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Upper Respiratory Medications in Pregnancy
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Upper Respiratory Medications in Pregnancy
, Cold Preparations in Pregnancy
See Also
Medications in Pregnancy
Over-The-Counter Medications in Pregnancy
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
Class B
No risk in controlled animal studies
Ammonium Chloride
Azatadine
Chlorpheniramine
(Chlor-Trimeton)
Antihistamine
of choice in pregnancy (but sedating, limit to night-time)
Clemastine (Tavist)
Cyproheptadine
Diphenhydramine
(
Benadryl
)
Oxytocin
-like effect at high dose
Crosses placenta
Doxylamine (Unisom)
Loratidine (
Claritin
)
Best to avoid in first trimester
Meclizine (Antivert)
Intranasal Budesonide (
Rhinocort
)
Safe in pregnancy (but use lowest effective dose)
Class C
Small risk in controlled animal studies
Guaifenesin
(
Robitussin
)
Early use may be associated with
Neural Tube Defect
s
Avoid combination products containing
Alcohol
Avoid in first trimester
Dextromethorphan
(
Robitussin
DM)
No increased risk in Collaborative Perinatal Project
Intranasal
Beconase
AQ (beclomethasone)
Benzonatate
(
Tessalon Perles
)
Codeine
Avoid in first trimester
Hydrocodone
Diphenhydramine
(
Benadryl
)
Avoid in first trimester
Pseudophedrine (
Sudafed
)
Associated with
Gastroschisis
, small intestinal atresia and hemifacial microsomia (avoid in first trimester)
Avoid in first trimester
Brompheniramine
Hydroxyzine
(
Atarax
)
Promethazine
(
Phenergan
)
Oxymetazoline
(
Afrin
)
Avoid in pregnancy (especially in first trimester)
Significant absorption from the nasal mucose
Cetirizine
(
Zyrtec
)
Avoid in first trimester
Fexofenadine
(
Allegra
)
Class D
Strong Evidence of Risk to the Human Fetus
Terpin Hydrate
Iodides
References
Briggs (1998) Drugs in Pregnancy and
Lactation
, 5th ed
Black (2003) Am Fam Physician 67(12):2517-24 [PubMed]
Larimore (2000) Prim Care 27(1):35-53 [PubMed]
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