Since the past decade, i works as a community pharmacy in Malaysia, many walk-in customers coming asking for medicines safe in pregnancy and breastfeeding. We have to be very careful in prescribing medicines to these group of patients as most of the medicines are under Category C, D & X where these drugs are not suitable in pregnancy use.
To make it simplify, we as a pharmacist got to refer to The MIMS Pregnancy Safety Index.
Definition of risks factors
As defined by US FDA, drugs in categories D, X and some cases C may pose some risks to foetus.
Category A: Controlled studies have not demonstrated a foetal risk. (in other words, VERY SAFE)
Category B: In animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women.
Category C: Studies in animals have revealed adverse effects on foetal.
Category D: There is positive evidence of human foetal risk
Category X: Studies in animals or human beings have demonstrated foetal abnormalities. (In other words, the drug is contraindicated in pregnant women).
Below are the summary of the drugs that are commonly prescribed by pharmacists.
Drug safe in Pregnancy | Drug safe in breastfeeding | Pain relief | Pain Relief | Paracetamol | Paracetamol | | Ibuprofen | | Naproxen | | | Antimicrobial | Antimicrobial | Amoxicillin (Ospamox) | Fluconazole (Diflucan / Fukole) | | Miconazole cream (Zarin Cream) | | Clotrimazole cream (Candazole Cream) | | Amoxicillin (Ospamox) | | Cephalexin | | | Antihistamine | Antihistamine | Loratadine (Ezede/ Clarirtyn/ Avorious) | Loratadine (Ezede/ Clarirtyn/ Avorious) | Cetirizine (Zyrtec) | Fexofenadine (Telfast/ Fexovid) | | Cetirizine (Zyrtec) | | | | Birth Control Pills | | Progestin-only contraceptives (Noriday) | | | Gastric medications | Gastric Medications | Alginates (Gaviscon Liq) | Famotidine | Omeprazole (Promesec) | Cimetidine | | Alginates (Gaviscon Liq) | | | | Antidepressants | | Paroxetine (Apo-Paroxetine / Seroxat CR) | | Sertraline (Zoloft) | | Fluvoxamine (Luvox) | | | Constipation | Constipation | Lactulose (Duphalac / Lactul) | Lactulose (Duphalac / Lactul) | | | Anti-diarrhoea | Anti-diarrhoea | Loperamide (Lomide) | Loperamide (Lomide) |
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References: MIMS |
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Disclamer: Please consult your healthcare professionals like doctors, pharmacists for more details.
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