Plasma levels of 9-deoxo-16,15-dimethyl-9-methylene-PGE2 in connection with its development as an abortifacient

Abstract

Gaschromatographic-mass spectrometric quantitation of 9-deoxo-16,16-dimethyl-9-methylene-PGE2 in plasma samples obtained during constant intravenous infusion of the drug revealed that a plasma level of about 20 ng/ml was associated with high enough uterine contractility for induction of second trimester abortions. This level was therefore aimed for during the development of formulations and dose schedules for interruption of pregnancy with this drug. For the first time it was possible to induce second trimester abortions through oral administration of a prostaglandin analog, although the plasma levels were low giving a moderate success rate (about 50%) within 25 hours. Rectal administration of 20 mg of the drug at 6 hours intervals resulted in high enough plasma levels for second trimester abortions. Highly efficient dose schedules for interruption of early first trimester ("menses induction") and second trimester pregnancies through vaginal administration were developed. The frequency of side effects in the early first trimester were so low that "home treatment" was possible. Formulations suitable for 3, 6 or 12 hours preoperative dilatation of the cervix were also developed. © 1982.