Medication & Drugs in Pregnancy

Last updated 16.11.13

   

MedsMeds

 

Definition

-  Use of medications & drugs in pregnancy

 

Features

-  Increasing age of conception means more pregnant women on medication

-  Many women take illicit/recrational drugs which they may or may not disclose to care givers

-  Late Dx of pregnancy also means many patitents will have taken medications or drugs during the vulnerable phase of fetal development

-  Where possible pre-pregnancy counselling shoulde be considered in all women of child bearing age on medications

 

Meds Top

Medications in Pregnancy

 

Features

-  Safety categories are listed in MIMS, product information & TGA Medications in Pregnancy Database

-  Specific considerations

-  Psychotropic medications RWH resource

-  Epilepsy in pregnancy

-  Thyroid disease in pregnany

-  Diabetes in pregnancy

 

Categories

-  System used to describe available evidence for safety in pregnancy in regards to fetus

-  Not hierarchical ie: Category B not necessarily more safe than Category C

-  Often drug companies apply a more restrictive category than can be justified based on available evidence

-  Category A

-  Drugs which have been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus having been observed

-  Category B

-  Based on animal studies with variable levels of evidence

-  Taken only by a limited number of pregnant women and women of childbearing age without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed

-  Category B1

-  Studies in animals have not shown evidence of an increased occurrence of fetal damage

-  Category B2

-  Studies in animals are inadequate or may be lacking, but available data show no evidence of an increased occurrence of fetal damage

-  Category B3

-  Studies in animals have shown evidence of an increased occurrence of fetal damage, the significance of which is considered uncertain in humans

-  Category C

-  Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations

-  These effects may be reversible

-  Category D

-  Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage

-  These drugs may also have adverse pharmacological effects

-  Not absolutely contraindicated in pregnancy

-  Category X

-  Drugs which have such a high risk of causing permanent damage to the fetus that they should not be used in pregnancy or when there is a possibility of pregnancy

 

Drugs Top

Drugs in Pregnancy

 

Features

-  RWH Alcohol & Drugs During Pregnancy information & planning

-  DirectLine 1800 888 236: 24/7 counselling & referral for D&A

 

   

 

References

 

Australian TGA: Categoristaion of Prescribing Medicines in Pregnancy

TGA Medications in Pregnancy Database

Perinatal Psychotropic Medicine Information Service (PPMIS)

  RWH Alcohol & Drugs During Pregnancy