II. Background
- Pregnancy Categories will be replaced on medication bottles with specific warnings and precautions by 2020 in U.S.
- http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm425317.htm
- Although FDA Pregnancy Categories are no longer FDA designated, they are included here
- As of 2018, succinct guidance (to replace ABCDX) on specific drugs in pregnancy is lacking
III. Preparations: Pregnancy
-
Topical Corticosteroids
- Low potency Topical Corticosteroids may be used in pregnancy
- Avoid high potency Topical Corticosteroids in pregnancy due to risk of low birth weight
-
Topical NSAIDs (e.g. topical Diclofenac or Pennsaid)
- Avoid in pregnancy
- Topical benzocaine
- Safe for limited use in pregnancy
- Topical Retinoids (e.g. Tretinoin, Adapalene)
- Topical Calcineurin Inhibitors (Protopic, Elidel)
- Avoid in pregnancy (theoretical risk of prematurity and low birth weight)
IV. Preparations: Lactation
-
Topical Corticosteroids
- Avoid use on the nipple in Lactation (due to ingestion risk by infant)
-
Topical NSAIDs (e.g. topical Diclofenac or Pennsaid)
- Appear to be safe in Lactation
- Topical benzocaine
- Avoid use on the nipple in Lactation (due to ingestion risk by infant with associated Methemoglobinemia)
- Topical Retinoids (e.g. Tretinoin, Adapalene)
- Tretinoin and Adapalene appear safe in Lactation, but limit the use of Tazarotene
- Topical Calcineurin Inhibitors (Protopic, Elidel)
- Appear to be safe in Lactation
V. References
- (2014) Presc Lett 21(10): 58
- Tyler (2013) J Am Acad Dermatol 68(4): 663-71 [PubMed]