A 55-year-old woman with hypertension develops a gastric ulcer while taking naproxen. Her physician prescribes misoprostol for ulcer healing. Which adverse effect limits the use of misoprostol in women of childbearing age?

• A QT prolongation and torsades de pointes
• B Agranulocytosis
• C Uterine contractions and abortion (abortifacient effect) ✓
• D Severe hypoglycaemia

Explanation

Misoprostol is a prostaglandin E1 analogue that stimulates uterine smooth muscle contraction, making it an effective abortifacient and contraindicated in pregnancy. This is the major limiting adverse effect in women of childbearing age. It is actually used for labour induction and postpartum haemorrhage, but its abortifacient property restricts use in pregnant women. The other options are not associated with misoprostol.

Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.