This list of commonly used medicines that should not be used during pregnancy and breastfeeding includes antibiotics, antimalarial and anticlotting medicines. Remember, if you have any questions about your prescription, you should contact your doctor and express your concerns.
What you should know: Pregnancy, breastfeeding and medicines
When pregnant, breastfeeding or if you have missed a period or have reason to believe that you maybe pregnant, you should makes sure your healthcare provider knows about this when seeking healthcare . This is because some commonly used medicines that your doctor may prescribe maybe harmful to your unborn child; others may pass through milk and harm your breastfeeding baby. The first trimester of pregnancy (conception to 12 weeks) is the most at risk period. We have to be extra careful during this period as your growing baby is still developing their organs. Therefore, if anything goes wrong, the baby may develop life threatening abnormalities or even die before being born.
Jump to: Tetracycline, Doxycycline, Ciprofloxacin, Dapsone, Primaquine, Halafantrine, Artemether Lumefantrine (AL),
Antibiotics that should not be used during pregnancy and breastfeeding
Tetracycline
Tetracycline is an antibiotic (anti-infective medicine) used to treat infections caused by bacteria such as urinary tract infections, chlamydia and acne. Tetracycline should not be used during pregnancy and breastfeeding as it can cause abnormalities of lens/cornea, skeletal and muscular growth and tooth development.
Doxycycline
Risk of cosmetic staining of primary teeth is undetermined, excreted into breast milk.
Ciprofloxacin
Not recommend during the first trimester due to possibility of congenital malformations including spina bifida (congenital defect of the spine), limb defects, hypospadia (congenital defect of the urethra), inguinal hernia, eye/ear defects, heart and skeleton defects and teeth discoloration.
Dapsone
Increases the risk of fetal abnormalities if administered during all trimesters
Antimalarial medicines that should not be used during pregnancy and breastfeeding
Primaquine
Harmful to newborns who are relatively Glucose-6 Phosphatase Dehydrogenase (G6PD) deficient
Halafantrine
No conclusive studies in pregnant women, has been shown to cause unwanted effects including death of the fetus in animals.
Artemether Lumefantrine (AL)
Artemether Lumefantrine (AL) maybe used in second and third trimesters of pregnancy and only used in the first trimester if no other treatment for malaria is available.
Summary of medicines to avoid during pregnancy and breastfeeding
Some commonly used medicines that your doctor may give you maybe harmful to your unborn child; others may pass through milk and harm your breastfeeding baby. The first trimester of pregnancy (from when you get pregnant to 12 weeks of pregnancy) is the most at risk period.| Antibiotic medicines that you should not use during pregnancy and when breastfeeding | Anticlotting agents that you should not use during pregnancy and when breastfeeding | Antimalarial medicines that you should not use during pregnancy and when breastfeeding | Sources |
|---|---|---|---|
| Tetracycline | Warfarin 3 | Primaquine | 3If possible, warfarin therapy should be avoided during pregnancy. If warfarin therapy is essential, it should be avoided at least during the first trimester (because of risk of causing anomalies) and from about 2 to 4 weeks before delivery to reduce risk of bleeding complications. |
| Ciprofloxacin | Halafantrine | ||
| Doxycycline | Artemether Lumefantrine (AL) 1 | 1 CDC recommends inclusion of Artemether Lumefantrine (AL) as a treatment option for uncomplicated malaria during the second (13 to 26 weeks) and third trimesters (week 27 to end of pregnancy) of pregnancy and during the first trimester of pregnancy when other treatment options are unavailable. | |
| Dapsone | Sulfadoxine-pyrimethamine (SP)2 | 2Starting as early as possible in the second trimester, SP for prevention of Malaria is recommended for all pregnant women at each scheduled antenatal care (ANC) visit until the time of delivery, provided that the doses are given at least one month apart. SP should not be given during the first trimester of pregnancy; however, the last dose of IPTp-SP can be administered up to the time of delivery without safety concerns. |
|
| Metronidazole (flagyl)4 | 4 Some authorities do not reccomend the use of metronidazole (flagyl) in the first trimester of pregnancy due to the risk of birth anomalies. | ||
Patient Information
Why should I trust what you tell me about medicines?
I regret that you might not trust us, but please know that the recommendations we are making are made all over the world.
- I would like you to trust us because we have your best interests at heart. But if you would like, please speak with a healthcare professional near you on the information you have read on our website.
- You should also know that here at Eastview Family Health, we do our best to help patients get information to guide their decisions about their health and the care they receive. As health professionals, we are bound by professional ethics and our sworn duty to do no harm.
If I still have concerns about my prescription, where can I learn more?
While at the hospital, find out if a pharmacist, doctor, clinical officer or nurse is available to speak with you about your prescription. If they are not available, make an appointment to speak to one later. You can also do some reading by yourself on medicines and their safety. As you self study, keep in mind that there is a lot of false information about medicines on the internet. Therefore, it is best for you to use only websites from reputable organizations such as the ones below.
- World Health Organization. Visit Website ->
- U.S. Centres for Disease Control and Prevention. Visit Website ->
- For FDA consumer information about drugs. Visit Website->
- MedlinePlus, a service of the National Library of Medicine (NLM), the world’s largest medical library, which is part of the National Institutes of Health (NIH). Visit Website ->
- Other credible websites, especially in the national language(s), including the website of your country’s Ministry of Health. Here you are likely to find well-done national publications with solid information on immunization.
- Our inhouse resource – Eastview Family Health Drugs A-Z
Article sources
1Ballard S, Salinger A, Arguin PM, Desai M, Tan KR. Updated CDC Recommendations for Using Artemether-Lumefantrine for the Treatment of Uncomplicated Malaria in Pregnant Women in the United States. MMWR Morb Mortal Wkly Rep 2018;67:424–431. DOI: http://dx.doi.org/10.15585/mmwr.mm6714a4External
2Peters PJ et al. (2007). Safety and toxicity of sulfadoxine-pyrimethamine: implications for malaria prevention in pregnancy using intermittent preventive treatment. Drug Safety. 2007;30(6):481-501.http://www.ncbi.nlm.nih.gov/pubmed/17536875
3Abadi S, Einarson A, Koren G. Use of warfarin during pregnancy. Can Fam Physician. 2002 Apr;48:695-7. PMID: 12046363; PMCID: PMC2214036.
