Where I work, we use Cytotec 25mcg PO q2h but NEVER with Pit. Sometimes we use it in combination with a Foley bulb. We use Cytotec when a patient's cervix is not "ripe" enough for Pitocin. Once they get to 3-4cm dilated, we switch them over to Pit if their contraction pattern is irregular. Same kind of deal with Cervidil.