Hematology Medications in Pregnancy

Aka: Hematology Medications in Pregnancy, Oncology Medications in Pregnancy

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II. Background

  1. Pregnancy Categories will be replaced on medication bottles with specific warnings and precautions by 2020 in U.S.
    1. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm425317.htm
    2. Although FDA Pregnancy Categories are no longer FDA designated, they are included here
      1. As of 2018, succinct guidance (to replace ABCDX) on specific drugs in pregnancy is lacking

III. Class B: No risk in controlled animal studies

  1. Iron Sulfate - Not in Briggs (1998)
  2. Anticoagulants
    1. Enoxaparin (Lovenox)
    2. Dalteparin (Fragmin)
    3. Danaparoid (Orgaran)
    4. Heparin

IV. Class C: Small risk in controlled animal studies

  1. Antiplatelet Medications
    1. Clopidogrel (Plavix) - not in Briggs (1998)
    2. Dipyridamole (Persantine)
    3. Ticlopidine (Ticlid) - not in Briggs (1998)
  2. Chemotherapeutics
    1. Asparaginase
    2. Dacarbazine
    3. Dactinomycin
    4. Interferon alfa

V. Class D: Strong evidence of risk to the human fetus

  1. Chemotherapeutics
    1. Bleomycin
    2. Cisplatin
    3. Cyclophosphamide
    4. Cytarabine
    5. Daunorubicin
    6. Doxorubicin
    7. Etoposide
    8. Fluorouracil
    9. Hydroxyurea
    10. Melphalan
    11. Mercaptopurine
    12. Methotrexate
    13. Plicamycin
    14. Tamoxifen
    15. Vinblastine
    16. Vincristine
  2. Miscellaneous Agents
    1. EDTA - Not in Briggs (1998)
    2. Penicillamine
  3. Anticoagulants
    1. Coumadin (Warfarin)
    2. Dicumarol

VI. Class X: Very high risk to the human fetus

  1. Leuprolide (Lupron)
  2. Aminopterin

VII. References

  1. Briggs (1998) Drugs in Pregnancy and Lactation, 5th ed
  2. Larimore (2000) Prim Care 27(1):35-53 [PubMed]

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