|
| |
Risk of headache & pain
medication for pregnant patient
Analgesics / NSAID
|
FDA
Risk class |
Notes |
| Acetaminophen |
B |
|
| Caffeine |
B |
|
| Fenoprofen, Ibuprofen,
Indomethacin, Meclofenamate, Naproxen, Sulindac |
B |
Risk factor D if used in 3rd trimester |
| Ketorolac, Tolmetin |
C |
| Aspirin |
C |
Narcotics:
|
| Butorphanol (Stadol) |
B |
D if prolonged or at
term |
| Hydromorphone, Meperidine, Morphine,
Methadone |
B |
| Codeine, Propoxyphene (Darvon) |
C |
Sedative/Hypnotics
|
| Bultalbital |
C |
risk factor C if used for prolonged periods or in high dose
at term |
| Phenobarbital, Clonazepam,
Chlordiazepoxide, Diazepam, Lorazepam |
D |
|
Antiemetics
|
| Emetrol, |
B |
|
| Prochlorperazine, Promethazine, Chlorpromazine,
Hydroxyzine, Trimethobenzamide |
C |
|
| The American College
of Obstetricians and Gynecologists (ACOG) has released a new guideline on
diagnosing and treating nausea and vomiting (morning sickness) in
pregnancy. "ACOG Practice Bulletin No. 52: Nausea and Vomiting of
Pregnancy," appears in the April 2004 issue of Obstetrics
and Gynecology |
The following
recommendations for the prevention and treatment of nausea and vomiting of
pregnancy are based on consistent scientific evidence:
 |
Taking a multivitamin at the time
of conception may decrease the severity of symptoms. |
|
Vitamin B6
25 mg three times a day alone.
|
|
Vitamin B6 (25 mg) and
Unisom (25 mg) at bedtime, and one half of each in the morning and
afternoon, is an effective combination.
|
|
The following
recommendations are based on limited or inconsistent scientific evidence:
| Ginger has shown beneficial effects and can be
considered a nonpharmacologic option. |
| Antihistamine H1-receptor
blockers, phenothiazines, and benzamines have been shown to be safe
and effective in treating refractory cases. |
| Early treatment of symptoms is recommended to prevent
progression to hyperemesis gravidarum. |
|
Triptans
& Ergots
|
| Sumatriptan, Naratriptan, Rizatriptan, Zolmitriptan |
C |
|
| Ergotamine, Dihydroergotamine, Methysergide |
X |
do not use |
| Steroid |
| Prednisone |
B |
|
| Dexamethasone, Triamcinolone |
C |
|
| Cortisone |
D |
|
Anticonvulsant
|
| Carbamazepine, Gabapentin,
Lamotrigine, Topiramate |
C |
|
| Phenobarbital, Phenytoin, Primidone,
Valproic Acid |
D |
|
| Tricyclics |
| Desipramine, Doxepin |
C |
|
| Amitriptyline, Nortriptyline, Imipramine |
D |
|
| SSRI & other
antidepressant |
| Bupropion |
B |
|
| Paroxetine, Lexapro, Fluoxetine,
Sertraline, |
C |
|
| Beta blockers |
| Metoprolol, Nadolol, Propranolol,
Timolol |
C |
Second or third trimester |
| Atenolol |
D |
|
| Calcium channel
blockers |
| Diltiazem, Nifedipine, Nimodipine, Verapamil |
C |
|
FDA Risk Factor Classification of drugs in pregnancy
| Class |
Explanation |
| A |
controlled studies showed no risk to fetus in first trimester.
Fetal harm is remote |
| B |
no controlled studies, but no known risks |
| C |
Studies on animals may show effects on fetuses, but no controlled
studies available. The drug can be used if risk is justified |
| D |
There are positive risks, but the drug may be used if serious
disease or life threatening conditions exist. |
| X |
Human and animal studies show risk. The risk of use outweighs any
benefit. |
|
