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ΕΡΜΗΝΕΙΑ
Δείτε το Category interpretation . Φάρμακα κατηγορίας A και Β είναι γενικά ασφαλή για το έμβρυο (αυτό δεν ισχύει και για εσάς , π.χ το έμβρυο δεν παθαίνει τίποτε με πενικιλλίνη , αλλά αν εσείς είστε αλλεργική στην πενικιλλίνη τότε θα πρέπει να την αποφύγετε , έστω και αν είναι ασφαλούς κατηγορίας φάρμακο για το εμβρυο) .

Οι κατηγορίες C , D , Χ αντιπροσωπεύουν φάρμακα με αυξανόμενο κίνδυνο για το έμβρυο .

Ενημερώστε ή ρωτήστε το γιατρό σας πρίν λάβετε οποιοδήποτε φάρμακο !


O Κατάλογος δεν είναι πλήρης , και δεν θα μπορούσε να είναι . Ταυτόχρονος έλεγχος στο Google (με έμφαση στο λήμμα <δραστική ουσία φαρμάκου> +  "Pregnancy category"  θα σας δώσει την απάντηση .


CATEGORY INTERPRETATION

      A  Adequate, well-controlled studies in pregnant women have not shown an increased risk of fetal abnormalities to the fetus in any trimester of pregnancy.

      B  Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate and well-controlled studies in pregnant women.
          OR
          Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.

      C  Animal studies have shown an adverse effect and there are no adequate and well-controlled studies in pregnant women.
          OR
          No animal studies have been conducted and there are no adequate and well-controlled studies in pregnant women.

      D  Adequate well-controlled or observational studies in pregnant women have demonstrated a risk to the fetus.
          However, the benefits of therapy may outweigh the potential risk. For example, the drug may be acceptable if needed in a life-threatening situation or serious disease for  
          which safer drugs cannot be used or are ineffective.

      X  Adequate well-controlled or observational studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities or risks.
           The use of the product is contraindicated in women who are or may become pregnant.

 

 

ACE inhibitors (Enalapril ®, Captopril ®, Lisinopril ®)
Antihypertensive
CATEGORY: C first trimester
CATEGORY: D second and third trimesters
2nd and 3rd trimester use is associated with hypocalvaria, and renal defects related to fetal hypotension and decreased renal perfusion. The latter may result in oligohydramnios.
BREAST FEEDING:Compatible.Excretion into milk negligible.
NEONATAL SIDE EFFECTS:At delivery renal failure,hypotension


ADDITIONAL READING:

·  Angiotensin-Converting Enzyme (ACE)Inhibitors and Pregnancy
1996 Illinois Teratogen Information Service

Acetaminophen (Tylenol ®)

Acetazolamide (Diamox ®)
Diuretic, Carbonic anhydrase inhibitor
CATEGORY: C
Sacrococcygeal teratoma has been reported in an infant born to a mother treated with acetazolamide until the 19th week of pregnancy [1]. The Collaborative Perinatal Project found no increase in major or minor fetal anomalies in the infants of 1,024 women exposed to acetazolamide at any time during pregnancy including 12 infants exposed during the 1st trimester[G10]. However, the sample size is too small to evaluate the risk for uncommon conditions such as sacrococcygeal teratoma which has an incidence of 1 in 35,000 to 40,000 live births [2].
Acetazolamide should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus.

BREAST FEEDING:Excreted into human breast milk [3]. Compatible [G3].
NEONATAL SIDE EFFECTS: Renal tubular acidosis has been reported in a preterm boy shortly after birth in a mother treated with oral acetazolamide[4].


1. Worsham F, Beckman EN and Mitchell EH. Sacrococcygeal teratoma in a neonate. Association with maternal use of acetazolamide. J Am Med Assoc. 240:251-2, 1978. MEDLINE
2. Havranek P, Hedlund H, Rubenson A, Guth D, Husberg M, Frykberg T, Larsson LT. Sacrococcygeal teratoma in Sweden between 1978 and 1989. J Pediatr Surg. 1992;27:916-918. MEDLINE
3. Soderman P, Hartvig P, Fagerlund C. Acetazolamide excretion into human breast milk. Br J Clin Pharmacol. 1984 May;17(5):599-600. MEDLINE
4. Ozawa H, Azuma E, Shindo K, Higashigawa M, Mukouhara R, Komada Y. Transient renal tubular acidosis in a neonate following transplacental acetazolamide. Eur J Pediatr. 2001 May;160(5):321-2. MEDLINE

Acyclovir (Zovirax ®)
Antiviral
CATEGORY: B
Crosses placenta (maternal:cord ratio of ~ 1.3 after IV/PO exposure). In a prospective epidemiological registry 1st trimester exposure to acyclovir in 749 pregnancies resulted in no increase in major or minor fetal anomalies. However, the manufacturer cautions, the small size of the registry is insufficient to evaluate the risk for less common defects or to permit reliable or definitive conclusions regarding the safety of acyclovir in pregnant women and their developing fetuses. [G6].
BREAST FEEDING:Compatible. Concentrated in human milk. Compatible [G3].
NEONATAL SIDE EFFECTS: None reported.


5.Breastfeeding and Maternal Medication. Recommendations for Drugs in the Eleventh WHO Model list of Essential Drugs. pp 12 World Health Organization, 2002. 20 Avenue Appia ,1211 Geneva ,Switzerland
(PDF file)

7.  Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Review.



Adenosine (Adenocard)
Antiarrhythmic, Miscellaneous
CATEGORY: C
There are no adequate human studies.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:None reported at birth.


Albuterol (Proventil)
Antiasthmatic. Beta 2 -adrenergic bronchodilator.
CATEGORY: C
Crosses placenta. 1st trimester exposure in 1090 infants resulted in no increase in major or minor anomalies .
BREAST FEEDING:Compatible.
NEONATAL SIDE EFFECTS:At birth hypoglycemia. Agitation, GI upset after breast feeding


Alfentanil (Alfenta)
Opiate Agonist
CATEGORY: C
Crosses placenta. There are no adequate human studies.
BREAST FEEDING:Compatible.Excretion into milk minimal.
NEONATAL SIDE EFFECTS:At birth respiratory depression.




Alendronate (Fosamax)
Bone Metabolism, Bisphosphonate
CATEGORY:C
There are no adequate human studies.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Allopurinol
Gout, Uricosuric
CATEGORY: C
There are no adequate human studies.
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:


Alprazolam (Xanax)
Antianxiety, Benzodiazepine
CATEGORY: D
No data on placental passage . However, benzodiazepines as a class freely cross the placenta and may accumulate in the fetus. 1st trimester exposure to alprazolam specifically in 542 infants, studied prospectively, resulted in no increase in major or minor anomalies, or rates of miscarriage.
BREAST FEEDING: The American Academy of Pediatrics has classified alprazolam as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS:Withdrawal,neonatal flaccidity and respiratory problems at birth.


ADDITIONAL READING:

·  Update:Benzodiazepines in Pregnancy
1999 Illinois Teratogen Information Service



Amantadine (Symmetrel)
Antiviral
CATEGORY: C
In a surveillance study of Michigan Medicaid patients 1st trimester exposure in 64 infants resulted in 5 birth defects (3.1 expected)[1]. The sample size is too small to draw firm conclusions.
BREAST FEEDING: The manufacturer reports amantadine is excreted in human milk, and recommends the drug not be used in nursing mothers [G3].
NEONATAL SIDE EFFECTS:Potential release of levodopa, urinary retention, vomiting, and rash after breast feeding.


1.Rosa F: Amantadine pregnancy experience. Reprod Toxicol. 1994 Nov-Dec;8(6):531. MEDLINE

Amikacin (Amikin)
Antibiotic, Aminoglycoside
CATEGORY: C
Crosses placenta. There are no adequate human studies. In utero aminoglycoside ototoxicity has not been reported to date with amikacin.
BREAST FEEDING:Compatible.Excretion into milk negligible. Oral absorption is poor.
NEONATAL SIDE EFFECTS:


Amiloride (Midamor)
Potassium Sparing Diuretic
CATEGORY: B
1st trimester exposure in 28 infants resulted in a 2 fold increase in major birth defects, but the sample size is to small to draw firm conclusions.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:




Aminocaproic acid (Amicar)
Hemostatic
CATEGORY: C
There are no adequate human studies.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Aminoglycosides
Antibiotic
CATEGORY: C
All cross placenta.In utero aminoglycoside ototoxicity has been reported to date with kanamycin, and streptomycin, but not with amikacin, gentamicin nor tobramycin.
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:Potentiation of MgSO4-induced neuromuscular blockade postpartum. Diarrhea after breast feeding.


ADDITIONAL READING:

·  Antibiotics and Pregnancy
1995 Illinois Teratogen Information Service


Aminophylline (Aminop) (see Theophylline)
Antiasthmatic/Bronchodilator
CATEGORY: C
BREAST FEEDING:Compatible
NEONATAL SIDE EFFECTS:Irritability




Amiodarone (Cordarone)
Antiarrhyythmic
CATEGORY: D
Crosses placenta. There are no adequate human studies. Congenital hypothyroidism described in second trimester (the drug is 38% iodine by weight).Fetal bradycardia.
BREAST FEEDING:Excretion into milk significant.Elimination half life is up to 58 days.The American Academy of Pediatrics has classified amiodarone as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS:May accumulate in infant with breast feeding. Possible hypothyroidism.


Amitriptyline (Elavil)
Antidepressant, Tricyclic
CATEGORY: Assigned to category D in past.
Presently carries the following precautions:

·  Amitriptyline has been shown to cross the placenta. Although a causal relationship has not been established, there have been a few reports of adverse events, including CNS effects, limb deformities, or developmental delay, in infants whose mothers had taken amitriptyline during pregnancy. Amitriptyline should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus.

1st trimester exposure in 467 infants resulted in no increase in major or minor anomalies [G1].

BREAST FEEDING: The American Academy of Pediatrics has classified amitriptyline as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS:Potential for urinary retention.


Amlodipine (Norvasc)
Antihypertensive, Calcium channel blocker
CATEGORY:C
There are no adequate human studies.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:




Amoxapine (Asendin)
Antidepressant,dibenzoxazepine
CATEGORY: C
1st trimester exposure in 19 infants resulted in a threefold increase in major anomalies ,but the sample size is to small to draw firm conclusions.
BREAST FEEDING: The American Academy of Pediatrics has classified amoxapine as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS:


Amoxicillin (Amoxil, Trimox)
Antibiotic, Penicillin
CATEGORY: B
1st trimester exposure in 8,538 infants resulted in no increase in major or minor anomalies
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:Possible diarrhea.


ADDITIONAL READING:

·  Antibiotics and Pregnancy
1995 Illinois Teratogen Information Service

Amoxicillin/Clavulanate (Augmentin)
Antibiotic, Penicillin
CATEGORY:B
BREAST FEEDING:Compatible
NEONATAL SIDE EFFECTS:Diarrhea


Amphetamine
Respiratory and Cerebral Stimulant
CATEGORY: C
Nonteratogenic when used under medical supervision (narcolepsy, appetitie suppressant). Illicit use is associated with IUGR , preterm labor, and fetal cerebrovascular accidents.
BREAST FEEDING:Contraindicated
NEONATAL SIDE EFFECTS:Withdrawal in infants born to amphetamine addicted mothers.




Amphotericin B (Amphocin, Fungizone)
Antifungal
CATEGORY: B
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Ampicillin
Antibiotic, Penicillin
CATEGORY: B
BREAST FEEDING:Compatible
NEONATAL SIDE EFFECTS:Diarrhea


ADDITIONAL READING:

·  Antibiotics and Pregnancy
1995 Illinois Teratogen Information Service


Aspartame (NutraSweet)
CATEGORY: NA
BREAST FEEDING:Compatible
NEONATAL SIDE EFFECTS:Caution in PKU carriers


Aspirin
Nonsteroidal Antiinflammatory Agent
CATEGORY: C in low dose (< 150 mg/day)
CATEGORY: D in standard doses
All NSAIDs used near term may cause closure of the ductus arteriosus, and inhibit labor. Oligohydramnios after prolonged use is a common complication.
BREAST FEEDING:The American Academy of Pediatrics has classified aspirin as a drug "which should be given to nursing mothers with caution" [G3]. The WHO Working Group on Human Lactation classified the salicylates as unsafe for use by nursing women [G8].
NEONATAL SIDE EFFECTS:Altered platelet function.Dose related metabolic acidosis


Atenolol (Tenormin)
Antihypertensive, Beta blocker
CATEGORY: D
Intrauterine growth retardation if started in 2nd trimester.
BREAST FEEDING: The American Academy of Pediatrics has classified atenolol as a drug "which should be given to nursing mothers with caution" [G3].
NEONATAL SIDE EFFECTS:Possible hypotension.




Atropine
Antimuscarinic/Antispasmodic
CATEGORY:C
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:


Atorvastatin (Lipitor)
Antilipemic, HMGCoA Reductase inhibitor

CATEGORY:X
Inadvertent exposure to other HMG-coA reductase inhibitors during pregnancy has not been shown to increase the risk of adverse pregnancy outcome[1].

BREAST FEEDING:
NEONATAL SIDE EFFECTS:


1. Manson JM, Freyssinges C, Ducrocq MB, Stephenson WP: Postmarketing surveillance of lovastatin and simvastatin exposure during pregnancy. Reprod Toxicol 1996;10:439-66. MEDLINE

Azathioprine (Imuran)
Antineoplastic
CATEGORY:D



Azithromycin (Zithromax)
 

Aztreonam (Azactam)
Antibiotic, Misc Beta-Lactam
CATEGORY:B
No human data. No teratogenic effects in animal studies.
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:


Baclofen (Lioresal)
Skeletal Muscle Relaxant
CATEGORY:C
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:




Barbiturates
CATEGORY: D
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:Sedation, withdrawal


Beclomethasone (Vancenase, Vanceril)
Corticosteroid; Antiasthmatic
CATEGORY: C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


ADDITIONAL READING:

·  Corticosteroids in Pregnancy
2000 Illinois Teratogen Information Service

Benazepril (Lotensin)
Antihypertensive Agent, ACE inhibitor
CATEGORY: C first trimester
CATEGORY: D second and third trimesters
2nd and 3rd trimester ACE inhibitor exposure is associated with hypocalvaria, and renal defects related to fetal hypotension and decreased renal perfusion. The latter may result in oligohydramnios.
BREAST FEEDING:Compatible.Excretion into milk negligible.
NEONATAL SIDE EFFECTS:Possible renal failure and hypotension at delivery.


Benztropine (Cogentin)
Anti-Parkinsonnian Agent
CATEGORY:C
Possible association with cardiovascular defects.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Betamethasone(Celestone)
Corticosteroid
CATEGORY: C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


ADDITIONAL READING:

·  Corticosteroids in Pregnancy
2000 Illinois Teratogen Information Service

Betaxolol (Betoptic)
Treatment of Glaucoma
CATEGORY: C
BREAST FEEDING:With caution
NEONATAL SIDE EFFECTS:Hypotension, bradycardia




Bethanechol
Cholinergic Agent
CATEGORY: C
BREAST FEEDING:Contraindicated
NEONATAL SIDE EFFECTS:Diarrhea, abdominal pain


Bismuth subsalicylate (Pepto-Bismol ®)
Antidiarrhea Agent
CATEGORY: C
After oral administration, bismuth subsalicylate is metabolized to bismuth salts and sodium salicylate [1].
1st trimester exposure to bismuth salts in 15 infants resulted in no increase in major or minor anomalies [G10]. However, the sample size is too small to draw firm conclusions.
Sodium salicylate and acetylsalicylic acid (Aspirin) belong to the nonsteroidal anti-inflammatory (NSAIDs) group of drugs. NSAIDs used near term may cause closure of the ductus arteriosus and inhibit labor. Oligohydramnios after prolonged use is a common complication.
BREAST FEEDING: Salicylates are excreted into breast milk. The American Academy of Pediatrics has classified salicylate as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3]. The WHO Working Group on Human Lactation classified the salicylates as unsafe for use by nursing women [G8].
NEONATAL SIDE EFFECTS: Possible metabolic acidosis due to salicylate metabolite.


1.Gorbach SL. Bismuth therapy in gastrointestinal diseases.Gastroenterology. 1990 99:863-75MEDLINE

Created: 11/17/2001
Last Update: 1/3/2003

Bleomycin
Antineoplastic
CATEGORY: D
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


ADDITIONAL READING:

·  Cancer, Chemotherapy and Pregnancy
1998 Illinois Teratogen Information Service

·  Chemotherapy in Pregnancy
Motherisk

Bromocriptine (Parlodel)
Treatment of Hyperprolactinemia
CATEGORY: B
BREAST FEEDING:Contraindicated
NEONATAL SIDE EFFECTS:Suppresses lactation in mom


Brompheniramine
Antihistamine
CATEGORY:C
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:Agitation, poor feeding and sleeping


ADDITIONAL READING:

·  Over the Counter Cold Medications in Pregnancy
1998 Illinois Teratogen Information Service

Budesonide (Pulmicort Turbuhaler ®)
 


Bumetanide (Bumex ®)
Diuretic
CATEGORY: C
BREAST FEEDING:Contraindicated
NEONATAL SIDE EFFECTS:May suppress lactation


Bupropion (Wellbutrin ®, Zyban ®)

Buspirone (Buspar ®)
Anxiolytic, sedative, hypnotic
CATEGORY:B
BREAST FEEDING:With caution. May be of concern.
NEONATAL SIDE EFFECTS:


Butalbital
Intermiediate-acting Barbiturate
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Butoconazole (Femstat, Mycelex)
Antifungal, Topical
CATEGORY:C
1st trimester exposure in 444 infants resulted in no increase in major or minor anomalies
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


ADDITIONAL READING:

·  Antifungal Drugs and Pregnancy
2000 Illinois Teratogen Information Service



Butorphanol (Stadol ®)
Analgesic; Partial Opiate Agonist
CATEGORY:C
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:


Caffeine
Stimulant
CATEGORY:B
BREAST FEEDING:Compatible [G3].
NEONATAL SIDE EFFECTS:Irritability, poor sleeping


ADDITIONAL READING:

·  Caffeine and Pregnancy
1997 Illinois Teratogen Information Service

Calcitonin (Miacalcin ®)
Calcium Metabolism
CATEGORY: C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Calcium channel blockers
CATEGORY:C
BREAST FEEDING:Compatible
NEONATAL SIDE EFFECTS:


ADDITIONAL READING:

·  Calcium Channel Blockers and Pregnancy
1996 Illinois Teratogen Information Service

Carbamazepine (Tegretol ®, Carbatrol ®)
Anticonvulsant
CATEGORY:D
The risk of neural tube defect is 1 to 2 % when used as monotherapy during first trimester. and . Syndrome similar to hydantoin syndrome is also seen.
BREAST FEEDING:Excreted into human breast milk. Compatible [G3].
NEONATAL SIDE EFFECTS:Possible marrow suppression


1.Teratology. ACOG technical bulletin number 236--April 1997

Carbimazole
Antithyroid Agent
CATEGORY:D
BREAST FEEDING:With caution
NEONATAL SIDE EFFECTS:Goiter




Carisoprodol (Soma ®)
Skeletal Muscle Relaxant
CATEGORY: C
BREAST FEEDING:Concentrated into human milk. Avoid breast feeding.
NEONATAL SIDE EFFECTS: Sedation.


Cefprozil (Cefzil ®)
Antibiotic, Cephalosporin
CATEGORY: B
BREAST FEEDING:Compatible [G3].
NEONATAL SIDE EFFECTS: Potential for diarrhea.


Cefuroxime (Ceftin ®)
Antibiotic, Cephalosporin
CATEGORY: B
Crosses placenta. 1st trimester exposure in 143 fetuses resulted in no increased rate of major or minor anomalies.
BREAST FEEDING:Excreted into milk. Compatible.
NEONATAL SIDE EFFECTS: Potential for diarrhea.


ADDITIONAL READING:

·  Antibiotics and Pregnancy
1995 Illinois Teratogen Information Service

Celecoxib (Celebrex)
Nonsteroidal Antiinflammatory, Cyclooxygenase-2 (COX-2) inhibitor
CATEGORY:C
BREAST FEEDING:It is not known whether this drug is excreted into human milk.
NEONATAL SIDE EFFECTS:


Cephalexin (Keflex, Keftab)
Antibiotic; Cephalosporin
CATEGORY:B
BREAST FEEDING:Compatible
NEONATAL SIDE EFFECTS:Diarrhea


ADDITIONAL READING:

·  Antibiotics and Pregnancy
1995 Illinois Teratogen Information Service

Cephalosporins
CATEGORY:B
BREAST FEEDING:Compatible
NEONATAL SIDE EFFECTS:Diarrhea


ADDITIONAL READING:

·  Antibiotics and Pregnancy
1995 Illinois Teratogen Information Service

Cetirizine (Zyrtec ® ,)See also Zyrtec-D
 


Chloramphenicol (Chloromycetin)
Antibiotic
CATEGORY:C
BREAST FEEDING: The American Academy of Pediatrics has classified chloramphenicol as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS:"Gray"disease, bone marrow suppression


Chlordiazepoxide (Librium)
Sedative; Benzodiazepine
CATEGORY:D
Crosses placenta.
BREAST FEEDING:Contraindicated
NEONATAL SIDE EFFECTS: Neonatal withdrawal, hypotonicity.


Chloroquine (Aralen)
Antimalarial Agent
CATEGORY: Assigned to category C in past.
Pregnancy is not a contraindication to malaria prophylaxis with chloroquine or hydroxychloroquine[1].
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:


1.Recommendations for the Prevention of Malaria Among Travelers. MMWR 39(RR-3);1-10,1990

Chlorothiazide(Diuril)
Diuretic
CATEGORY:C
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:Thrombocytopenia


Chlorpheniramine (Chlor-Trimeton ®,Efidac ®, Teldrin ®)

Chlorpromazine (Thorazine)
Tranquilizer
CATEGORY: Assigned to category C in past.
Presently carries the following precautions:

·  Safety for the use of chlorpromazine during pregnancy has not been established. Therefore, it is not recommended that the drug be given to pregnant patients except when, in the judgment of the physician, it is essential. The potential benefits should clearly outweigh possible hazards.
BREAST FEEDING: The American Academy of Pediatrics has classified chlorpromazine as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS: There are reported instances of prolonged jaundice, extrapyramidal signs, hyperreflexia or hyporeflexia in newborn infants whose mothers received phenothiazines prenatally.


ADDITIONAL READING:

·  The Treatment of Nausea and Vomiting in Pregnancy
2001 Illinois Teratogen Information Service



Chlorpropamide (Diabinese)
Antidiabetic Agent, Sulfonylurea
CATEGORY:C
Crosses placenta.
BREAST FEEDING:Excreted into breast milk.
NEONATAL SIDE EFFECTS:Hypoglycemia


Cholestyramine (Prevalite)
Antilipemic Agent; Resin
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Cimetidine (Tagamet)
Treatment of Peptic Ulcer
CATEGORY:B
BREAST FEEDING: Compatible. Concentrated in human milk [G3].
NEONATAL SIDE EFFECTS:None reported.

ADDITIONAL READING:

·  Gastroesophogeal Reflux (GERD) Medications in Pregnancy
1999 Illinois Teratogen Information Service


Ciprofloxacin (Cipro)
Antiinfective; Quinolone
CATEGORY:C
Crosses placenta. 1st trimester exposure in 105 fetuses resulted in no increased rate of major or minor anomalies. Achievement of developmental milestones and musculoskeletal system development were normal. However, the authors of the study cautioned that longer follow-up and magnetic resonance imaging of the joints may be warranted to exclude subtle cartilage and bone damage.[1]
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS: None reported.


1. Loebstein R et al.Pregnancy Outcome Following Gestational Exposure to Fluoroquinolones: a Multicenter Prospective Controlled StudyAntimicrob. Agents Chemother. 1998. 42:1336-1339.

Cisapride (Propulsid) Removed from U.S. market 2000.
Treatment of Gastroesophageal Reflux Disease; GI Stimulant.
CATEGORY: C
A prospective multicenter study of 129 pregnant women exposed to cisapride at any time during pregnancy, including 88 infants exposed during organogenesis, found no increase in major or minor anomalies, or rates of miscarriage. [1]
BREAST FEEDING:Excreted into human milk in low concentration. Compatible [G3].
NEONATAL SIDE EFFECTS:


1.Bailey B, Addis A, Lee A, Sanghvi K, Mastroiacovo P, Mazzone T, Bonati M, Paolini C, Garbis H, Val T, De Souza CF, Matsui D, Schechtman AS, Conover B, Lau M, Koren G. Cisapride use during human pregnancy: a prospective, controlled multicenter study. Dig Dis Sci. 1997 Sep;42(9):1848-52.MEDLINE

ADDITIONAL READING:

·  Gastroesophogeal Reflux (GERD) Medications in Pregnancy
1999 Illinois Teratogen Information Service

Cisplatin (Platinol)
Antineoplastic
CATEGORY:D
BREAST FEEDING: Excreted into human breast milk [1,2]. The American Academy of Pediatrics has classified cisplatin as a drug "usually compatible with breastfeeding" [G3]. The WHO Working Group on Human Lactation does not recommend nursing during cisplatin chemotherapy [G8].
NEONATAL SIDE EFFECTS:


1. de Vries EG, van der Zee AG, Uges DR, Sleijfer DT. Excretion of platinum into breast milk. Lancet 1:497, 1989. MEDLINE
2. Ben-Baruch G, Menczer J, Goshen R, Kaufman B, Gorodetsky R. Cisplatin excretion in human milk. J Natl Cancer Inst 84: 451-2, 1992. MEDLINE

ADDITIONAL READING:

·  Cancer, Chemotherapy and Pregnancy
1998 Illinois Teratogen Information Service

·  Chemotherapy in Pregnancy
Motherisk

Citalopram (Celexa)

Clarithromycin (Biaxin)
Anti-infective; Macrolide
CATEGORY:C
In prospective controlled study Einarson et al. found no increase in major or minor fetal anomalies in the infants of 157 women exposed to clarithromycin at any time during pregnancy including 122 infants exposed during the 1st trimester. However, the frequency of spontaneous abortions in the exposed group was higher (14%) than in the control group (7%) (p = 0.04) [1].
BREAST FEEDING:Excreted into human breast milk [2].
NEONATAL SIDE EFFECTS:


1.Einarson A, Phillips E, Mawji F, D'Alimonte D, Schick B, Addis A, Mastroiacova P, Mazzone T, Matsui D, Koren G. A prospective controlled multicentre study of clarithromycin in pregnancy. Am J Perinatol. 1998;15(9):523-5.MEDLINE
2. Sedlmayr T, Peters F, Raasch W, Kees F.[Clarithromycin, a new macrolide antibiotic. Effectiveness in puerperal infections and pharmacokinetics in breast milk] Geburtshilfe Frauenheilkd. 1993 Jul;53(7):488-91. German.MEDLINE
3. Drinkard CR, Shatin D, Clouse J.Postmarketing surveillance of medications and pregnancy outcomes: clarithromycin and birth malformations. Pharmacoepidemiol Drug Saf. 2000;9:549-56.MEDLINE

Clindamycin (Cleocin)
Antibiotic, Semisynthetic
CATEGORY:B
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:One case of GI bleeding


Clofibrate (Atromid-S)
Anilipemic Agent
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Clomiphene (Clomid, Serophene)
Nonsteroidal Ovulatory Stimulant
CATEGORY:X
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


ADDITIONAL READING:

·  Clomiphene Citrate (Clomid) and Pregnancy
1996 Illinois Teratogen Information Service

Clonazepam (Klonopin)
Anticonvulsant; Benzodiazepine
CATEGORY: D
BREAST FEEDING: Contraindicated
NEONATAL SIDE EFFECTS: Neonatal flaccidity, respiratory and feeding difficulties, and hypothermia in children born to mothers who have been receiving benzodiazepines late in pregnancy. Risk of withdrawal symptoms during the postnatal period.


ADDITIONAL READING:

·  Update:Benzodiazepines in Pregnancy
1999 Illinois Teratogen Information Service

Clonidine (Catapres)
Antihypertensive Agent,Alpha-agonist
CATEGORY:C
Crosses placenta.
BREAST FEEDING: Excreted into milk in high concentration. In a clinical study involving nine nursing mothers clonidine concentrations in the serum of the breast-fed newborns were about half those of the mothers. No adverse effects were observed in any of the infants [1]. The manufacturer recommends caution should be exercised when clonidine is administered to a nursing woman.
NEONATAL SIDE EFFECTS:


1.Hartikainen-Sorri AL, Heikkinen JE, Koivisto M. Pharmacokinetics of clonidine during pregnancy and nursing. Obstet Gynecol. 1987 Apr;69(4):598-600. MEDLINE



Clopidogrel (Plavix)
Oral Antithrombic Agent,Platelet Inhibitor
CATEGORY: B
BREAST FEEDING:It is not known whether this drug is excreted in human milk.
NEONATAL SIDE EFFECTS:


Clotrimazole (Lotrimin, Mycelex)
Topical Antifungal
CATEGORY:B
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Cloxacillin (Cloxapen)
Antibiotic, Penicillins
CATEGORY:B
BREAST FEEDING:Compatible
NEONATAL SIDE EFFECTS:Diarrhea


Cocaine
CATEGORY:C
CATEGORY: X as illicit drug.
Placental abruption, cerebral infarcts ,necrotizing enterocolitis.
BREAST FEEDING:Contraindicated
NEONATAL SIDE EFFECTS:Seizure,apnea


ADDITIONAL READING:

·  Cocaine
1999 Organization of Teratology Information Services

Codeine
Opiate Agonist
CATEGORY:C
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:


Colchicine
Treatment of gout
CATEGORY:D
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:


Contraceptives,oral
CATEGORY:X
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:Breast enlargement, proliferation of vaginal epithelium,decreased milk production





Cyclizine (Marezine)
Antiemetic, Antihistamine. Chemically similar to meclizine
CATEGORY:B
1st trimester exposure to cyclizine in 111 pregnancies resulted in no increase in the rate of major or minor fetal anomalies [G1].
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


ADDITIONAL READING:

·  The Treatment of Nausea and Vomiting in Pregnancy
2001 Illinois Teratogen Information Service

Cyclobenzaprine (Flexeril)
Tricyclic muscle relaxant
CATEGORY: B
1st trimester exposure in 542 fetuses resulted in no increased rate of major or minor anomalies [G1].
BREAST FEEDING:It is not known whether this drug is excreted in human milk.
NEONATAL SIDE EFFECTS:


Cyclophosphamide (Cytoxan)
Antineoplastic Agent
CATEGORY:D
BREAST FEEDING: The American Academy of Pediatrics classified cyclophosphamide as contraindicated during breastfeeding in 1994[G9]. , and listed it as a cytotoxic drug " that may interfere with cellular metabolism of the nursing infant" in 2001[G3].
NEONATAL SIDE EFFECTS:Possible immune suppression[1]


1. Amato D, Niblett JS. Neutropenia from cyclophosphamide in breast milk. Med J Aust. 1977;1:383-384

ADDITIONAL READING:

·  Cancer, Chemotherapy and Pregnancy
1998 Illinois Teratogen Information Service

·  Chemotherapy in Pregnancy
Motherisk

Cyclosporine (Neoral, Sandimmune)
Antineoplastic Agent
CATEGORY:C
Possible increase in low birth weight and increased rate of preterm birth.
BREAST FEEDING: Cyclosporine is excreted into human milk. However, blood levels of cyclosporine in 7 infants breastfed by cyclosporine-treated mothers were below the detection limit of the drug assay. The American Academy of Pediatrics has classified cyclosporine as a cytotoxic drug " that may interfere with cellular metabolism of the nursing infant"[G3].
NEONATAL SIDE EFFECTS: Possible immune suppression



1. Nyberg G, Haljamae, Frisenette-Fich C, Wennergren M, Kjellmer I. Breast-feeding during treatment with cyclosporine. Transplantation. 1998;65:253-255 MEDLINE



Cyproheptadine (Periactin)
Antihistamine, Antiserotonergic Agent
CATEGORY:B
BREAST FEEDING:Compatible
NEONATAL SIDE EFFECTS:Agitation, poor sleep and feeding pattern


Desipramine (Norpramin)
CATEGORY: Previously assigned to category C.
Presently carries the following precautions:

·  Safe use of desipramine hydrochloride during pregnancy and lactation has not been established; therefore, if it is to be given to pregnant patients, nursing mothers, or women of childbearing potential, the possible benefits must be weighed against the possible hazards to mother and child. Animal reproductive studies have been inconclusive.
BREAST FEEDING: The American Academy of Pediatrics has classified desipramine as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS:


Desmopressin
CATEGORY:B
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Dexamethasone (Decadron)
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


ADDITIONAL READING:

·  Corticosteroids in Pregnancy
2000 Illinois Teratogen Information Service

Dexfenfluramine (Redux)
Anti-Obesity Agent
CATEGORY:C
BREAST FEEDING:Not recommended
NEONATAL SIDE EFFECTS:


Dextroamphetamine
CATEGORY:D
BREAST FEEDING:Contraindicated
NEONATAL SIDE EFFECTS:CNS stimulation


Dextromethorphan (Benylin DM, Robitussin DM)

Diazepam
CATEGORY:D
BREAST FEEDING: The American Academy of Pediatrics has classified diazepam as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS:Sedation



ADDITIONAL READING:

·  Update:Benzodiazepines in Pregnancy
1999 Illinois Teratogen Information Service



Diazoxide
CATEGORY:C
BREAST FEEDING:Contraindicated
NEONATAL SIDE EFFECTS:Hyperglycemia


Dicumarol
CATEGORY:D
BREAST FEEDING:As for warfarin
NEONATAL SIDE EFFECTS:


Digoxin(Lanoxin)
Antiarrhythmic, miscellaneous
CATEGORY:C
BREAST FEEDING:Compatible [G3].
NEONATAL SIDE EFFECTS:GI upset,diarrhea,heart rate changes


Diltiazem (Cardizem)
Calcium channel blocker
27 first trimester exposures during first trimester showed an increase rate of cardiovascular defects. Suggestive of an association.
CATEGORY: C
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS: Potential for hypotension.


ADDITIONAL READING:

·  Calcium Channel Blockers and Pregnancy
1996 Illinois Teratogen Information Service

Diphenhydramine (Benadryl)


Dipyridamole
CATEGORY:C
BREAST FEEDING:Compatible
NEONATAL SIDE EFFECTS:


Disopyramide (Norpace)
CATEGORY:C
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:




Divalproex (Depakote)
Anticonvulsant.
CATEGORY: D
1% to 2% risk of neural tube defect when used in first trimester.
Valproic acid embryopathy: Neural tube defects, brachycephaly, high forehead, epicanthal folds, strabismus, nystagmus, shallow orbits, flat nasal bridge, small up-turned nose,hypertelorism,long upper lip,thin upper vermilion border, microstomia,long thin fingers,hypodspadias in males, low birth weight.
Crosses placenta.
BREAST FEEDING:Excreted into human breast milk in low concentration.Compatible.
NEONATAL SIDE EFFECTS: None reported.


Docusate sodium (Colace® )

Donepezil (Aricept® )
Acetylcholinesterase inhibitor
CATEGORY: C
There are no adequate or well-controlled studies in pregnant women
BREAST FEEDING:It is not known whether donepezil is excreted in human breast milk.
NEONATAL SIDE EFFECTS:


Doxazosin (Cardura® )
Alpha adrenergic receptor inhibitor
CATEGORY: C
There are no adequate and well-controlled studies in pregnant women.
BREAST FEEDING:It is not known whether this drug is excreted in human milk. However, doxazosin has been found to concentrate in the breast milk of animals.
NEONATAL SIDE EFFECTS:


Doxepin
CATEGORY:C
BREAST FEEDING:The American Academy of Pediatrics has classified doxepin as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS:Apnea


Doxorubicin
CATEGORY:D
BREAST FEEDING: Contraindicated
NEONATAL SIDE EFFECTS:Possible immune suppression






Doxycycline
CATEGORY:D
Effects occur after 12 weeks EGA abnormalities of decidual teeth. Associated with maternal renal failure and fatty liver degeneration
BREAST FEEDING:Compatible  [G3]
NEONATAL SIDE EFFECTS:


Doxylamine(Unisom ®)
CATEGORY:A
BREAST FEEDING: Possible sedation
NEONATAL SIDE EFFECTS:


Droperidol
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Enalapril (Vasotec ®)
Antihypertensive; ACE inhibitor
CATEGORY: C first trimester
CATEGORY: D second and third trimesters
2nd and 3rd trimester ACE inhibitor exposure is associated with hypocalvaria, and renal defects related to fetal hypotension and decreased renal perfusion. The latter may result in oligohydramnios.
BREAST FEEDING:Compatible. Excretion into milk negligible. [G3].
NEONATAL SIDE EFFECTS:Possible renal failure and hypotension at delivery.


Endocet®, Percocet ®, Roxicet®, Roxilox®, Tylox ®

Enoxaparin (Lovenox ®)
Anticoagulant
CATEGORY:B
BREAST FEEDING: It is not known whether this drug is excreted in human milk.
NEONATAL SIDE EFFECTS:


Ephedrine
CATEGORY:C
Minor malformations, inguinal hernia
BREAST FEEDING:
NEONATAL SIDE EFFECTS:Agitation


Epoetin Alfa
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Ergotamine
CATEGORY:X
BREAST FEEDING: Contraindicated [G3]
NEONATAL SIDE EFFECTS:Convulsions, vomiting, diarrhea, gangrene


Erythromycin
CATEGORY:B
BREAST FEEDING:Compatible [G3]
NEONATAL SIDE EFFECTS: Possible diarrhea




Escitalopram (Lexapro TM)

Ethambutol
CATEGORY:B
BREAST FEEDING:Compatible [G3]
NEONATAL SIDE EFFECTS:


Ethanol
CATEGORY:X if used in large amounts [G1].
BREAST FEEDING:Minimal dose
NEONATAL SIDE EFFECTS:


ADDITIONAL READING:

·  Alcohol Consumption in Pregnancy
Royal College of Obstetricians and Gynaecologists

Ethosuximide
Anticonvulsant
CATEGORY:C
BREAST FEEDING:Compatible [G3]
NEONATAL SIDE EFFECTS:Close clinical monitoring of the infant is recommended if it is decided to continue breast feeding in mothers being treated with ethosuximide  [1,2,3]


1. Hagg S, Spigset O. Anticonvulsant use during lactation. Drug Saf. 2000;  22:425-40 MEDLINE
2. Nau H, Kuhnz W, Egger HJ, Rating D, Helge H. Anticonvulsants during pregnancy and lactation. Transplacental, maternal and neonatal pharmacokinetics.
Clin Pharmacokinet.1982 7:508-43. MEDLINE
3. Rane A, Tunell R.Ethosuximide in human milk and in plasma of a mother and her nursed infant. Br J Clin Pharmacol. 1981;12:855-8.MEDLINE
 

Etretinate
CATEGORY:X
Effects similar to isotretinoin, teratogenicity may persist long after discontinuing drug [G2]
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Famotidine (Pepcid ®)
CATEGORY:B
BREAST FEEDING:Compatible [1]
NEONATAL SIDE EFFECTS:


1. Hagemann TM. Gastrointestinal medications and breastfeeding. J Hum Lact. 1998;14:259-62. Review.PMID: MEDLINE

Felodipine (Plendil ®)
Calcium channel blocker
CATEGORY: C
BREAST FEEDING:It is not known whether this drug is secreted in human milk.
NEONATAL SIDE EFFECTS:


Fexofenadine (Allegra ®)



Fluconazole (Diflucan ®)
CATEGORY:C
More than 250 pregnancies exposed to one or several doses of less than 150 mg showed no increase in malformation. However, Antley-Bixler syndrome (craniosynostosis, choanal atresia, radiohumareal synostosis) was seen with doses of > 400 mg/day.[G4]
BREAST FEEDING:Compatible
NEONATAL SIDE EFFECTS: None reported.


Fluoxetine (Prozac ®)
 

Fluphenazine (Prolixin ®)
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Fluticasone (Flovent ®)
Corticosteroid
CATEGORY: C
There are no adequate and well-controlled studies in pregnant women.
BREAST FEEDING: It is not known whether fluticasone propionate is excreted in human breast milk.
NEONATAL SIDE EFFECTS:


Fluvastatin (Lescol ®)
Hyperlipidemia; HMG-CoA reductase inhibitor
CATEGORY:X
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Folic acid
CATEGORY:A
BREAST FEEDING:Compatible [G3].
NEONATAL SIDE EFFECTS:




Fosinopril
Antihypertensive; Ace Inhibitors
CATEGORY: C first trimester
CATEGORY: D second and third trimesters
2nd and 3rd trimester ACE inhibitor exposure is associated with hypocalvaria, and renal defects related to fetal hypotension and decreased renal perfusion. The latter may result in oligohydramnios.
BREAST FEEDING:Excreted into breast milk. Not considered compatible with breast feeding by the manufacturer.
NEONATAL SIDE EFFECTS:Possible renal failure and hypotension at delivery.


Furosemide (Lasix ®)
Diuretic
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Gabapentin (Neurontin ®)
Anticonvulsant
CATEGORY: C
There are no adequate and well-controlled studies in pregnant women.
BREAST FEEDING:It is not known if gabapentin is excreted in human milk.
NEONATAL SIDE EFFECTS:


Gallium-69
CATEGORY:X
BREAST FEEDING:Contraindicated Radioactivity in breast milk for 2 weeks
NEONATAL SIDE EFFECTS:


Gemfibrozil (Lopid ®)
Hyperlipidemia
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Gentamicin (Garamycin ®)
Antibiotic, Aminoglycoside
CATEGORY:C
BREAST FEEDING:Compatible [G3].
NEONATAL SIDE EFFECTS: Diarrhea,bloody stools reported.




Glimepiride (Amaryl ®)
Blood Glucose Regulator
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Glipizide (Glucotrol ®)
Blood Glucose Regulator, Sulfonylurea
CATEGORY:C. No increase above baseline anomaly rate in diabetics. Crosses placenta.
BREAST FEEDING: Contraindicated
NEONATAL SIDE EFFECTS: Possible hypoglycemia


Glyburide(Diabeta ®, Micronase ®)
Blood Glucose Regulators, Sulfonylurea
CATEGORY:C
1st trimester exposure in 37 fetuses resulted in no increased rate of major or minor anomalies.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Gold salts
CATEGORY:C
BREAST FEEDING: With caution
NEONATAL SIDE EFFECTS: Rash, liver and kidney inflammation


Guaifenesin
Expectorant
CATEGORY:C
1st trimester exposure in 382 fetuses resulted in no increased rate of major or minor anomalies.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:




Guanethidine (Ismelin ®)
Antihypertensive Agent
CATEGORY:C
BREAST FEEDING: Not recommended
NEONATAL SIDE EFFECTS:


Haloperidol (Haldol ®)
Tranquilizer
CATEGORY:C
BREAST FEEDING: The American Academy of Pediatrics has classified haloperidol as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS:


Halothane (Fluothane ®)
General Anesthetic
CATEGORY:C
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:


SEARCH LITERATURE FOR GENERAL ANESTHESIA

Heparin
Anticoagulant
CATEGORY:C
BREAST FEEDING: Compatible [G1]
NEONATAL SIDE EFFECTS:


Heroin
Illicit Drug
CATEGORY:NA
BREAST FEEDING: Contraindicated
NEONATAL SIDE EFFECTS:Withdrawal,depression


Hydralazine (Apresoline ®)
Antihypertensive Agent
CATEGORY:C
BREAST FEEDING:Compatible [G3]
NEONATAL SIDE EFFECTS:




Hydrochlorothiazide
Diuretic, Antihypertensive Agent
CATEGORY: B
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:


Hydrocodone (Vicodin ®)
Narcotic analgesic,Opiate agonist
CATEGORY:C, D
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Hydromorphone (Dilaudid ®)
Narcotic analgesic,Opiate agonist
CATEGORY:B,D
BREAST FEEDING:Compatible
NEONATAL SIDE EFFECTS:Sedation,inhibition of milk ejection


Hydroxychloroquine (Plaquenil ®)
Antimalarial Agent
CATEGORY:C
Treatment of 49 pregnancies throughout gestation in patients with SLE resulted in no fetal or newborn adverse effects. Discontinuation of the drug in patients at risk for lupus flare is not recommended [1].
BREAST FEEDING:Compatible  [G9]
NEONATAL SIDE EFFECTS: Potential for accumulation of drug.


1. J Rheumatol 23:1715, 1996 and Ann Rheum Dis 55:486, 1996

Hydroxyzine (Atarax ®, Vistaril ®)
Anxiolytic-Sedative and Hypnotic
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Ibuprofen (Advil ®, Motrin ®, Nurofen)
Nonsteroidal Antiinflammatory Agent
CATEGORY:B, (D if used in third trimester)
Borderline association with gastroschisis [1].
All NSAIDs used near term may cause premature closure of the ductus arteriosus, and inhibit labor. Oligohydramnios after prolonged use is a common complication with NSAIDs as a class.

BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:


1.Torfs et al.Teratology 54:84,1996

Imipramine (Tofranil ®)
Antidepressant
CATEGORY:D
BREAST FEEDING:The American Academy of Pediatrics has classified imipramine as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS:


Indomethacin (Indocin ®)
Nonsteroidal Antiinflammatory Agent
CATEGORY:B ,(D if used for longer than 48 hours or after 34 weeks gestation)
All NSAIDs used near term may cause closure of the ductus arteriosus, and inhibit labor. Oligohydramnios after prolonged use is a common complication with NSAIDs as a class.
BREAST FEEDING:Compatible [G3].
NEONATAL SIDE EFFECTS:1 case of seizure (questionable association)


1. Lebedevs TH, Wojnar-Horton RE, Yapp P, Roberts MJ, Dusci LJ, Hackett LP, Ilett KF. Excretion of indomethacin in breast milk. Br J Clin Pharmacol. 1991 Dec;32(6):751-4.MEDLINE

Insulin
CATEGORY:B
BREAST FEEDING:Compatible  [G1]
NEONATAL SIDE EFFECTS:


Iodine- 125
CATEGORY:X
BREAST FEEDING:Contraindicated Radioactivity in milk for 2 weeks
NEONATAL SIDE EFFECTS:


Ipratropium (Atrovent ®)
Antimuscarinic, Antispasmodic
CATEGORY:B
No adequate or well controlled studies have been conducted in pregnant women.
BREAST FEEDING: the minimal systemic absorption makes it unlikely that ipratropium bromide would reach the infant in an amount sufficient to cause a clinical effect.
NEONATAL SIDE EFFECTS:


Irbesartan (Avapro ®)
Antihypertensive; Angiotensin II receptor (AT 1 subtype) antagonist
CATEGORY: C first trimester
CATEGORY: D Second and third trimesters
Drugs that act directly on the renin-angiotensin system have been associated with hypocalvaria, and renal defects related to fetal hypotension and decreased renal perfusion when used during the 2nd and 3rd trimester. Oligohydramnios has been complication.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Isoniazid
Antituberculosis Agent
CATEGORY:C
BREAST FEEDING:Compatible [G3]. Mom should be on pyridoxine
NEONATAL SIDE EFFECTS:Rash, diarrhea, constipation.


Isoproterenol
Sympathomimetic (Adrenergic) Agent
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:Agitation, GI upset


Isosorbide Mononitrate (Imdur)
Vasodilating Agent
CATEGORY: C
BREAST FEEDING:It is not known whether this drug is excreted in human milk.
NEONATAL SIDE EFFECTS:


Isotretinoin (Accutane ®)
Misc. Skin and Mucus Membrane Agent
CATEGORY:X
16% spontaneous abortion, 19% major malformations
Isotretinoin embryopathy:Anotia or microtia or anotia, brain abnormalities, cleft palate, conotruncal heart and great vessel defects, eye malformations, micrognathia, thymic abnormalities [1].
BREAST FEEDING: Contraindicated
NEONATAL SIDE EFFECTS:


1. Drugs and Medications in Cunningham GF, MacDonald PC et al (eds);Williams Obstetrics,20th ed,Stamford ,CT:.Appleton and Lange, 1997 p 955

ADDITIONAL READING:

·  Accutane
2000 Organization of Teratology Information Services



Kanamycin
CATEGORY:D
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS: Diarrhea


Ketorolac (Toradol ® )
Nonsteroidal Antiinflammatory Agent
CATEGORY:C
All NSAIDs used near term may cause closure of the ductus arteriosus, and inhibit labor. Oligohydramnios after prolonged use is a common complication with NSAIDs as a class.
BREAST FEEDING: Excreted into human milk. Compatible [G3].
NEONATAL SIDE EFFECTS:


Labetalol
CATEGORY:C
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:Hypotension,bradycardia


Lamotrigine (Lamictal ®)
Anticonvulsant
CATEGORY:C
Crosses placenta.
BREAST FEEDING: Excreted into breast milk in considerable amounts. Contraindicated [1]
NEONATAL SIDE EFFECTS: None reported.


1.Ohman I, Vitols S, Tomson T. Lamotrigine in pregnancy: pharmacokinetics during delivery, in the neonate, and during lactation. Epilepsia. 2000 Jun;41(6):709-13. MEDLINE

Lansoprazole (Prevacid ®)
Control of stomach acid,Proton Pump Inhibitor
CATEGORY:B
BREAST FEEDING:It is not known whether lansoprazole is excreted into human milk.
NEONATAL SIDE EFFECTS:


Latanoprost (Xalatan ® Ophthalmic Solution)
Treatment of Glaucoma
CATEGORY:C
BREAST FEEDING:It is not known whether this drug or its metabolites are excreted in human milk.
NEONATAL SIDE EFFECTS:




Levetiracetam (Keppra® )

Levodopa
CATEGORY:C
BREAST FEEDING:Contraindicated. Inhibits prolactin release
NEONATAL SIDE EFFECTS:


Levofloxacin (Levaquin ®)
Anti-infective;Quinolone
CATEGORY:C
BREAST FEEDING: Based upon data from ofloxacin, it can be presumed that levofloxacin will be excreted in human milk. Contraindicated [G1].
NEONATAL SIDE EFFECTS:Potential for arthropathy.


Levothyroxine (Levoxyl ®, Synthroid ®)
Thyroid Agent
CATEGORY:A
BREAST FEEDING: Compatible [G3]
NEONATAL SIDE EFFECTS:


Lidocaine
CATEGORY:B
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:


Lindane
CATEGORY:B
BREAST FEEDING: Use alternate method of feeding for four days following exposure [G1].
NEONATAL SIDE EFFECTS:




Lisinopril (Prinivil ®,Zestril ®)
Antihypertensive; ACE inhibitor
CATEGORY: C first trimester
CATEGORY: D second and third trimesters
2nd and 3rd trimester ACE inhibitor exposure is associated with hypocalvaria, and renal defects related to fetal hypotension and decreased renal perfusion. The latter may result in oligohydramnios.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Lithium
CATEGORY:D
8% risk of serious cardiovascular anomaly, 2.7% risk of Ebstein anomaly REF:1
BREAST FEEDING: Contraindicated [G3].
NEONATAL SIDE EFFECTS:Hypotonia,bradycardia


Loperamide (Imodium A-D®)
Antidiarrhea Agent
CATEGORY:B
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:


Loracarbef (Lorabid ®)
Antibiotic,Beta-lactam (structurally resembles a cephalosporin)
CATEGORY: B
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Loratadine (Claritin ®)


Lorazepam
CATEGORY:D
BREAST FEEDING: The American Academy of Pediatrics has classified lorazepam as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS: Sedation


Losartan (Cozaar ®)
Antihypertensive, Angiotensin II receptor antagonist
CATEGORY: C first trimester
CATEGORY: D second and third trimesters
Drugs that act directly on the renin-angiotensin system have been associated with hypocalvaria, and renal defects related to fetal hypotension and decreased renal perfusion when used during the 2nd and 3rd trimester. Oligohydramnios has been a common complication.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Lovastatin
CATEGORY:X
Inadvertent exposure in 134 pregnancies to lovastatin or simvastatin resulted in no increased risk of anomaly [1].
BREAST FEEDING: Contraindicated [G1]
NEONATAL SIDE EFFECTS:


1. Manson JM, Freyssinges C, Ducrocq MB, Stephenson WP: Postmarketing surveillance of lovastatin and simvastatin exposure during pregnancy. Reprod Toxicol 1996;10:439-66.MEDLINE

Magnesium
CATEGORY:B
BREAST FEEDING: Compatible [G3]
NEONATAL SIDE EFFECTS:


Marijuana
Hallucinogen
CATEGORY: Illicit drug.
The majority of studies have shown no increased rate of major or minor anomalies after in utero exposure to marijuana. One case-control study reported an increased rate of childhood acute nonlymphoblastic leukemia after prenatal exposure to marijuana. The authors of the study pointed out that the presence of herbicides or pesticides on the marijuana could not be ruled out.[1]. Reports on the effects of prenatal marijuana exposure on the length of gestation, fetal growth, and neurobehavioral effects are conflicting. Confounding factors such as possible impurities in the drug and concomitant tobacco smoking may be responsible for these inconsistent reports.
BREAST FEEDING: Excreted into breast milk. Contraindicated.
NEONATAL SIDE EFFECTS: None reported.


1.Robison LL et al.Maternal drug use and risk of childhood nonlymphoblastic leukemia among offspring. An epidemiologic investigation implicating marijuana (a report from the Childrens Cancer Study Group). Cancer. 1989; 63:1904-11.Medline

Mebendazole
CATEGORY:C
The manufacturer recommends against use in pregnancy . However, inadvertent exposure during first trimester has not resulted in an increased rate of spontaneous abortions nor congenital anomalies.
BREAST FEEDING: Compatible [G1]
NEONATAL SIDE EFFECTS:


Meclizine
CATEGORY:B
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Medroxyprogesterone (Depo-Provera ®,Provera ®)
CATEGORY:X
BREAST FEEDING: Compatible [G3]
NEONATAL SIDE EFFECTS: None reported.




Mefenamic acid (Ponstel)
Nonsteroidal Anti-Inflammatory
CATEGORY:C
All NSAIDs used near term may cause premature closure of the ductus arteriosus, and inhibit labor. Oligohydramnios after prolonged use is a common complication with NSAIDs as a class.
BREAST FEEDING: Excreted into human milk. Compatible [G3]
NEONATAL SIDE EFFECTS:


Meperidine
CATEGORY:B,D
All narcotics may produce withdrawal syndrome in neonates with prolonged use
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS: Possible lethargy


Mepindolol
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:Hypotension,bradycardia


Meprobamate
CATEGORY:D
BREAST FEEDING:Contraindicated,concentrated in milk
NEONATAL SIDE EFFECTS: Sedation


Mesalamine (Pentasa ®)
Anti-inflammatory agent for gastrointestinal use. 5-aminosalicylic acid
CATEGORY:B
1st trimester exposure in 242 infants resulted in no increase in major or minor anomalies.[1, 2]
BREAST FEEDING: The American Academy of Pediatrics has classified 5-aminosalicylic acid as a drug that "should be given to nursing mothers with caution" [G3].
NEONATAL SIDE EFFECTS: Diarrhea.


1.Diav-Citrin O, Park YH, Veerasuntharam G, Polachek H, Bologa M, Pastuszak A, Koren G. The safety of mesalamine in human pregnancy: a prospective controlled cohort study. Gastroenterology. 1998 Jan;114(1):23-8. MEDLINE
2. Marteau P, Tennenbaum R, Elefant E, Lemann M, Cosnes J.Foetal outcome in women with inflammatory bowel disease treated during pregnancy with oral mesalazine microgranules. Aliment Pharmacol Ther. 1998 Nov;12(11):1101-8. MEDLINE

Metformin (GLUCOPHAGE ®)
Blood Glucose Regulator
CATEGORY:B
No increase in anomaly rate above baseline for diabetic.
BREAST FEEDING: A small study of nursing mothers taking metformin (median dose of 1500 mg) found  the mean infant exposure to the drug was only 0.28% of the weight-normalized maternal dose. This is well below the 10% level of concern for breastfeeding [1]
NEONATAL SIDE EFFECTS: None reported [1]


1. Hale TW, Kristensen JH, Hackett LP, Kohan R, Ilett KF.Transfer of metformin into human milk.Diabetologia. 2002 Nov;45(11):1509-14.
MEDLINE



Methadone (Dolophine ®)
CATEGORY: Assigned to category C in past.
Presently carries the following precautions:

·  Safe use in pregnancy has not been established in relation to possible adverse effects on fetal development. Therefore, methadone should not be used in pregnant women unless, in the judgment of the physician, the potential benefits outweigh the possible hazards.
BREAST FEEDING:Compatible [G3].
NEONATAL SIDE EFFECTS:Sedation,withdrawal
All narcotics may produce withdrawal syndrome in neonates with prolonged use


Methimazole
CATEGORY:D
BREAST FEEDING: Compatible [G9].
NEONATAL SIDE EFFECTS: None reported with doses up to 20 mg daily[1].


1. Azizi F, Khoshniat M, Bahrainian M, Hedayati M.Thyroid function and intellectual development of infants nursed by mothers taking methimazole. J Clin Endocrinol Metab. 2000 Sep;85(9):3233-8.MEDLINE

Methotrexate (Methotrex ®, Rheumatrex ®)
Antineoplastic Agent
CATEGORY:X
BREAST FEEDING: Contraindicated [G3].
NEONATAL SIDE EFFECTS: Possible immune suppression


Methyldopa
CATEGORY:B
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS:


Methylphenidate (CONCERTA ™,RITALIN ®)
Respiratory and Cerebral Stimulant
CATEGORY:C
BREAST FEEDING: It is not known whether methylphenidate is excreted in human milk.
NEONATAL SIDE EFFECTS:




Methylprednisolone (Medrol®, Solu-Medrol®)

Metoclopramide (Reglan ®)
Treatment of emesis, gastric reflux, and gastroparesis
CATEGORY:B
BREAST FEEDING: The American Academy of Pediatrics has classified metoclopramide as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS:


Metoprolol
CATEGORY:C
BREAST FEEDING: Compatible [G3]. However, drug is concentrated in human milk.
NEONATAL SIDE EFFECTS: Observe infants for possible beta-blockade.


Metronidazole (Flagyl ®, Protostat ®)
Anti-infective Agent, Antiprotozoal and antibacterial.
CATEGORY:B
BREAST FEEDING:The American Academy of Pediatrics has classified metronidazole as a drug "for which the effect on nursing infants is unknown but may be of concern". Discontinue breastfeeding for 12-24 h to allow excretion of drug. [G3].
NEONATAL SIDE EFFECTS: Diarrhea


Miconazole
CATEGORY:C  [G1]
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Minoxidil
Antihypertensive Agent
CATEGORY:C
BREAST FEEDING: Compatible [G3].
NEONATAL SIDE EFFECTS: None.




Misoprostol (Cytotec®)
CATEGORY:X [1]

"Congenital anomalies sometimes associated with fetal death have been reported subsequent to the unsuccessful use of misoprostol as an abortifacient, but the drug's teratogenic mechanism has not been demonstrated. Several reports in the literature associate the use of misoprostol during the first trimester of pregnancy with skull defects, cranial nerve palsies, facial malformations, and limb defects.

Cytotec is not fetotoxic or teratogenic in rats and rabbits at doses 625 and 63 times the human dose, respectively"[1]

The American College of Obstetricians and Gynecologists states that misoprostol is an acceptable agent for the induction of labor. Misoprostol is not recommended for patients with prior uterine surgery [2].


BREAST FEEDING: The manufacturer recommends Cytotec should not be administered to nursing mothers because the potential excretion of misoprostol acid could cause significant diarrhea in nursing infants [1].



1. Physicians Desk Reference 57th ed. Montvale, NJ: Thomson PDR; 2003: 3111
2. ACOG Committee Opinion. Induction of Labor with Misoprostol. Number 228, November 1999. The American College of Obstetricians and Gynecologists, 409 12th Street SW PO Box 96920, Washington, DC 20090-6920

Mometasone (Elocon ®, Nasonex ® )
Anti-Inflammatory Agent, Topical dermatological or nasal spray
CATEGORY:C [1]
BREAST FEEDING: It is not known if mometasone furoate is excreted in human milk.
NEONATAL SIDE EFFECTS:


1. Physicians Desk Reference 57th ed. Montvale, NJ: Thomson PDR; 2003: 3054

Montelukast (Singulair® )
Leukotriene Receptor Antagonist
CATEGORY:B
ACOG and ACAAI suggest zafirlukast or montelukast "...could be considered in patients with recalcitrant asthma who have shown a uniquely favorable response prior to becoming pregnant."[1]
BREAST FEEDING: It is not known if montelukast is excreted in human milk.
NEONATAL SIDE EFFECTS:


1. The use of newer asthma and allergy medications during pregnancy. Position Statement. The American College of Obstetricians and Gynecologists (ACOG) and The American College of Allergy, Asthma and Immunology (ACAAI). Ann Allergy Asthma Immunol. 2000;84:475-480. MEDLINE

Morphine
CATEGORY: C, ( D in prolonged doses)  [G1]
All narcotics may produce withdrawal syndrome in neonates with prolonged use
BREAST FEEDING:Compatible [G3]
NEONATAL SIDE EFFECTS: Withdrawal, sedation


Nabumetone (RELAFEN®)
Nonsteroidal Anti-Inflammatory
All NSAIDs used near term may cause premature closure of the ductus arteriosus, and inhibit labor. Oligohydramnios after prolonged use is a common complication with NSAIDs as a class.
CATEGORY:C ( D third trimester)  [G1]
BREAST FEEDING: It is not known whether nabumetone or its metabolites are excreted in human milk. The manufacturer recommends Relafen not be administered to nursing mothers because of the possible adverse effects of prostaglandin-synthesis-inhibiting drugs on neonates. [1].
NEONATAL SIDE EFFECTS:


1. RELAFEN® tablets package insert, 2000.

Nalidixic acid (NegGram® )
Anti-infective;Quinolone
CATEGORY:C
BREAST FEEDING: Compatible [G9]
NEONATAL SIDE EFFECTS: Hemolysis in G6PD deficiency


Naproxen (Naprosyn® , Anaprox® )
Nonsteroidal Anti-Inflammatory
CATEGORY:B, (D in third trimester)[G1]
All NSAIDs used near term may cause premature closure of the ductus arteriosus, and inhibit labor. Oligohydramnios after prolonged use is a common complication with NSAIDs as a class.  Intrauterine exposure after 34 weeks has resulted in premature closure of the ductus arteriosus, renal dysfunction, and coagulopathy.
BREAST FEEDING: Compatible.[G3]
NEONATAL SIDE EFFECTS:




Nefazodone (Serzone® )
Antidepressant
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Nicotine (NICOTROL®,NICODERM®)
Smoking Cessation
CATEGORY:D[1]
Crosses placenta freely[2]
BREAST FEEDING: Compatible [3]. Passes into human breast milk [4, 5]

NEONATAL SIDE EFFECTS:


1. Physicians Desk Reference 57th ed. Montvale, NJ: Thomson PDR; 2003: 2776
2. Luck W, Nau H, Hansen R, Steldinger R. Extent of nicotine and cotinine transfer to the human fetus, placenta and amniotic fluid of smoking mothers. Dev Pharmacol Ther. 1985;8:384-95.MEDLINE
3. Dempsey DA, Benowitz NL. Risks and benefits of nicotine to aid smoking cessation in pregnancy.Drug Saf. 2001;24:277-322. MEDLINE
4. Dahlstrom A, Lundell B, Curvall M, Thapper L. Nicotine and cotinine concentrations in the nursing mother and her infant. Acta Paediatr Scand. 1990;79:142-7.MEDLINE
5. Luck W, Nau H.Nicotine and cotinine concentrations in serum and milk of nursing smokers.Br J Clin Pharmacol. 1984;18:9-15.MEDLINE
 

Nifedipine (Adalat® , Procardia® )
Antihypertensive Agent, Cardiac Drug
CATEGORY:C
BREAST FEEDING: Compatible [G3]
NEONATAL SIDE EFFECTS:


Nitrofurantoin (Furadantin® , Macrobid® , Macrodantin® )
Urinary Anti-Infective
CATEGORY:B
BREAST FEEDING: Excreted into breast milk. Compatible [1,G3]
NEONATAL SIDE EFFECTS: Hemolysis in G6PD deficiency [G3]


1.Pons G, Rey E, Richard MO, Vauzelle F, Francoual C, Moran C, d'Athis P, Badoual J, Olive G. Nitrofurantoin excretion in human milk. Dev Pharmacol Ther. 1990;14(3):148-52. MEDLINE

Nitroglycerin (NITROSTAT®, NITRO-DUR®, NITROLINGUAL®)
Vasodilating Agent
CATEGORY: B   [G1]
BREAST FEEDING: It is not known whether nitroglycerin is excreted in human milk.
NEONATAL SIDE EFFECTS:

Nizatidine (AXID® )
H2-receptor antagonist
CATEGORY:B
BREAST FEEDING: Excreted into breast milk. Compatible [1]
NEONATAL SIDE EFFECTS:


1. Hagemann TM. Gastrointestinal medications and breastfeeding. J Hum Lact. 1998;14:259-62. Review.PMID: MEDLINE
 



Nortriptyline (Aventyl ®, Pamelor ®)
Tricyclic antidepressant. Nortriptyline is a metabolite of amitriptyline.
CATEGORY: "Safe use of nortriptyline during pregnancy and lactation has not been established; therefore, when the drug is administered to pregnant patients, nursing mothers, or women of childbearing potential, the potential benefits must be weighed against the possible hazards"[G6].
BREAST FEEDING: The American Academy of Pediatrics has classified nortriptyline as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3]. The WHO Working Group on Human Lactation estimated that 2% of the maternal daily dose would be ingested by a breast feeding infant, and concluded that breastfeeding while taking this medication is probably safe.[G8].
NEONATAL SIDE EFFECTS: Possible urinary retention [1].


1.Shearer WT et al.: Urinary retention in a neonate secondary to maternal ingestion of nortriptyline. J Pediatr 81:570-2, 1972. MEDLINE

NSAID
CATEGORY:B or C in early pregnancy depending on compound.
CATEGORY:D near term .
NSAIDs used near term may cause premature closure of the ductus arteriosus, and inhibit labor. Oligohydramnios after prolonged use is a common complication with NSAIDs as a class.
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:


Nystatin, vaginal tablet
Antifungal
CATEGORY: C
BREAST FEEDING: Compatible.[G1].
NEONATAL SIDE EFFECTS: None reported.


Ofloxacin (Floxin ®)
Anti-infective;Quinolone
CATEGORY:C
BREAST FEEDING: The American Academy of Pediatrics has classified ofloxacin as a drug "Usually Compatible With Breastfeeding" [G3]. However, Briggs GG et al. do not consider this drug compatible with breast feeding, because of high excretion of this drug into human milk [G1].
NEONATAL SIDE EFFECTS: None reported.


Olanzapine (Zyprexa ®)
Antipsychotic. Monoaminergic antagonist
23 olanzapine-exposed pregnancies resulted in no increase in major or minor anomalies. However, the sample size is too small to draw firm conclusions [1].
CATEGORY:C
BREAST FEEDING: The manufacturer does not consider this drug to be compatible with breast feeding.
NEONATAL SIDE EFFECTS:


1.Goldstein DJ, Corbin LA, Fung MC. Olanzapine-exposed pregnancies and lactation: early experience. J Clin Psychopharmacol. 2000 Aug;20(4):399-403. MEDLINE

Olsalazine (Dipentum ®)
Anti-inflammatory agent for gastrointestinal use. Olsalazine is converted to mesalamine (5-aminosalicylic acid) in the colon.
CATEGORY:C
BREAST FEEDING: The American Academy of Pediatrics has classified 5-aminosalicylic acid as a drug that "should be given to nursing mothers with caution" [G3].
NEONATAL SIDE EFFECTS: May cause diarrhea.


Omeprazole (Prilosec ®)
Proton Pump Inhibitor. Used for control of stomach acid
CATEGORY:C
Although there are a number of case reports of fetal anomalies (anencephaly, hydranencephaly, and talipes) following the use of omeprazole [G1] large human studies have not supported an association between omeprazole and congenital defects[1-4].
BREAST FEEDING: A single case report suggests that there is minimal excretion of omeprazole into human breast milk [5]. Because of the limited data regarding the potential for serious adverse reactions in nursing infants from omeprazole, and because of the potential for tumorigenicity shown for omeprazole in rat carcinogenicity studies, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
NEONATAL SIDE EFFECTS:


1. Lalkin A, Loebstein R, Addis A, Ramezani-Namin F, Mastroiacovo P, Mazzone T, Vial T, Bonati M, Koren G. The safety of omeprazole during pregnancy: A multicenter prospective controlled study. Am J Obstet Gynecol 1998;179:727-30. MEDLINE
2. Kallen B: Delivery outcome after the use of acid-suppressing drugs in early pregnancy with special reference to omeprazole. Br J Obstet Gynaecol 105:877-881, 1998. MEDLINE
3.Ruigomez A, Garcia Rodriguez LA, Cattaruzzi C, Troncon MG, Agostinis L, Wallander MA, Johansson S. Use of cimetidine, omeprazole, and ranitidine in pregnant women and pregnancy outcomes. Am J Epidemiol 150:476-481, 1999. MEDLINE
4.Kallen BA. Use of omeprazole during pregnancy--no hazard demonstrated in 955 infants exposed during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2001 May;96(1):63-8. MEDLINE
5. Marshall JK, Thompson AB, Armstrong D. Omeprazole for refractory gastroesophageal reflux disease during pregnancy and lactation.Can J Gastroenterol. 1998 Apr;12(3):225-7. MEDLINE

Ondansetron (Zofran ®)


Oxacillin
Antibiotic, Penicillin
CATEGORY:B
First trimester exposure to penicillin derivatives in more than 3500 human pregnancies was not associated with an increased risk of congenital anomalies [G1]. The findings of a more recent small study did not find an increased risk of congenital anomaly after exposure to oxacillin during pregnancy [1].
BREAST FEEDING: Excreted into human breast milk.
NEONATAL SIDE EFFECTS: Possible diarrhea.


1.Czeizel AE, Rockenbauer M, Sorensen HT, Olsen J.Teratogenic evaluation of oxacillin. Scand J Infect Dis. 1999;31(3):311-2. MEDLINE

Oxaprozin (Daypro ®)
Nonsteroidal Anti-Inflammatory
CATEGORY:C
NSAIDs used near term may cause premature closure of the ductus arteriosus, and inhibit labor. Oligohydramnios after prolonged use is a common complication with NSAIDs as a class.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Oxazepam (Serax ®)
Anxiolytic. Metabolite of diazepam, prazepam and temazepam
CATEGORY:D
BREAST FEEDING: The WHO Working Group on Drugs and Human Lactation considers oxazepam compatible with breast feeding when taken by mothers in occasional small doses .[G8].
NEONATAL SIDE EFFECTS: Possible sedation and depression.


ADDITIONAL READING:

·  Benzodiazepines in Pregnancy
1999 Illinois Teratogen Information Service

Oxycodone (Oxyir ®, Oxyfast ®, OxyContin ®, Percolone®, Roxicodone®)

Paromomycin (Humatin ®)
Antibiotic, Aminoglycoside.Used in the treatment of intestinal parasites.
CATEGORY:C
In the absence of intestinal ulceration paromomycin is poorly absorbed [1].
BREAST FEEDING: Compatible with breast feeding. Because this drug is poorly absorbed orally high concentrations in breast milk would not be expected [G1].
NEONATAL SIDE EFFECTS: None reported.


1. Gardner TB, Hill DR.Treatment of giardiasis. Clin Microbiol Rev. 2001 Jan;14(1):114-28. Review. MEDLINE



Paroxetine (Paxil ®)
Antidepressant
CATEGORY:C
Limited human data suggests no increased rate of anomaly. However, there is insufficient data on possible behavioral teratogenic effects .
BREAST FEEDING: Excreted into breast milk. Compatible [1]. The American Academy of Pediatrics has classified paroxetine as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS: Neonatal withdrawal syndrome has been reported after third trimester in utero exposure [2] .


1. Begg EJ, Duffull SB, Saunders DA, Buttimore RC, Ilett KF, Hackett LP, Yapp P, Wilson DA. Paroxetine in human milk. Br J Clin Pharmacol. 1999 Aug;48(2):142-7. MEDLINE
2. Nordeng H, Lindemann R, Perminov KV, Reikvam A. Neonatal withdrawal syndrome after in utero exposure to selective serotonin reuptake inhibitors. Acta Paediatr. 2001 Mar;90(3):288-91. MEDLINE

ADDITIONAL READING:

·  Paxil (PDF file)
2000 Organization of Teratology Information Services

Penicillamine
CATEGORY:D
BREAST FEEDING: Contraindicated [1,2]
NEONATAL SIDE EFFECTS:

SEARCH LITERATURE

1. Ostensen M. Treatment with immunosuppressive and disease modifying drugs during pregnancy and lactation. Am J Reprod Immunol. 1992 ;28:148-52.MEDLINE
2. Copper disposition of the fetus and placenta in a patient with untreated Wilson's disease. Am J Obstet Gynecol. 1993;169:196-8.MEDLINE

Penicillin
CATEGORY:B
BREAST FEEDING: Compatible [1]
NEONATAL SIDE EFFECTS: Rash, diarrhea


1. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984;5(2):57-60.MEDLINE

Pentazocine (Talwin ®)
CATEGORY: C, D*
BREAST FEEDING: It is not known whether this drug is excreted in human milk.
NEONATAL SIDE EFFECTS:


*All narcotics may produce withdrawal syndrome in neonates with prolonged use.

Permethrin (Elimite ®, Acticin ®)
Scabicide, topical
CATEGORY:B
BREAST FEEDING: Compatible [1]
NEONATAL SIDE EFFECTS:


1. Clinical Effectiveness Group (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Disease). National guidelines for the management of scabies. Sex Transm Inf 1999;75:S76-7 (PDF file)

Phenobarbital
CATEGORY:D
BREAST FEEDING:The American Academy of Pediatrics has classified phenobarbital as a drug that has been associated with significant effects on some nursing infants and should be given to nursing mother with caution.[G3].
NEONATAL SIDE EFFECTS: Sedation, rash, withdrawal, methemoglobinemia [G3]




Phenothiazines (Chlorpromazine, prochlorperazine, promethazine)
CATEGORY:C
BREAST FEEDING: See individual agents.
NEONATAL SIDE EFFECTS:


Phentermine (Adipex ®, Fastin ®, Ionamin ®, Zantryl ®)
Sympathomimetic amine chemically related to amphetamine. Used as appetite suppressant.
CATEGORY:C. Safe use in human pregnancy has not been established. However, a small controlled prospective cohort study of 98 pregnancies found no increased risk of spontaneous pregnancy loss, or of major or minor anomalies after first trimester exposure to the combination phentermine/fenfluramine [1].
BREAST FEEDING: It is not known whether phentermine is excreted into human milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
NEONATAL SIDE EFFECTS:


1. Jones KL, Johnson KA, Dick LM, Felix RJ, Kao KK, Chambers CD.Pregnancy outcomes after first trimester exposure to phentermine/fenfluramine. Teratology. 2002;65:125-30. MEDLINE

ADDITIONAL READING:

·  Phentermine(PDF file)
2000 Organization of Teratology Information Services

Phenylpropanolamine
The FDA has requested that all drug companies discontinue marketing products containing phenylpropanolamine, because of an association between phenylpropanolamine and an increased risk of hemorrhagic stroke in women.

First trimester exposure has been associated with a statistically significant increased rate of eye and ear malformations [G10].
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


ADDITIONAL READING:

·  Over the Counter Cold Medications in Pregnancy
1998 Illinois Teratogen Information Service

Phenytoin (Dilantin ®)
Anticonvulsant
CATEGORY:D
Fetal Hydantoin Syndrome: Cardiac defects, dysmorphic craniofacial features, hypoplastic nails, and distal phalanges, intrauterine growth restriction, and microcephaly. Mental retardation may be seen when the full syndrome is present.

·  Up to 30% of exposed fetuses may have anomalies; The full syndrome occurs in 10% of exposed fetuses [1].

·  Fetuses with low activity of the enzyme microsomal epoxide hydrolase appear to be at highest risk for developing the syndrome. [2].
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS: Rare methemoglobinuria


1.Teratology. ACOG technical bulletin number 236--April 1997
2. Buehler BA et al.,Prenatal prediction of risk of the fetal hydantoin syndrome. N Engl J Med 322:1567, 1990 MEDLINE

Pindolol (Visken ®)
Hypotensive agent, beta-adrenergic blocking agent
CATEGORY:B
BREAST FEEDING: The manufacturer does not consider pindolol to be compatible with breast feeding.
NEONATAL SIDE EFFECTS: Possible hypotension, bradycardia


Piroxicam (Feldene ®)
Nonsteroidal Anti-Inflammatory
CATEGORY:C
NSAIDs used near term may cause premature closure of the ductus arteriosus, and inhibit labor. Oligohydramnios after prolonged use is a complication with NSAIDs as a class.
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:




Potassium Chloride (K-Dur ®)
CATEGORY: C
BREAST FEEDING: Compatible [G1].  
NEONATAL SIDE EFFECTS:


Potassium Iodide (PIMA ®)
Expectorant
CATEGORY:D
Crosses placenta. Prolonged use may cause hypothyroidism in the fetus.
BREAST FEEDING: Compatible [G9].
NEONATAL SIDE EFFECTS: Goiter, allergic reactions


Pravastatin (Pravachol ®)
Antilipemic Agent, HMG-CoA reductase inhibitor
CATEGORY:X
BREAST FEEDING: Contraindicated [G1].
NEONATAL SIDE EFFECTS:


Prednisone (Deltasone ®)
Corticosteroid
CATEGORY:" The use of these drugs (corticosteroids) in pregnancy, nursing mothers or women of childbearing potential requires that the possible benefits of the drug be weighed against the potential hazards to the mother and embryo or fetus."[G6].

·  Many older studies including a surveillance study of Michigan Medicaid recipients do not support an association between prenatal prednisone exposure and congenital anomalies[G1]. However, more recent studies suggest a possible increased risk of oral cleft when prednisone is used during the first trimester in humans [1,2].
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS: Infants born of mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.


1. Carmichael SL; Shaw GM: Maternal corticosteroid use and risk of selected congenital anomalies. Am J Med Genet 1999;86:242-4. MEDLINE
2.Park-Wyllie L, Mazzotta P, Pastuszak A, Moretti ME, Beique L, Hunnisett L, Friesen MH, Jacobson S, Kasapinovic S, Chang D, Diav-Citrin O, Chitayat D, Nulman I, Einarson TR, Koren G. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology. 2000 Dec;62(6):385-92. MEDLINE

ADDITIONAL READING:

·  Corticosteroids in Pregnancy
2000 Illinois Teratogen Information Service

Premarin (Conjugated estrogen)
CATEGORY:X
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Primidone
Anticonvulsant
CATEGORY:D
BREAST FEEDING: The American Academy of Pediatrics has classified primidone as a drug that has been associated with significant effects on some nursing infants and should be given to nursing mother with caution.[G9].
NEONATAL SIDE EFFECTS: Sedation.




Procainamide
CATEGORY:C
BREAST FEEDING: Compatible With Breastfeeding[G9].
NEONATAL SIDE EFFECTS:


Prochlorperazine (Compazine ®)
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS: Possible sedation.


Progesterone (Prometrium ®)
CATEGORY:B
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:


Promethazine
CATEGORY:C
BREAST FEEDING: With caution
NEONATAL SIDE EFFECTS:


Propanolol
CATEGORY:C
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:Hypotension,bradycardia


Propoxyphene
CATEGORY:C
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS: Withdrawal


Propylthiouracil
CATEGORY:D
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS: Potential for hypothyroidism




Pseudoephedrine (Sudafed ®)

Pyrantel pamoate
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Pyridostigmine
CATEGORY:C
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:


Pyridoxine
CATEGORY: A
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:


Pyrimethamine
CATEGORY:C
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS: Vomiting, marrow suppression


Quinapril (Accupril®)
Antihypertensive; ACE inhibitor
CATEGORY: C first trimester
CATEGORY: D second and third trimesters
2nd and 3rd trimester ACE inhibitor exposure is associated with hypocalvaria, and renal defects related to fetal hypotension and decreased renal perfusion. The latter may result in oligohydramnios.
BREAST FEEDING: Excreted into human milk. Compatible [1].
NEONATAL SIDE EFFECTS:


1.Begg EJ, Robson RA, Gardiner SJ, Hudson LJ, Reece PA, Olson SC, Posvar EL, Sedman AJ. Quinapril and its metabolite quinaprilat in human milk. Br J Clin Pharmacol. 2001 May;51(5):478-81. MEDLINE

Quinidine
CATEGORY:C
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:Anemia,rash,arrhythmias,optic neuritis




Raloxifene (Evista ®)
Selective estrogen receptor modulator (SERM)
CATEGORY:X
BREAST FEEDING: Contraindicated
NEONATAL SIDE EFFECTS:


Ramipril (Altace ®)
Antihypertensive; ACE inhibitor
CATEGORY: C first trimester
CATEGORY: D second and third trimesters
2nd and 3rd trimester ACE inhibitor exposure is associated with hypocalvaria, and renal defects related to fetal hypotension and decreased renal perfusion. The latter may result in oligohydramnios.
BREAST FEEDING: Excreted into human milk. The manufacturer does not consider this drug to be compatible with breast feeding.
NEONATAL SIDE EFFECTS:


Ranitidine (Zantac ®)
Treatment of peptic disorders, Antihistamine (H2 Receptor Antagonist)
CATEGORY:B
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS: Reduces gastric acidity


Reserpine
Antihypertensive Agent
CATEGORY:C
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:Galactorrhea


Rifampin
Antituberculosis Agent
CATEGORY:C
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:


Risperidone (Risperdal ®)
Antipsychotic, Antimanic
CATEGORY: C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Rofecoxib (Vioxx ®)
Nonsteroidal Anti-Inflammatory, cyclooxygenase-2 inhibitor
CATEGORY: C
Animal studies showed a treatment dependent decrease in the diameter of the ductus arteriosus. No delay in labor or parturition was seen. There is no data on the use of rofecoxib during human pregnancy.
BREAST FEEDING:
NEONATAL SIDE EFFECTS:




Salmeterol xinafoate (Serevent Diskus ®)
 

Secobarbital
CATEGORY:D
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS: Withdrawal


Sertraline (Zoloft®)
 

Simethicone

Simvastatin (Zocor ®)
Antilipemic Agent, HMG-CoA reductase inhibitor
CATEGORY:X
Inadvertent exposure in 134 pregnancies to lovastatin or simvastatin resulted in no increased risk of anomaly [1].
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


1. Manson JM,et al.Postmarketing surveillance of lovastatin and simvastatin exposure during pregnancy.Reprod Toxicol; 10,439,1996 MEDLINE

Sulbactam
CATEGORY:B
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:




Spironolactone
CATEGORY:C
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:


Sulfapyridine/sulfisoxazole
CATEGORY:C
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS: Caution in infant with jaundice or G-6-PD deficiency and ill, stressed, or premature infant.


Sulfasalazine
CATEGORY:B
BREAST FEEDING: With caution.[G3].
NEONATAL SIDE EFFECTS: Bloody diarrhea.


Sumatriptan
CATEGORY:C
BREAST FEEDING: Negligible excretion into breast milk. Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:


Technitium-99m
CATEGORY:X
BREAST FEEDING: Contraindicated Radioactivity in milk for 3 days
NEONATAL SIDE EFFECTS:


Temazepam (Restoril ®)
CATEGORY:X
Stillbirth has been reported following the use of diphenhydramine and temazepam in combination during human pregnancy [G1 ].
BREAST FEEDING: The American Academy of Pediatrics has classified temazepam as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS: Irritability


Terbinafine (Lamisil ®)
Antifungal
CATEGORY:B
BREAST FEEDING: Excreted into breast milk. Contraindicated.
NEONATAL SIDE EFFECTS:


Terbutaline (Brethine ®)
CATEGORY:B
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS: Agitation and vomiting


Terfenadine (Seldane ®)

Tetanus Toxoid

Tetracycline


Theophylline
CATEGORY:C
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS: Irritability


Thioridazine
CATEGORY:C
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:


Thyroid hormone
CATEGORY:A
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:


Ticarcillin
CATEGORY:B
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS: Diarrhea




Timolol
CATEGORY:C
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:Hypotension,bradycardia


Tinidazole
CATEGORY:C
BREAST FEEDING: The American Academy of Pediatrics has classified tinidazole as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].

NEONATAL SIDE EFFECTS: SeeMetronidazole

Tobramycin
CATEGORY:D
BREAST FEEDING:
NEONATAL SIDE EFFECTS: Diarrhea


Tolbutamide
CATEGORY:C
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS: Jaundice, hypoglycemia


Tolmetin
CATEGORY:C
See NSAIDS
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:


Topiramate (Epitomax®, Topamax ®)


Tramadol (Ultram ®)
CATEGORY:C
No human data. Transient developmental delay seen in animal studies.
BREAST FEEDING: Not recommended. Excreted into breast milk in high concentrations.
NEONATAL SIDE EFFECTS:


Trazodone (Desyrel®)

Triamcinolone acetonide (Azmacort ®)
Corticosteroid, Inhalation Aerosol
CATEGORY:C

BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Triamterene (Dyazide ®)
Antihypertensive, Diuretic
CATEGORY:C
1st trimester exposure in 318 infants resulted in no increase in major or minor anomalies.
BREAST FEEDING: Contraindicated.
NEONATAL SIDE EFFECTS:


Trifluoperazine (Stelazine  ®)
Tranquilizer
CATEGORY:C
BREAST FEEDING: The American Academy of Pediatrics has classified trifluoperazine as a drug "for which the effect on nursing infants is unknown but may be of concern" [G3].
NEONATAL SIDE EFFECTS:


Trimethobenzamide (Tigan  ®)
Antiemetic
CATEGORY:C
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:




Trimethoprim/sulfamethoxazole (Bactrim ®)
Anti-Infective
CATEGORY:C

Folic acid antagonists, which include such common drugs as trimethoprim, triamterene, carbamazepine, phenytoin, phenobarbital, and primidone, may increase the risk not only of neural-tube defects, but also of cardiovascular defects, oral clefts, and urinary tract defects.


BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:


1. Czeizel AE, et al The teratogenic risk of trimethoprim-sulfonamides: a population based case-control study.
Reprod Toxicol. 2001 Nov-Dec;15(6):637-46.
PMID: 11738517 MEDLINE

Hernandez-Diaz SFolic acid antagonists during pregnancy and the risk of birth defects.
N Engl J Med. 2000 Nov 30;343(22):1608-14.
PMID: 11096168

Neural tube defects in relation to use of folic acid antagonists during pregnancy.
Am J Epidemiol. 2001 May 15;153(10):961-8.
PMID: 11384952

Created: 11/17/2000
Last Update: 11/30/2002

Triprolidine
CATEGORY:C


BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:


Troglitazone (Rezulin®)
Antidiabetic Agent
CATEGORY:B
BREAST FEEDING: Contraindicated.
NEONATAL SIDE EFFECTS:


TylenolCold ®

Vaccine, Anthrax Adsorbed (BioThrax TM )

Vaccine, Cholera

Vaccine,Haemophilus B Conjugate

Vaccine, Hepatitis A

Vaccine, Hepatitis B

Vaccine, Influenza

Vaccine, Measles

Vaccine, Meningococcus

Vaccine, Mumps

Vaccine, Plague

Vaccine, Pneumococcal

Vaccine, Poliovirus Inactivated

Vaccine, Poliovirus Live

Vaccine, Rabies

Vaccine, Rubella (MERUVAX®II)

Vaccine,TC-83 Venezuelan Equine Encephalitis

Vaccine, Typhoid

Vaccine, Vaccinia - Smallpox, (Dryvax ®)

Vaccine,Varicella (Varivax ®)

Vaccine, Yellow Fever

Valproic acid
CATEGORY:D
Incidence of neural tube defect (spina bifida) after first trimester exposure is approximately 1% [1].
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:Hepatitis,hemorrhagic pancreatitis


1.Teratology. ACOG technical bulletin number 236--April 1997

Vancomycin
CATEGORY:C
BREAST FEEDING:
NEONATAL SIDE EFFECTS:


Vegetarian Diet
-
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:B12 deficiency


Venlafaxine (Effexor ®)


Verapamil
CATEGORY:C
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:


Vitamin A
CATEGORY:A
CATEGORY:X in high doses.
High doses produce urogenital anomalies and defects similar to isotretinoin
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:


ADDITIONAL READING:

·  Vitamin A and Pregnancy
1996 Illinois Teratogen Information Service

Vitamin B12
CATEGORY:C
BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:


Vitamin D

BREAST FEEDING: Compatible
NEONATAL SIDE EFFECTS:Hypercalcemia


Warfarin (Coumadin ®)
CATEGORY:D
Anticoagulant
Embryopathy: Nasal hypoplasia, stippling of secondary epiphysis, IUGR, anomalies of eyes, hands, neck, and CNS. Up to 25% risk of an affected infant following exposure until the 14th week of pregnancy. Later exposure is associated with fetal hemorrhage, abruption, and stillbirth [1].
BREAST FEEDING: Compatible With Breastfeeding[G3].
NEONATAL SIDE EFFECTS:


1.Teratology. ACOG technical bulletin number 236--April 1997



Zidovudine
CATEGORY:C
BREAST FEEDING: Breast feeding is contraindicated in HIV infection
NEONATAL SIDE EFFECTS:


 

 

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