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Pregnancy and Lactation

I have been receiving requests for information regarding the safety of various drugs in pregnancy and lactation.  First of all, medications are grouped into 1 of 5 categories  based on the potential for producing birth defects. The categories are A, B, C, D and X.  Generally speaking, drugs that fall into either class A or B are considered safe and are routinely used.  There may be exceptions.

Category A: Controlled studies in pregnant women fail to demonstrate a risk to the fetus in the first trimester with no evidence of risk in later trimesters. The possibility of harm appears remote.

Category B: Presumed safety based on animal studies, with no controlled studies in pregnant women, or animal studies have shown an adverse effect that was not confirmed in controlled studies in women in the first trimester and there is no evidence of a risk in later trimesters.

Category C:  Studies in women and animals are not available or  studies in animals have revealed adverse effects on the fetus and there are no controlled studies in women. Drugs should be given only if the potential benefits justify the potential risk to the fetus.

Category D: There is positive evidence of human fetal risk (unsafe), however in some cases such as a life-threatening illness the potential risk may be justified if there are no other alternatives.

Category X: Highly unsafe: risk of use outweighs any potential benefit. Drugs in this category are contraindicated in women who are or may become pregnant.

Drug List

This is an abbreviated list of medications that are usually considered safe during pregnancy. Always consult your health care provider before taking any medication. A comprehensive reference can be found by clicking on the image found below this table. Once you reach this site, select a drug from the drop-down list and then hit search. This reference will list not only the pregnancy category listed above, but also whether or not the drug is safe when breast feeding. 
Acetaminophen
(Tylenol)
azithromycin
(Zithromax)
bisacodyl (Dulcolax) Cephalosporins: Ancef, Duricef, Keflex, Ceclor, Ceftin, others..)
clotrimazole (Mycelex) docusate (Colace) erythromycin (base and EES) not estolate guaifenesin (Robitussin)
insulin levothyroxine (Synthroid) methyldopa (Aldomet) nystatin
Penicillins (dicloxacillin, amoxicillin, ampicillin) pyridoxine simethicone terbutaline
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Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer
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