Drugs in Pregnancy and Lactation

Data is from Briggs, Freeman, Yaffe, Drugs in Pregnancy and Lactation, 7th ed, 2005, Lippincott Williams & Williams
Please see also Toxnet from NIH
Quick-Links on this page: Pain, Anti-emetics, Rhinorrhea/Cough, GERD, Anti-bacterial/fungal

Table of Medications commonly used and their safety in pregnancy and lactation

Generic NameTrade NamesPregnancy CategoryPregnancy NotesLactation Notes
IbuprofenAdvilB1st and 3rd trimester riskCompatible
Codeinein Robitussin AC™ and Tylenol #3C3rd trimester riskLimited human data, probably compatible
HydroxyzineVistarilCHuman data suggest low risk
Pyridoxine, Vitamin B6ACompatibleCompatible, but excessively high doses inhibit lactation
MetoclopramideReglanBCompatibleUnknown effects, limited human data, potential toxicity due to dopaminergic blocking mechanism. However, sometimes given to induce lactation.
PromethazinePhenerganCCompatibleNo human data, probably compatible
OndansetronZofranBLimited human data, animal data suggest low risk.No human data, probably compatible
DoxylamineACompatibleNo human data, probably compatible
TrimethobenzamideTiganCHuman data suggest low riskNo human data, probably compatible
Saline Nasal sprayOcean™ASafeSafe
Vick's vapor-rub Not ingested, and therefore safeSafe
Steam inhalation SafeSafe
Vaseline applied nasally or on lips, and therefore safeSafe
NasalCrom™BCompatibleNo data, probably compatible
Afrin™Cinsufficient evidence. Small studies show normal use ok, but heavy use, (against label), results in fetal brady most likely from vasoconstrictor activity.Compatible
Flonase™CNo other data found by meUnknown, no other data found by me
Nasocort™CNo other data found by me regarding nasal administration, but other routes are classified as having risk.No human data, probably compatible
Dextromethorphanin Robitussin DMCCompatibleCompatible
CodeineSee above
DiphenhydramineBenadrylBCompatibleLimited human data, probably compatible, though antihistamines are suspected to decrease lactation
PseudoephedrineSudafed™CLimited human data and no relevant animal data, not recommended before 18weeks given association with omphaloceleLimited human data, probably compatible, compatible per AAP, but known to sometimes reduce or halt lactation
Phenylephrine CHuman data suggest riskNo human data, probably compatible, but known to sometimes reduce or halt lactation
Guaifenesinin Robitussin DM, AC, and Mucinex™CCompatible, Surveillance studies show no increased risks of birth defectsNo human data, probably compatible
RanitidineZantacBCompatibleLimited human data, probably compatible, cimetidine compatible per AAP
PantoprazoleProtonixBNo human data, animal data suggest low riskLimited human data with potential toxicity
OmeprazolePrilosecCHuman data suggest low riskLimited human data with potential toxicity
FluconazoleDiflucanCHuman data suggest risk at >=400mg/day 1st trimester especiallyCompatible
Ciprofloxacin CHuman data suggest riskLimited human data, probably compatible, compatible per AAP
NitrofurantoinMacrobidBRisk in 3rd trimester of hemolytic anemia possibly from immature erythrocyte enzymes - glutathione.Limited human data, probably compatible
TMP-SMXBactrim, SeptraCHuman data suggest riskCompatible

Combination Name Brand Medications