The rule about taking medicines during pregnancy is simple: Always ask your doctor first. That includes questions about prescription and over-the-counter (OTC) drugs. You should definitely not take some medicines. For others — the yellow flags — your doctor may need to weigh the risks and benefits to you and your baby. Here is a list of drugs contraindicated in pregnancy and the side effects which occur due to using these medications:
(1)NSAIDS (Asprine, Diclofenac, Ibuprofen, Indomethacine… etc) during 3rd trimester. May has effects on the fetal cardiovascular system (closure of the ductus arteriosus).
(2) Statins (Atrovastatine, Simvastatine, Levostatine… etc). Cholesterol is needed for fetal growth and its reduction by statins could harm the fetus.
(3) Warfarin:- Causes multiple birth defects.
(4) Testosterone:- Can cause birth defects.
(5) Misoprostol:- Miscarriage.
(6)Sulfamethoxazole/trimethoprim (Bactrim) during 3rd trimester. May increase bilirubin levels leading to kernicterus.
(7) Nitroimidazole, (Metronidazole and Tinidazole) during 1st trimester.
(8) Griseofulvin:- May increased risk of spontaneous abortion.
(9) Methotrexate:- Causes cleft palate along with multiple defects.
(10) Estradiol:- Urogenital abnormalities in offspring that manifest later in life. May couse uterine cervix, vaginal and testicular cancer have developed later in life in offspring.
(11) Thalidomide:- Seal like limbs and other defects.
(12) Clomiphene citrate:- Can cause birth defects.
(13) Medroxyprogesterone acetate:- Can cause birth defects.
(14) Vitamin A and its derivatives:- Birth defects, miscarriage.
(15) Danazol:- Causes malformations in sex organs of female fetus.
(16) Finasteride:- Even pregnant women should not handle broken or crushed tablets since it can get absorbed through the skin and affect the sexorgan development of the male fetus.
(17) Tetracyclines:- Get deposited in fetal bones and retard their growth, also affect teeth causing them to be discolored and deformed.
(18) Chloramphenicol:- Gray baby syndrome.
(19) Isoniazid:- Neuropthy and seizures in fetus, liver damage in mother.
(20) Sodium Valproate:- Defects of the nervous system.
(21) ACE inhibitors (Enalapril, Captopril, Lisinopril…etc):- Growth retardation, birth defects, fetal death.
(22) Lithium:- Affects fetal thyroid, heart beside causing other abnormalities.
(23) Phenytoin:- Cleft lip/ palate along with other deformities.
(24) Anti convulsants:- Trimethadione, Valproic acid, Carbamazepine – Multiple birth defects.
(25) Androgens:- Multiple defects.list of drugs contraindicated in pregnancy.
FDA categorization of drugs in pregnancy.
Category A; Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
Category B; Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
Category C; Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Category D; There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Category X; Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.