How effective is isoxsuprine Hcl in prevention of PTL & dysmenorrhoea

Duvadilan (isoxsuprine, )  is a   Beta-agonists, like  ritodrin, terbulin, salbutamol, and phenotrol : These drugs may be used  in women  negative cervical  fern test with presence of uterine contractions present at a frequency of four contractions every 20 minutes or eight contractions in 60 minutes, or dilatation of the cervix exceeding 1 cm or effacement equal to or more than 80% with the diagnosis of pre-term labor and intact membranes . Interventions in order to postpone the delivery::-- Go to:

Pre-term labor is defined as delivery before 37 full weeks of gestation. 1In the United States, the incidence is one in every ten births accounting for about 75% of neonatal mortality unrelated to congenital malformations. Unfortunately, the incidence hasn’t decreased during the past 40 years.

 Neonatal morbidity in pre-term labor is expected to decrease with early definite diagnosis and interventions in order to postpone the delivery, including corticosteroid administration and suitable perinatal care .. Neonatal morbidity and mortality are affected significantly by gestational age and fetal maturity. Death and severe morbidity are associated with births before 26 weeks of gestation, and they occur almost universally in births before 24 weeks. Another important issue after survival is overcoming the physical and mental disabilities in extremely low birth-weight neonates ..

Many medications are used for preventing pre-term labor, but their effectiveness is not clearly known, and recent studies do not support some of the medications being used for this purpose  .  Beta-agonists, such as ritodrin, terbulin, isoxsuprine, salbutamol, and phenotrol, have long been used in the prevention of pre-term labor with better neonatal outcomes, but further studies are needed for evaluating their efficacy and side effects .Beta-agonists act via beta 2-adrenergic receptors, and they increase intra-cellular cAMP in the myometrium and decrease myometrial contraction .   Isoxsuprine (Vasodilan) is a beta-adrenergic that directly affects vascular smooth muscle and results in peripheral vascular dilation. Isoxsuprine relaxes the uterine smooth muscles and is used for treatment of pre-term labor and dysmenorrhea. It is absorbed in the gastrointestinal system and is excreted in urine. Its effect is seen within 10 minutes after intravascular use and one hour after oral administration. It is contraindicated in patients who have cardiovascular disease (especially arrhythmias), hyperthyroidism, chorioamnionitis, bleeding, and eclampsia or severe pre-eclampsia . Few studies have reported its efficacy and safety in pre-term labor ., but it is used extensively in hospitals and private clinics in Iran. This may be due to the easier accessibility of this agent in Iran and because the physicians are more familiar with its effects and side effects.(Source:- PMCID: PMC4578532

PMID: 26396726

Effect of Maintenance Therapy with Isoxsuprine in the Prevention of Preterm Labor: Randomized controlled trial)

Azin Alavi,¹ Minoo Rajaee,¹ Malihe Amirian,¹ Hamidreza Mahboobi,^2,3 Keramat Allah Jahanshahi,² and Armaghan Faghihi¹