Obstetrics Book


Medications in Pregnancy

Aka: Medications in Pregnancy, FDA Pregnancy Categories
  1. See Also
    1. Over-The-Counter Medications in Pregnancy
    2. Analgesic Medications in Pregnancy
    3. Antibiotics in Pregnancy
    4. Cardiovascular Medications in Pregnancy
    5. Cold Preparations in Pregnancy
    6. Endocrine Medications in Pregnancy
    7. Fetal Hydantoin Syndrome
    8. Gastrointestinal Medications in Pregnancy
    9. Hematology Medications in Pregnancy
    10. Lactation Safe Medications
    11. Neuro-Psychiatric Medications in Pregnancy
    12. Respiratory Medications in Pregnancy
    13. Teratogen Exposure
  2. 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
  3. 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
  4. Preparations: Class A
    1. No risk in controlled human studies
    2. Examples
      1. Acetaminophen (Tylenol)
      2. Pyridoxine (Vitamin B6)
  5. Preparations: Class B
    1. No risk in controlled animal studies
    2. Examples
      1. Amoxicillin
      2. Cephalosporin antibiotics
  6. Preparations: Class C
    1. Small risk in controlled animal studies
    2. Examples
      1. Codeine
      2. Dicloxacillin
  7. Preparations: Class D
    1. Strong evidence of risk to the human fetus
    2. Examples
      1. Coumadin
      2. Valium
  8. Preparations: Class X (Never to be used in Pregnancy)
    1. Very high risk to the human fetus
    2. Examples
      1. Xanax
      2. Accutane
  9. 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
  10. 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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