What is an adverse effect of methimazole?

A. Renal failure: Methimazole does not typically exert nephrotoxic effects. It is not known to impair glomerular filtration or tubular function, and renal failure is not associated with its primary pharmacologic pathway of inhibiting thyroid hormone synthesis. B. Agranulocytosis: Methimazole can suppress bone marrow activity, leading to a dangerous drop in neutrophils. This severe adverse effect increases vulnerability to infections and may present with fever, sore throat, or malaise, requiring immediate discontinuation and medical evaluation. C. Hypertension: Methimazole works to reduce excess thyroid hormones and does not directly elevate blood pressure. In fact, by lowering circulating thyroid hormone levels, it typically improves hyperthyroidism-related cardiovascular strain rather than worsening it. D. Heart palpitations: Palpitations are usually a symptom of untreated hyperthyroidism rather than a direct adverse effect of methimazole. As methimazole reduces thyroid hormone levels, palpitations generally improve rather than being triggered by the medication.