Pregnancy: Reducing risk

Last updated: Sunday, July 12, 2015


Strategies to reduce risks to the fetus when prescribing to a pregnant woman include:

  • Consider non-drug treatments and only prescribe drugs if essential.

  • Consider the period of gestation and, if possible, avoid all drugs during the first trimester.

  • Avoid known human teratogens, unless absolutely unavoidable.

  • Do not use new drugs because usually there is little information on their effects in pregnancy.

  • Avoid polypharmacy.

  • Where appropriate, use the lowest effective dose for as short a period as possible.

No drug has been demonstrated to be completely safe in pregnancy because it would not be ethical to conduct studies to prove the point. However, the drugs below are generally considered to carry minimal risk of adverse effects in pregnancy at normal therapeutic doses:

    Antacids   
    Paracetamol     
    Penicillins     
    Laxatives     
    Cephalosporins     
    Inhalers for asthma    
Conversely, the following medicines are known to carry a higher risk in pregnancy. Refer to your Information Sources to find out what common malformations or complications are associated with the following higher risk drugs:

      ACE inhibitors   
      Phenytoin     
      Isotretinoin     
      Alcohol     
      Tetracyclines    
      Warfarin