TABLE 1
A
B
C
D
X
Pregnancy Risk Factors
Controlled human studies show no risk. 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 fetal harm appears remote.
Either animal-reproduction studies have not demonstrated a fetal risk but there are no
controlled studies in pregnant women, or animal-reproduction studies have shown an
adverse effect (other than a decrease in fertility) that was not confirmed in controlled
studies in women in the first trimester and there is no evidence of a risk in later trimesters.
Risk cannot be ruled out. Either studies in animals have revealed adverse effects on the
fetus (teratogenic or embryocidal effects or other) and there are no controlled studies in
women, or studies in women and animals are not available. Drugs should be given only if
the potential benefits justify the use.
Positive evidence of risk: There is positive evidence of human fetal risk, but the benefits
from use in pregnant women may be acceptable despite the risk (eg, if the drug is needed
in a life-threatening situation or for a serious disease for which safer drugs cannot be
used or are ineffective).
Contraindicated in pregnancy: Studies in animals or human beings have demonstrated
fetal abnormalities or there is evidence of fetal risk based on human experience, or both,
and the risk of the use of the drug in pregnant women clearly outweighs any possible
benefit. The drug is contraindicated in women who are or may become pregnant.
Medications
TABLE 2
Acetaminophen
B
Opiates:
C
Oxycodone
SSRIs:
Paroxetine
Fluoxetine
Sertraline
B
hydrocodone, codeine,
methadone
hydromorphone
tramadol
D
C
C
SNRIs:
C
Duloxetine
Venlafaxine
C
TCAs C
NSAIDs
C/D
> 30 weeks
AEDs:
Valproate
D
B/D
Phenobarbital
-manufacturer dependant
Lamotrigine
C
Topiramate
D
Gabapentin
C
Pregabalin
C
Levitiracetam
C
Triptans
C
DHE X
Benzodiazepine
D
Antihypertensives:
Propranolol
C
Verapamil
C
Losartan
C/D )