When This Medicine Should Not Be Used:
You should not receive this medicine if you have had an allergic reaction to dinoprostone.

How to Use This Medicine:
Insert, Suppository, Gel/Jelly

• You will receive this medicine in a hospital or clinic, unless otherwise directed by your doctor.
• A nurse or doctor will insert this medicine into your vagina so that the medicine comes into contact with your cervix. The nurse or doctor will need to use a speculum to insert the gel.
• The gel or suppository should be brought to room temperature just before being placed in the vagina.
• You will need to lie on your back for up to 2 hours after the insert is put in place. You will need to lie on your back for up to 30 minutes after the gel or suppository is inserted.
• The insert will be removed 12 hours after it was inserted or when active labor begins.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Let your doctor know if you are using any other vaginal medicines.

Warnings While Using This Medicine:

• Tell your doctor if you have had any unusual vaginal bleeding, if you have had 6 or more full-term pregnancies, or if you have pelvic inflammatory disease.
• Let your doctor know if you have heart disease, liver disease, kidney problems, asthma, lung disease, or a history of bleeding disorders, diabetes, glaucoma, or seizures.
• If you are breastfeeding, talk to your doctor before using this medicine.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Chest pain or tightness
• Fast, slow, or irregular heartbeat
• Labor pains
• Rash or itching
• Trouble breathing or swallowing

If you notice these less serious side effects, talk with your doctor:

• Back pain or stomach pain
• Diarrhea, nausea, or vomiting
• Fever or chills
• Headache
• Warm feeling in the vagina

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088