Pregnant/Breast feeding
All drugs cab diffuse across the placenta some foetal exposure will occur.
Drugs can affect the pregnancy (eg teratogenicity; increased risk for complications) and the pregnancy can affect the drugs (eg Vd is decreased by about 20%; albumin concentrations decrease).
FDA classification of drugs:
• Category A – controlled studies in animals and women have not shown risk
• Category B – animal studies have not shown risk but there is no controlled studies in pregnant women OR animal studies have shown risk but controlled studies in women have not (eg paracetamol; NSAID’s)
• Category C – animal studies have shown risk but studies in women have not done so (eg antihistamines)
• Category D – positive evidence of some human risk but benefits may in some circumstances outweigh risk (eg diuretics; warfarin)
• Category X – too dangerous/contraindicated (eg thalidomide)
General advice:
• avoid all drugs, if possible, especially during first trimester
• use drugs with greatest track record of safety and least toxicity
• use shorter courses and lowest doses
Drugs in human milk:
• all drugs diffuse in varying amounts into breast milk by passive diffusion
• risk is related to the dose, the plasma concentration in the infant and the toxicity of that plasma concentration
General advice:
• avoid drugs if possible
• feed baby prior to next dose
• alternative breast and bottle feeding to reduce possible dose
We have not yet got to this page to finish it yet. We will eventually. Please contact us if you have something to contribute to it or sign up for our newsletter or like us on Facebook and Instagram or follow us on Twitter. |
Page last updated:
Comments are closed.