In a pregnant patient with recurrent peptic ulcer disease, which medication is safe to use?

• A. Sucralfate
• B. Misoprostol
• C. Sulfasalazine
• D. Metoclopramide

Answer: (A)

Safe, locally acting mucosal protectants are ideal in pregnancy because they work at the site of the ulcer with minimal fetal exposure. Sucralfate forms a viscous barrier over ulcers, protecting the mucosa from acid and promoting healing, and it is not absorbed systemically. This makes it safe for use during pregnancy, addressing recurrent peptic ulcers without affecting the fetus.

Misoprostol, by contrast, stimulates uterine contractions and can induce abortion—so it is contraindicated in pregnancy. Sulfasalazine can be used for inflammatory bowel disease in pregnancy but is not a treatment for peptic ulcers and may require folate supplementation; it doesn’t address ulcer healing in this context. Metoclopramide is generally considered safe for nausea in pregnancy but does not treat peptic ulcers, so it isn’t the appropriate choice here.