Medications used during pregnancy and breastfeeding. Each chapter contains twofold information regarding drugs that are appropriate for prescription during pregnancy and an assessment of the risk of a drug when exposure during pregnancy. Particularly, the use of psy chotropic drugs during pregnancy seems to attract attention. Drugs during pregnancy and lactation 3rd edition elsevier. The fact that not all antirheumatic medications can be continued safely during pregnancy lactation and many women have unplanned pregnancies when on inappropriate drugs makes management complicated. Drug use during pregnancy and lactation is an almost inevitable event. An alternative to this drug should be prescribed during pregnancy or in women of childbearing potential. Since it is not a complete list, patients are advised to check the drug label of each drug before taking them during pregnancy. Weiner, md, mba this is the second of a twopart series on the use of medication during pregnancy and lactation. Thus, the practical view to take when prescribing drugs during pregnancy is that the transfer of drugs to the fetus is inevitable.
A reference guide to fetal and neonatal risk lists more than 1,200 commonly prescribed drugs taken during pregnancy and lactation, with detailed monographs that provide the information you need on known or possible effects on the mother, embryo, fetus, and nursing infant. A reference guide to fetal and neonatal risk drugs in pregnancy and lactation solution lippincott williams wilkins ebook. Most medicines are assigned one of five fda pregnancy categories to help identify the potential level of risk. Mothertobaby, a service of the nonprofit organization of teratology information specialists, is dedicated to providing evidencebased information to mothers, health care professionals, and the general public about medications and other exposures during pregnancy and while breastfeeding. Changes during pregnancy, drugs used in pregnancy and their side effects, drugs used in lactation. Use of a single medication at a higher dose is favored over the use of multiple medications for the treatment of psychiatric illness during pregnancy. Each chapter contains twofold information regarding drugs that are appropriate for prescription during pregnancy and an assessment of the risk of a drug when exposure during pregnancy has already occurred. A recent world health organization who international study involving 14,778 pregnant women from 22 countries revealed 86% of these women took medications during pregnancy. Medication guidelines for obstetrics and gynaecology.
The physiologic alterations of pregnancy may affect the absorption, distribution, metabolism, and elimination of lithium, and close monitoring of lithium levels during pregnancy and postpartum is. Almost every pregnant woman will face a decision about taking medicines before and during pregnancy. Navigate quickly to additional resources for pregnancy and breastfeeding. During pregnancy, a womans gastric ph is increased and gastric motility is. Use of psychotropic drugs during pregnancy and breast. Drugs during pregnancy and lactation, 3rd edition is a quick and reliable reference for all those working in disciplines related to fertility, pregnancy, lactation, child health and human genetics who prescribe or deliver medicinal products, and to those who evaluate health and safety risks.
On the other hand, the placenta, like other organ barriers, contains efflux transporters that may prevent substantial transfer of particular substances to the fetus. Pdf drugs in pregnancy and lactation ebook education. Drugs in pregnancy and lactation medicinescomplete. Drugs in pregnancy motherisks published studies on the safety or risk of specific drugs during pregnancy drugs in pregnancy and lactation. In clinical practise, safety concerns regarding medications must be weighed against the risk of undertreating women in pregnancy. Drug use during pregnancy and lactation pregnancy heart. State of research on medications used during pregnancy and. Drugs during pregnancy and lactation, 3 rd edition is a quick and reliable reference for all those working in disciplines related to fertility, pregnancy, lactation, child health and human genetics who prescribe or deliver medicinal products, and to those who evaluate health and safety risks.
An understanding of the principles underlying the transfer into breast milk is important, as is an awareness of the potential adverse effects on the infant. The updated 11th edition of drugs in pregnancy and lactation. Drugs with minimal or unknown human teratogenic effect catalin s. There are very few kinds of treatment during which breastfeeding is absolutely contraindicated. Pregnancy and lactation labeling drugs final rule fda. Currently available fact sheets are listed below by category of exposure. This book is based on a survey of the literature on drug risks during.
Drugs during pregnancy and lactation, 3rd edition is a quick and reliable reference for all those working in disciplines related to fertility, pregnancy, lactation, child health and human genetics. No rational indication for use during pregnancylactation andor teratogen or prenatal toxic or. It is a regulatory fact that only 14 drugs are approved for use during pregnancy. Some medicines may cause birth defects, pregnancy loss, prematurity, infant death, or developmental disabilities. Talk directly to the experts behind the most uptodate research. Provides conclusive information on the prevention of birth defects through the safe use of drugs before pregnancy, as well as during pregnancy and lactation. Essential new information on herbs, vitamins, and nutrition supplements used during pregnancy. Listed below are some safe drugs and some harmful drugs in pregnancy. Drugs contraindicated during breastfeeding include anticancer drugs, lithium, oral retinoids, iodine, amiodarone and gold salts. The use of medications in pregnancy should be evaluated for the benefits. Discuss the physiological changes occurring in pregnancy that affect the pharmacodynamics and pharmacokinetics in mother. Judicious amounts of oral narcotic pain medications. Some of the drugs may have adverse effects on the baby on exposure.
Breastfeeding and maternal medication 1 introduction often there is a need to decide whether a mother who is breastfeeding and who needs treatment with drugs can take the necessary medication and still continue breastfeeding safely. It drives decision making by providing expert analysis and essential evidencebased information, listing nearly 1,200 commonly prescribed drugs taken during pregnancy and lactation. Substance use in women national institute on drug abuse. Define a teratogen and list important teratogenic drugs. Benadryl, claritin, tylenol sinus medication, and zyrtec. Pregnancy and lactation food and drug administration. Pregnancy risk factors together with an increased incidence of chronic diseases and the rise. An update on selected topics, external icon indicates that most medications and immunizations are safe to use during lactation. A reference guide to fetal and neonatal risk classic text by briggs gg, freeman rk, yaffe s. It is therefore necessary for the physician to be aware. In this situation the risks associated with drug exposure to the fetus and newborn need to be balanced against the risks incurred by seizures, and knowledge of pharmacokinetic alterations becomes. Drugs are placed in different risk categories based on available studies in humans and animals see table 1.
This was surpassed during the intrapartum period, where 79% of women received an average of 3. This use continues unabated during pregnancy and lactation. Drugs in pregnancy and lactation, sixth edition pdf free. During lactation, misclassification of drug risk may lead to the advice to stop breastfeeding, even though the drug in question is acceptable or alternatives appropriate for the breastfeeding period are available. During pregnancy, a womans gastric ph is increased and gastric motility is reduced which may interfere with the rate and extent of medication absorption. Drug use during pregnancy and lactation free download as powerpoint presentation.
A 20 clinical report by the american academy of pediatrics aap, the transfer of drugs and therapeutics into human breast milk. Most over the counter allergy meds are okay including. May cause withdrawal symptoms in nursing infants, lethargy and weight loss, so should be avoided during lactation. However, not all medicines are safe to take during pregnancy.
Consumer version the trusted provider of medical information since 1899. Discuss the principles of prescribing drugs during pregnancy, lactation and menstruation. The use of antithyroid drugs in pregnancy and lactation. Some medicines are safe to take during pregnancy while other medicines may have adverse effects on the unborn baby. Breastfeeding and maternal medicationpdf file world health. No wellcontrolled human data but reported to cause congenital hypothyroidism and goiter. Purchase drugs during pregnancy and lactation 3rd edition.
There are more than 6 million pregnancies in the united states every year, 5 and about 9 out of 10 pregnant women take medication. Heavy reliance upon pregnancy categories often led to misinterpretation of the information. Many changes are happening to her body that may affect the pharmacology of medications. Drugs during pregnancy and lactation sciencedirect. Home exposures drugs in pregnancy and breast feeding. Review of antithyroid drug use during pregnancy and report of a case of aplasia cutis. Conveying the benefits and risks of drug products in the prescription drug. Is it safe for mothers to use prescription medications while breastfeeding. With the use of antiepileptic drugs aeds for other indications, the proportion of women taking aeds during pregnancy and lactation is substantial. Medications in pregnancy and breastfeeding sciencedirect. Chronic maternal use of the drug throughout pregnancy can cause neonatal withdrawal. Mothertobaby fact sheets are available in both english and spanish and can be downloaded for free.
Fda pregnancy categories and the new rule in december 2014, the federal drug administration pub lished the final version of the pregnancy and lactation labeling rule mandating changes to the content and for mat of prescription drug labeling as they pertain to use during pregnancy and lactation. The experts behind mothertobaby have created fact sheets that answer frequently asked questions about exposures during pregnancy and breastfeeding. An alternative to this drug should be prescribed or patients should be advised to discontinue breastfeeding. Drug therapy in pregnancy and lactation authorstream. The risks of taking the drug during pregnancy and breastfeeding. Drug in pregnancy and lactation silpakorn university. Locating a pregnancy risk category is the first step in evaluating the safety of drugs in pregnancy. The use of unnecessary drugs should be avoided and the mother should be advised to limit the use of over the counter medication, and to seek advice if she is using them. With the current emphasis on breast feeding, more data describing levels of drugs in fetal blood and drug levels in breast milk are necessary.
1339 366 596 941 878 301 259 251 742 629 839 1476 1431 151 611 1497 325 1244 1373 259 747 1082 1165 157 1175 42 783 470 266 34 1209 42 1437 1139 735