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CONSUMER VERSION

Some Drugs That Can Cause Problems During Pregnancy *

Type

Examples

Problem

Antianxiety drug

Diazepam

When the drug is taken late in pregnancy,

depression, irritability, shaking, and exaggerated
reflexes in the newborn

Antibiotics

Fluoroquinolones
(such as
ciprofloxacin,
ofloxacin,
levofloxacin, and
norfloxacin)

Possibility of bone and joint abnormalities (seen only

in animals)

Nitrofurantoin

In women or fetuses with G6PD deficiency, the

breakdown of red blood cells

Streptomycin

Damage to the fetus's ear, resulting in deafness

When the drugs are given late in pregnancy, jaundice

Sulfonamides (such and possibly brain damage in the newborn
as sulfasalazine
With sulfasalazine, much less risk of problems
and trimethoprimsulfamethoxazole) In women or fetuses with G6PD deficiency, the
breakdown of red blood cells

Tetracycline

Slowed bone growth and permanent yellowing of the

teeth
Occasionally, liver failure in the pregnant woman

Trimethoprim

Defects of the brain and spinal cord (neural tube

defects), such as spina bifida

Anticoagulants

Heparin

Thrombocytopenia (a decrease in the number of

platelets, which help blood clot) in the pregnant
woman, possibly resulting in excessive bleeding
Birth defects

Warfarin

Bleeding problems in the fetus and the pregnant

woman
Some risk of birth defects, including neural tube
defects (such as spina bifida)

Anticonvulsants

Carbamazepine

Bleeding problems in the newborn (hemorrhagic

disease of the newborn), which can be prevented if
pregnant women take vitamin K by mouth every day
for a month before delivery or if the newborn is
given an injection of vitamin K soon after birth

Phenobarbital

Same as those for carbamazepine

Phenytoin

Same as those for carbamazepine

Valproate

Some (1%) risk of birth defects, including a cleft

palate, neural tube defects (such as a
meningomyelocele), and defects of the heart, face,
skull, spine, and limbs

Angiotensinconverting enzyme
(ACE) inhibitors
Antihypertensives
(see Table:
Antihypertensive
Drugs.)

Beta-blockers

When the drugs are taken late in pregnancy, kidney

damage in the fetus, a reduction in the amount of
fluid around the developing fetus (amniotic fluid),
and defects of the face, limbs, and lungs

When some beta-blockers are taken during

pregnancy, a slowed heart rate, a low blood sugar
level, and possibly slowed growth in the fetus
Low blood pressure in the mother

Calcium channel
blockers

Thiazide diuretics

Inadequate growth before birth (growth restriction)

A decrease in the levels of oxygen, sodium, and

potassium and in the number of platelets in the
fetus's blood
Inadequate growth before birth

Chemotherapy
drugs

Actinomycin

Possibility of birth defects (seen only in animals)

Busulfan

Birth defects such as underdevelopment of the lower

jaw, cleft palate, abnormal development of the skull
bones, spinal defects, ear defects, and clubfoot
Slowed growth

Chlorambucil

Same as those for busulfan

Cyclophosphamide Same as those for busulfan

Doxorubicin

Heart problems, depending on the dose taken

Possibly birth defects (seen only in animals)

Mercaptopurine

Same as those for busulfan

Methotrexate

Same as those for busulfan

Vinblastine

Possibility of birth defects (seen only in animals)

Vincristine

Possibility of birth defects (seen only in animals)

Possibly birth defects (mainly of the heart)

Mood-stabilizing
drug

Lithium

Aspirin and other

Nonsteroidal anti- salicylates
inflammatory
Ibuprofen
drugs (NSAIDs)
Naproxen

Lethargy, reduced muscle tone, poor feeding,

underactivity of the thyroid gland, and nephrogenic
diabetes insipidus in the newborn

When the drugs are taken in large doses, possibly

miscarriages during the 1st trimester, a delay in the
start of labor, premature closing of the connection
between the aorta and artery to the lungs (ductus
arteriosus), jaundice, necrotizing enterocolitis
(damage to the lining of the intestine), and
(occasionally) brain damage in the fetus and bleeding
problems in the woman during and after delivery
and/or in the newborn
When the drugs are taken late in pregnancy, a
reduction in the amount of fluid around the
developing fetus

Chlorpropamide
Oral
Glyburide
antihyperglycemic
Metformin
drugs
Tolbutamide

Sex hormones

Danazol

Diethylstilbestrol
(DES)

A very low blood sugar level in the newborn

Inadequate control of diabetes in the pregnant
woman
When the drug is taken early in pregnancy by a
woman with type 2 diabetes, possibility of increased
risk of miscarriage
When this drug is taken very early in pregnancy,
masculinization of a female fetuss genitals,
sometimes requiring surgery for correction
Abnormalities of the uterus, menstrual problems, and
an increased risk of vaginal cancer and complications
during pregnancy in daughters
Abnormalities of the penis in sons

Synthetic
progestins (but not
the low doses
Same as those for danazol
used in oral
contraceptives)

Skin treatments

Etretinate

Birth defects, such as heart defects, small ears, and

hydrocephalus (sometimes called water on the brain)
Same as those for etretinate

Isotretinoin

Intellectual disability
Risk of miscarriage

Thyroid drugs

Methimazole

Propylthiouracil

An enlarged or underactive thyroid gland in the fetus

Scalp defects in the newborn
An enlarged or underactive thyroid gland in the fetus
Destruction of the thyroid gland in the fetus

Radioactive iodine When the drug is given near the end of the 1st
trimester, a very overactive and enlarged thyroid
gland in the fetus

Vaccines (live
virus)

Other

Triiodothyronine

An overactive and enlarged thyroid gland in the fetus

Vaccine for
German measles
(rubella) and
chickenpox
(varicella)

Potential infection of the placenta and developing

fetus

Vaccines for
measles, mumps,
polio, or yellow
fever

Potential but unknown risks

Buprenorphine
and methadone,

Drowsiness in the newborn shortly after birth

Irritability and shaking (symptoms of drug

which are opioids

Corticosteroids

Pseudoephedrine
(a decongestant)

Vitamin K

withdrawal) in the newborn because at birth, passage

of the opioid from the mother is stopped
Possibly a cleft lip when these drugs are taken during
the 1st trimester
Narrowing of the blood vessels in the placenta,
possibly reducing the amount of oxygen and
nutrients the fetus receives and thus resulting in
inadequate growth before birth
Possible risk of a defect in the wall of the abdomen
that allows the intestines to protrude outside the
body (called gastroschisis)
In women or fetuses with G6PD deficiency,
destruction of red blood cells (hemolysis)

*Unless medically necessary, drugs should not be used during pregnancy. However, drugs
can be essential to maintain the health of the pregnant woman and the fetus. In such cases,
a woman should talk with her health care practitioner about the risks and benefits of the
prescription drugs she is taking before she stops taking them. She should not stop taking
them on her own.

2015 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ., USA