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Medications (Birth Defect Information: Exposures and Risk Factors)

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Before taking any medication, pregnant women should weigh the risks and benefits and always consult their health care provider before using any medication – including those sold over the counter (OTCs).

A woman who is pregnant may have a short-term or long-term illness that requires the use of medication for her own health and safety as well as that of her baby. Examples include asthma, epilepsy, high blood pressure, and depression.

Prescription medications are tested before being released to the public; unfortunately, these tests do not include pregnant women. Therefore, the possibilities of side effects of medications on the fetus most often come from results of testing on pregnant animals. Often times, over-the-counter medications, vitamins, and dietary or herbal supplements are not tested at all. If you are currently taking any medications or have any questions, contact your doctor and/or genetic counselor.

The Federal Drug Administration (FDA) categorizes prescription drug risks to the fetus. The categories are A, B, C, D, and X. Category A is considered the safest to use during pregnancy, while a category X drug is known to have an adverse effect on pregnancy and/or the fetus. A woman taking any of the following prescription drugs should talk to her doctor before getting pregnant. It may be necessary to switch to a safer drug for pregnancy. The following drugs may cause serious birth defects and should be avoided by all pregnant women:

  • ACE inhibitors (enalapril or captopril)
  • Androgens and testosterone by-products
  • Anticancer drugs
  • Antifolic acid drugs (methotrexate or aminopterin)
  • Carbamazepine
  • Levothyroxine
  • Lithium
  • Phenytoin
  • Streptomycin and kanamycin
  • Tetracycline
  • Trimethadione and paramethadione
  • Valproic acid
  • Warfarin and other coumarin by-products

The following drugs are known to cause birth defects and should be avoided by women who are pregnant or may become pregnant. It is very important to use birth control in order to prevent pregnancy while taking these drugs.

  • Accutane, Amnesteem, Claravis, Sotret (Isotretinoin) and other retinoids
  • Soriatane (acitretin)
  • Revlimid (lenalidomide)

The March of Dimes has the following suggestions for pregnant women in regards to medications:

  • Don't take someone else's prescription drugs.
  • Take only medications prescribed for you or recommended by a health care provider  who knows you are pregnant.
  • Check with your provider before taking any over-the-counter drugs (including aspirin), pills, herbal products or dietary supplements.

The California Birth Defects Monitoring Program conducted a study to investigate the possible link between pain relievers/decongestants and the birth defect gastroschisis. Please click on the link below to read about this study.

  • Gastroschisis and Medications (PDF)Opens a new browser window.
  • Additional Resources:

  • http://www.perinatology.com/exposures/Drugs/FDACategories.htm
  • http://www.fda.gov
  • http://www.womenshealth.gov/faq/pregnancy-medicines.cfm
    Last modified on: 8/5/2010 8:00 AM