Which patients should avoid using misoprostol?

Misoprostol is a medication that is commonly used for a variety of indications, including gastric protection, induction of labor, and management of postpartum hemorrhage. However, certain patient populations should avoid its use due to specific risks.

Premenopausal women should avoid misoprostol primarily due to its potent effects on uterine contractions and its ability to induce labor. The medication is a synthetic prostaglandin E1 analog that can lead to uterine stimulation, which can be dangerous in pregnant patients or those who might be pregnant. In premenopausal women who are not in a controlled clinical setting, the risk of unintended pregnancy and potential uterine contractions poses significant safety concerns. Therefore, its use in this population should be closely monitored or avoided entirely.

Other patient populations, such as those with asthma, kidney disease, or elderly patients, may have specific considerations for the use of misoprostol, but the primary concern in premenopausal women relates directly to the potential for adverse reproductive effects.