delivery and block a blood vessel leading to a condition called anaphylactoid syndrome of pregnancy, which could include, symptoms such as: shortness of breath, low blood pressure, anxiety and chills; life-threatening problems with blood clotting, seizures, coma, bleeding and fluid in the lungs and fetal distress such as a slow heartrate.
- Hypersensitivity reaction and severe allergic reactions (anaphylactic reaction), which can include: difficult breathing, shortness of breath, weak or rapid pulse, dizziness, itching, redness of skin and rash.
- Abdominal pain
- Nausea
- Vomiting
- Diarrhea
- Swelling of the genital area
- Tearing of the womb
If you get any side effects, talk to your doctor or nurse. This includes any side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme website: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.
Keep this medicine out of the sight and reach of children.
Do not use DINOPROSTONE after the expiry date which is stated on the foil sachet and the carton.
Store in a freezer (-10 to -25°C). Store in the original container in order to protect from moisture.
Medicines should not be disposed via wastewater or household waste. After usage, your doctor or nurse will dispose the whole product as clinical waste. These measures will help to protect the environment.
- The active substance is dinoprostone, more commonly known as Prostaglandin E2. Each vaginal delivery system contains 10 mg of dinoprostone which is released at approximately 0.3 mg per hour over 24 hours.
- The other ingredients are crosslinked macrogol (hydrogel) and polyester yarn.
The vaginal delivery system is a small rectangular shaped piece of plastic contained in a knitted retrieval system. The plastic piece is a hydrogel polymer which swells in the presence of moisture to release dinoprostone. The retrieval system has a long tape which allows the doctor or nurse to remove it when they need to.
Each vaginal delivery system is contained within an individual sealed foil sachet produced from an aluminium/polyethylene foil laminate strip and packed in a carton.
Pack containing 5 vaginal delivery systems
Ferring Pharmaceuticals Ltd
Drayton Hall
Church Road
West Drayton
UB7 7PS
UK
DINOPROSTONE PL 03194/0084
Ferring Controlled Therapeutics Ltd (FCT)
1 Redwood Place
Peel Park Campus
East Kilbride
Scotland
G74 5PB
United Kingdom
This leaflet was last revised in April 2023
PM-3022/9