Drugs to avoid in pregnancy

Here is a list of some commonly prescribed drugs that should be avoided or used with caution during pregnancy:

  1. Angiotensin-Converting Enzyme (ACE) Inhibitors & Angiotensin II Receptor Blockers (ARBs): These can cause developmental abnormalities, especially if taken in the second and third trimesters.
  2. Antiepileptic Drugs: Some of these can cause congenital malformations. However, epilepsy itself poses a risk during pregnancy, so treatment decisions should be individualized.
  3. Statins: They can potentially cause fetal harm.
  4. Warfarin: An anticoagulant that can cross the placenta and cause fetal bleeding and congenital malformations. Enoxaparin is ok.
  5. Tetracyclines: They can affect fetal bone growth and discoloration of teeth.
  6. Fluoroquinolones (Ciprofloxacin, Norfloxacin) : Cause joint and bone abnormalities in animals, so they are typically avoided unless necessary.
  7. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): When taken in the third trimester, they can cause premature closure of the ductus arteriosus and impair kidney function in the fetus.
  8. Isotretinoin: Can cause severe birth defects.
  9. Thalidomide: Notorious for causing limb abnormalities and other birth defects.
  10. Methotrexate: Is teratogenic and can cause miscarriage.
  11. Lithium: Is associated with cardiac and other congenital anomalies, though it may be continued in pregnancy under close monitoring if the benefits outweigh the risks.
  12. Misoprostol: Can cause miscarriage when taken inadvertently in early pregnancy.
  13. Dihydrotestosterone (DHT) Blockers: Such as finasteride and dutasteride, used for benign prostatic hyperplasia and hair loss. They can cause abnormalities in the male fetus’s genitalia.
  14. Some Antipsychotics and Antidepressants: Though many are used in pregnancy when benefits outweigh risks, it’s essential to consult a specialist for the best choice and dose adjustment.
  15. Live Vaccines: Like MMR and VZV vaccines should be avoided during pregnancy.
  16. Some Antiretroviral Drugs: Used in HIV/AIDS treatment, like efavirenz, have shown teratogenic effects.