Safe/Unsafe Medicines in Pregnancy
Written by Dr.M.D.Mazumdar, MD
Drugs which are harmful to the fetus and are unsafe to be used in pregnancy are called teratogens and the effects are known as the teratogenic effects. When taken in the 1st trimester, some drugs can cause birth defects and miscarriages. In the 2nd trimester or 3rd trimester, there are chances of intra-uterine fetal growth retardation, defects in the placenta, preterm labor etc.
The use of any medicine during pregnancy requires careful consideration of both risks and benefits by both the mother as well as the doctor.
Most medicines cross the placenta. While some do not affect the baby, others may cause birth defects, unwanted effects around the time of birth which may or may not be reversible or may cause problems in later life.
The list of drugs here are given in the alphabetical order. The type of drug and whether it affects the baby is also mentioned.
Maternal medication | Drug Type | Crosses Placenta | Effect on foetus | Use in Pregnancy |
Acetaminophen(Tylenol) | Non-narcotic painkiller | Yes | Not known | Painkiller of choice |
Actifed | Antihistaminic | Yes | Not Known | Safe |
Alcohol | CNS Depressant | Yes | Fetal Alcohol Syndrome (mental retardation, growth retardation,facial abnormalitis-small eyes,drooping eyelids, wide nose) | Avoided |
Aluminum hydroxide/magnesium hydroxide (Maalox) |
Antacid | Yes | Not known | Safe |
Amphetamines | CNS Stimulant | Yes | Congenital heart disease | Avoided |
Ampicillin | Antibiotic | Yes | No toxic effect | Safe |
Anaesthetics | CNS Depressant | Yes | Depresses vital foetal centers | Use with Care |
Anti-thyroid Drugs | Immuno-modulatory | Yes | Depresses foetal thyroid | Avoid |
Anti-Convulsant Drugs | Controls Convulsions, epileptic attacks | Yes | Cleft lip/palate, congenital heart disease, abnorm- lities of the fingers, toes | Avoided as far as possible |
Aspirin | Salicylate analgesic | Yes | Can cause fetal bleeding, miscarriage if dose more than 100mg per day and in last Trimester | Avoided after 37 weeks |
Anusol | Anti-hemorrhoid | No | Not Known | Safe |
Benadryl | Antihistaminic | Yes | Not Known | Safe |
Bismuth subsalicylate (Pepto Bismol) |
Antidiarrheal | Yes | Salicylate can cause feal bleeding | Avoid |
Caffeine | Stimulant | Yes | Stillbirth, abortion, growth retardation | Avoid |
CarbamazepineAnticonvulsant, |
Mood Stabilising Yes |
Neural tube defects |
Avoid |
|
Cocaine | CNS Depressant, effects mood | Yes | Miscarriage, Placental abruption, Placenta previa Stillbirth,Growth retardation, |
Avoid |
Chloramphenicol | Antibiotic | Yes | Neonatal grey baby syndrome | Avoid |
Chloroquine | Antimalarial | Yes | Deafness, Changes in the inner ears | Avoid |
Chlorthiazide | Diuretic, Antihypertensive | Yes | Fetal or neonatal jaundice, Thrombocytopenia |
Avoid |
Chlorpheniramine maleate | Antihistaminic | Yes | Not Known | Safe |
Chlorpropamide | Oral Hypogycemic | Yes | Intrauterine or Neonatal death | Avoided |
Diazepam (Valium) | Benzodiazepine (Sedative, Antianxiety) |
Yes | Birth defects | Avoided |
Estrogen | Female Hormone | Yes | Defect in testicular formation | Avoid |
Frusemide (Lasix) | Diuretic, anti-hypertensive | Yes | needs more Study Can cause higher birth weights |
Only if needed |
Glucocorticoids | Steroid Hormone | Yes | Early Lung maturation placental vessels affected |
Only if needed |
Isotretinoin | Retinoid | Yes | Birth Defects, neonatal death |
Avoid |
Lithium | Antipsychotic Drug | Yes | Heart Defects, Goiter | Only if absolutely needed |
LSD(Lysergic Acid Diethylamide) | Hallucinogen | Yes | Low birth weight Brain damage, |
Avoid |
Metronidazole (oral) | Antibiotic | Yes | Birth defects | Avoid oral pills can take vaginal ovules, ointment |
Methyldopa | Antihypertensive | Yes | None recorded | Safe |
Methotrexate | Antihypertensive | Yes | neonatal death Severe fetal anomalies |
Avoid |
Nitrofurantoin | Antibiotic | Yes | No fetal effects recorded | Safe |
Penicillin | Antibiotic | Yes | No fetal effects recorded | Safe |
Prednisolone | Steroid | Yes | Cleft lip is used in early pregnancy |
Used with care |
Phenobarbitone | Sedative | Yes | Foetal bleeding (rarely) | Avoided |
Phenytoin | Yes | Multiple Fetal Anomalies | Avoided | |
Progestogens | Female Hormone | Yes | Masculinisation of female foetus | Avoided |
Promethazine (phenargan) | ||||
Reserpine | Foetal nasal congestion | Avoided at term | ||
Streptomycin | Fetal deafness (rarely) | Used with care | ||
Smoking (Nicotine, other teratogens) |
Yes | Multiple fetal anomaies | Avoided | |
Sulphonamides | Antibiotic | Yes | Neonatal jaundice | Avoided in the 3rd trimester |
Tetracyclines | Antibiotic | Yes | Affects bone and teeth development |
Avoided |
Thalidomides | Sedative | Yes | Limb Deformities | Avoided |
Tolbutamide | Multiple deformities | Avoided | ||
Triflupromazine | Safe? | |||
Trimethoprim | Antibiotic | Yes | Avoided | |
Valproic Acid | Yes | Neural tube defects | Avoided | |
Warfarin | Yes | Skeletal and limb defects, low birth weight |
Avoided |
Also Read-
- How Pregnancy Occurs.
- The Problem of Infertility.
- Vaginal Discharge with Itching .
- Different Methods of Birth Control.
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