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

III. Approach: General Recommendations

  1. Avoid medications if possible in first trimester
  2. Limit use to safe, short-acting, non-combination drugs
  3. Topical medications are preferred over systemic agents
  4. Use the lowest effective dose of a medication

IV. Preparations: Class A

  1. No risk in controlled human studies
  2. Examples
    1. Acetaminophen (Tylenol)
    2. Pyridoxine (Vitamin B6)

V. Preparations: Class B

  1. No risk in controlled animal studies
  2. Examples
    1. Amoxicillin
    2. Cephalosporin antibiotics

VI. Preparations: Class C

  1. Small risk in controlled animal studies
  2. Examples
    1. Codeine
    2. Dicloxacillin

VII. Preparations: Class D

  1. Strong evidence of risk to the human fetus
  2. Examples
    1. Coumadin
    2. Valium

VIII. Preparations: Class X (Never to be used in Pregnancy)

  1. Very high risk to the human fetus
  2. Examples
    1. Xanax
    2. Accutane

IX. Resources

  1. CDC Medications in Pregnancy
    1. http://www.cdc.gov/pregnancy/meds/index.html
  2. Vaccines and Medications in Pregnancy Surveillance System (VAMPSS)
    1. http://www.aaaai.org/about-the-aaaai/strategic-relationships/vampss/vampss-consumer.aspx
  3. MotherToBaby Fact Sheets (from Organization of Teratology Information Specialists or OTIS)
    1. http://www.mothertobaby.org/fact-sheets-s13037

X. 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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