Amantadine | C | Contraindicated (first trimester) |
Aminoglutethimide (anticonvulsant) | D | No data |
Aminopterin | X | Contraindicated (any trimester) |
Amiodarone | D | Risk (third trimester) |
Amphetamine | C | Risk (third trimester) |
Androgenic hormones | X | Contraindicated (any trimester) |
Angiotensin-converting enzyme (ACE) inhibitors | C/D | Risk (second and third trimesters) |
Angiotensin II receptor antagonists | C/D | Risk (second and third trimesters) |
Antidepressants | C | Risk (third trimester) |
Antineoplastic cytotoxic agents | C/D/X | Look up individual drugs. Only category X drugs are given in table. Recommendations vary widely. |
Azathioprine | D | Risk (third trimester) |
Barbiturates | C or D | Recommendation by drug varies from Probably Compatible to Risk (first and third trimesters) |
Benzodiazepines | D/X | Recommendation varies by agent from Low Risk (animal data) to Contraindicated (any trimester). Look up individual agents. |
Benzphetamine | X | Contraindicated (any trimester) |
Beta-adrenergic blockers | C/D | Risk (second and third trimesters) |
Bexarotene | X | Contraindicated (any trimester) |
Blue cohosh (herb) | C | Risk (third trimester)—used to stimulate labor |
Bromides, anticonvulsant | D | Risk (third trimester) |
Carbamazepine | D | Compatible: benefits >> risks |
Carbarsone, 29% arsenic | D | Contraindicated (any trimester) |
Carbimazole | D | Risk (third trimester); use propylthiouracil (PTH) |
Chenodiol | X | Contraindicated (any trimester) |
Ciguatoxin | | Contraindicated (any trimester) |
Clarithromycin | C | High risk (animal data) |
Clomiphene (fertility agent) | X | Contraindicated (any trimester) |
Clonazepam, anticonvulsant | D | Low risk (animal data) |
Cocaine, systemic use | C/X | Contraindicated (any trimester; topical use okay) |
Colchicine | D | Risk (animal data) |
Corticosteroids | C/D | Recommendation varies from compatible, to benefits >> risks, to risk in third trimester. Look up individual agents. |
Coumarin derivatives | D/X | Contraindicated (any trimester) |
Diazoxide | C | Risk (third trimester) |
Dihydroergotamine | X | Contraindicated (any trimester) |
Diuretics | B or C/D | Compatible but do not use for gestational hypertension (Category D) |
"Ecstasy" (methylenedioxymethamphetamine, MDMA) | C | Contraindicated (any trimester) |
Edrophonium | C | Risk (third trimester) |
Electricity | D | Risk (third trimester); stillbirth associated with relatively mild shocks |
Epinephrine | C | Risk (third trimester) |
Ergotamine | X | Contraindicated (any trimester) |
Erythromycin (estolate salt) | | Hepatic toxicity in pregnant women. Other salts are compatible |
Estrogenic hormones | X | Contraindicated (any trimester) |
Ethanol | D/X | Contraindicated (any trimester) |
Ethotoin | D | Compatible (benefits >> risks) |
Fenfluramine | C | Contraindicated (any trimester) |
Fluconazole ≥ 400 mg/d | C | Risk (third trimester) |
Flucytosine | C | Contraindicated (first trimester) |
Fluorouracil | D/X | Contraindicated (first trimester) |
Fluphenazine | C | Risk (third trimester) |
HMG Co-Ac reductase inhibitors: all drugs in this class | X | Contraindicated (any trimester) |
Iodide 125| and 131| (radiopharmaceuticals) | X | Contraindicated (any trimester)—ablates fetal Thyroid |
Iodine and iodide-containing compounds, including topicals, expectorants, and diagnostic agents | D/X | Varies from contraindicated (any trimester) to risk (second and third trimesters). Fetal and neonatal goiter and hypothyroidism |
Kanamycin | D | Risk (third trimester) |
Leflunomide | X | Contraindicated (any trimester) |
Lenalidomide (potent thalidomide analog) | X | Contraindicated (any trimester) |
Leuprolide | X | Contraindicated (any trimester) |
Lithium | D | Risk (third trimester) |
LSD (lysergic acid diethylamide) | C | Contraindicated (any trimester) |
Marijuana | X | Contraindicated (any trimester) |
Measles vaccine (live attenuated) | C | Contraindicated (any trimester)—avoid from 1–2 months before pregnancy until after delivery |
Menadiol, menadione, vitamin K3 | C | Risk (third trimester) |
Mephobarbital, anticonvulsant | D | Compatible: benefits >> risks |
Meprobamate | D | Contraindicated (first trimester) |
Metaraminol | C | Risk (second and third trimesters) |
Methaqualone | D | No data |
Methimazole | D | Risk (third trimester); use propylthiouracil (PTH) |
Methotrexate | X | Contraindicated (any trimester) |
Methylene blue, intra-amniotic | C/D | Contraindicated (second and third trimesters) |
Methylergonovine maleate, ergot derivative | C | Contraindicated (any trimester) |
Mifepristone, RU 486 | X | Contraindicated (any trimester) |
Misoprostol (oral) | X | Contraindicated (any trimester) |
Misoprostol: low dose for cervical ripening | X | Low risk (human data) |
Mumps vaccine (live attenuated) | C | Contraindicated (any trimester) |
Naloxone | B | Compatible |
Narcotic agonist analgesics | B or C/D | Risk (third trimester): Category D—risk associated with prolonged use or high doses at term |
Narcotic agonist-antagonist analgesics | B or C/D | Risk (third trimester) |
Narcotic antagonists (except naloxone) | D | Risk (third trimester) or no data; use naloxone. |
Nonsteroidal anti-inflammatory drugs (NSAIDs, full-dose aspirin) | B or C/D | Risk (first and third trimesters) |
Norepinephrine | D | Risk (third trimester) |
Oral antidiabetic agents | C | Insulin is the preferred agent for management of diabetes during pregnancy. Oral antidiabetic agents cross placenta—risk for severe hypoglycemia in newborn |
p-Aminosalicylic acid | C | Risk (third trimester) |
Paramethadione | D | Contraindicated (first trimester) |
Penicillamine | D | Risk (third trimester) |
Phencyclidine | X | Contraindicated (any trimester) |
Phensuximide | D | Risk (third trimester) |
Phentermine | C | Contraindicated (any trimester) |
Phenylephrine | C | Risk (third trimester) |
Phenytoin | D | Compatible: benefits >> risks |
Plicamycin, mithramycin | X | Contraindicated (first trimester) |
Podofilox, podophyllum | C | Contraindicated (any trimester) |
Primidone | D | Risk (third trimester) |
Progestogenic hormones | D or X | Contraindicated (any trimester) |
Quinine, antimalarial | D/X | Risk (third trimester) |
Quinolone antibiotics | C | Arthropathy in immature animals |
Retinoid agents | X | Contraindicated (any trimester) |
Ribavirin, antiviral | X | Contraindicated (any trimester) |
Rubella vaccine (live attenuated) | C/D | Contraindicated (any trimester)—avoid from 1–2 months before pregnancy until after delivery |
Smallpox vaccine (live attenuated) | X | Epidemic: compatible (benefits >> risks); otherwise risk (third trimester) |
Streptomycin | D | Risk (third trimester) |
Sulfonamides | C/D | Risk (third trimester) |
Tacrolimus | C | Risk (third trimester) |
Tamoxifen | D | Contraindicated (any trimester) |
Terpin hydrate | D | Contraindicated (any trimester) owing to ethanol content |
Tetracyclines, all | D | Contraindicated (second and third trimesters) |
Thalidomide and analogs | X | Contraindicated (any trimester) |
Tramadol | C | Risk (third trimester) |
Tretinoin: topical doses | C | Low risk (human data) |
Triamterene | C/D | Risk (any trimester)—weak folic acid antagonist, and Category D for gestational hypertension use |
Trimethadione | D | Contraindicated (first trimester) |
Trimethaphan | C | Contraindicated (any trimester) |
Trimethoprim | C | Risk (third trimester) |
Valproic acid | D | Risk (third trimester) |
Varicella vaccine (live attenuated) | C | Contraindicated (any trimester)—avoid from 1–2 months before pregnancy until after delivery |
Venezuelan equine encephalitis vaccine, VEE TC-84 (live attenuated) | X | Contraindicated (any trimester)—avoid from 1–2 months before pregnancy until after delivery |
Vidarabine, antiviral | C | Teratogenic in animals |
Vitamin A | A/X | Contraindicated (any trimester) in doses greater than FDA RDAc |
Vitamin D | A/D | Compatible except for doses greater than FDA RDAc |
Vitamin K3, menadiol, menadione | C | Risk (third trimester) |
Voriconazole | D | Teratogenic in animals |
Warfarin | D/X | Contraindicated (any trimester) |
Yellow fever vaccine (live attenuated) | D | Epidemic: compatible (benefits >> risks). Otherwise avoid from 1–2 months before pregnancy until after delivery |
Zonisamide, anticonvulsant | C | Teratogenic in animals |