Pyrexia and Fever

Misoprostol is a Prostaglandin E1 analogue. Prostaglandins are naturally released in response to tissue damage and cause fever. Prostaglandin E also acts on the central thermoregulatory centres, which may explain why fever and pyrexia are seen in misoprostol use.

In numerous randomised controlled trials looking at misoprostol to treat or prevent postpartum haemorrhage, there is a higher or significantly higher incidence of pyrexia or fever in women treated with misoprostol than with either placebo or another uterotonic. A large meta-analysis and systematic review of misoprostol to treat postpartum haemorrhage recorded pyrexia as significantly higher in all sub groups. Click here to read the Systematic Review.

In many studies, these adverse effects appeared to be self-limiting, and required little or no treatment. One RCT in Ecuador, in which the incidence of pyrexia was particularly high, reported that the time to discharge was similar between women who had experienced high fever and those who had not. It also noted that those who had experienced high fever were just as likely to be reported as in ‘good condition’ at discharge than those who had not. Click here to read the Ecuador Study.
Misoprostol, like the vast majority of drugs, has potential adverse effects. The links below list the common symptom characteristics.