DON’T EVER USE These Medications When You Are Pregnant!

Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. These expert reports are free of charge and can be saved and shared.

Note: always follow your doctor’s instructions. Never change your medication regimen on your own.

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During pregnancy, taking medications brings a whole new level of stress. Rest assured, however, that many medications are safe during pregnancy and being pregnant doesn’t mean you need to avoid every prescription and nonprescription drug. Your healthcare provider and your pharmacist are excellent resources for understanding how medications affect you and your unborn baby. The FDA and drug manufacturers also provide helpful resources for deciding what is safe during pregnancy.

While you will be able to safely take many medications for a variety of aches, pains, illnesses, and conditions, below is a list of medications that are known to be harmful to developing babies. This list is not inclusive and does not include medications that are not available in the United States.

Dermatology

Acne medications, such as isotretinoin, can cause cardiac and brain defects and physical abnormalities in developing fetuses.

Oral tetracycline antibiotics, such as doxycycline (Doryx, Vibramycin, and others), are also used to treat acne. These medications can cause permanent discoloration of a baby’s teeth.

Infections and immune therapy

Antifungal medications, such as fluconazole (Diflucan), can be prescribed for vaginal fungal infections. Long-term use of high doses of this drug during the first trimester of pregnancy can result in physical deformities and congenital heart disease in the baby. If you need treatment for a vaginal yeast infection, check with your doctor about the dose and length of treatment.

Fluoroquinolone antibiotics, such as ciprofloxacin (Cipro) and levofloxacin (Levaquin), may damage a developing baby’s muscle and skeletal growth. They may also increase the risk of miscarriage.

Primaquine is used to treat malaria. There are not a lot of human data available with primaquine during pregnancy, but limited evidence shows that it can damage fetal blood cells.

Trimethoprim (a component of Bactrim, Septra, and others) can cause neural tube defects in a developing baby.

Ribavirin (Rebetol, Ribasphere) is used to treat chronic hepatitis C infections. It should not be taken by women who are pregnant or by male sexual partners of women who are pregnant. Both men and women should avoid pregnancy for 6 months after exposure to ribavirin.

Methotrexate (Trexall, others) and leflunomide (Arava) are used to treat rheumatoid arthritis and other immune disorders. They should not be taken during pregnancy because they can cause miscarriage and severe birth defects.

Cardiovascular drugs

Warfarin (coumadin) prevents blood clots and can be used in the treatment of atrial fibrillation. If taken during the first trimester of pregnancy, it can cause serious defects in the baby, as well as spontaneous abortion. Other drugs for atrial fibrillation, including dabigatran (Pradaxa) and apixaban (Eliquis), should also be avoided during pregnancy. If you need long-term anticoagulation therapy, talk to your doctor about an alternative drug during pregnancy.

Cholesterol-lowering drugs called “statins”, such as atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor), are not safe during pregnancy because they have been determined to cause birth defects.

ACE inhibitors, which lower blood pressure, including benazepril (Lotensin) and lisinopril (Prinivil, Zestril), should be avoided during pregnancy because they can damage a developing fetus’s kidneys.

Pain and musculoskeletal drugs

Except in rare cases, opioids should be avoided during pregnancy. They can cause birth defects and can lead to symptoms of withdrawal in newborns.

Aspirin and anti-inflammatory drugs should not be taken during certain trimesters of pregnancy, but they may be safe in some instances. Read about pain relievers that are safe during pregnancy here.

Ergotamine and dihydroergotamine are used to treat migraine. They cause uterine contractions, fetal distress, and miscarriage and should be avoided during pregnancy.

Hormone therapy

Oral contraceptives and steroid hormones, especially those intended to improve fertility, should be avoided during pregnancy. All gonadotropin, antigonadotropins, growth hormone-releasing factors, prostaglandin analogs, and selective estrogen receptor modulators such as clomiphene and raloxifene should be avoided during pregnancy.

Testosterone 5-alpha reductase inhibitors such as dutasteride (Avodart) and finasteride (Propecia) are used to treat enlarged prostate in men. These drugs are not safe for pregnant women and should not even be handled by women who are pregnant or breastfeeding.

Mifepristone (Mifeprex) is an abortion-inducing drug and should be avoided during pregnancy.

Mental health and neurology

Benzodiazepines, such as alprazolam (Xanax) and diazepam (Valium), can treat seizures, panic disorders, anxiety, and other mental health conditions, as well as insomnia. These can cause birth defects in fetuses and may cause the baby to have symptoms of withdrawal after birth. Some benzodiazepines may be used by certain women under specific circumstances: talk to your doctor or pharmacist if you have any questions.

Remember, this is not a complete list of drugs that should be avoided during pregnancy. Talk to your doctor or pharmacist if you have any questions or concerns about how medications will affect your growing baby. Additionally, if you are already taking one of these medications and are planning to get pregnant, or didn’t know you were pregnant when you were still taking it, talk to your doctor about the best treatment plan and follow-up care that is needed.

Jennifer Gibson
Dr. Jennifer Gibson earned a Bachelor of Science degree in Biochemistry from Clemson University and a Doctor of Pharmacy degree from the Medical College of Virginia School of Pharmacy at Virginia Commonwealth University. She trained as a hospital pharmacist and is the author of clinical textbooks, peer-reviewed journal articles, and continuing education programs for the medical community, as well as a contributor to award-winning healthcare blogs and websites. In her free time, she enjoys running, reading, traveling, and spending time with her family.

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