Protecting the Unborn: Understanding 11 Drugs to Avoid During Pregnancy

Protecting the Unborn: Understanding 11 Drugs to Avoid During Pregnancy


During pregnancy, certain medications can pose risks to the developing fetus and should be avoided. These medications are considered contraindicated in pregnancy. Contraindication means that the use of a specific drug is not recommended or should be avoided due to potential harm to the mother or the unborn baby.

There are various reasons why certain drugs are contraindicated in pregnancy. Some medications have been found to cause birth defects or other adverse effects when taken during pregnancy, while others may increase the risk of pregnancy complications or have unknown effects on fetal development. It is important for healthcare professionals and pregnant individuals to be aware of these contraindications to ensure the safety and well-being of both the mother and the baby.

11 Examples of drugs contraindicated in pregnancy include

  1. Accutane (isotretinoin): Accutane is a medication used to treat severe acne. It has been shown to cause severe birth defects and is highly contraindicated during pregnancy. Women of childbearing potential must use effective contraception while taking Accutane and for a certain period of time after discontinuation.
  2. ACE inhibitors: ACE inhibitors, such as enalapril and lisinopril, are commonly used to treat high blood pressure. They can cause fetal harm and are contraindicated during pregnancy, particularly during the second and third trimesters. Alternative blood pressure medications are usually recommended for pregnant women.
  3. Warfarin: Warfarin is an anticoagulant medication used to prevent blood clots. It can cross the placenta and may cause bleeding complications or birth defects. Warfarin is generally avoided during pregnancy, and alternative medications, such as heparin, may be used for anticoagulation.
  4. Methotrexate: Methotrexate is a medication used for various conditions, including rheumatoid arthritis and certain cancers. It is known to cause birth defects and should be avoided during pregnancy. Women are typically advised to use effective contraception and wait for a certain period of time after stopping methotrexate before attempting pregnancy.
  5. Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs like ibuprofen are commonly used for pain relief. However, they are generally contraindicated in the third trimester of pregnancy due to the potential risk of harm to the fetus, such as premature closure of the ductus arteriosus.
  6. Valproic acid: Used for epilepsy and mood disorders, it carries a high risk of birth defects, particularly neural tube defects.
  7. Misoprostol: A medication used to induce labor or for abortion, it can cause severe birth defects and should be avoided during pregnancy.
  8. Lithium: Prescribed for bipolar disorder, it has been associated with an increased risk of cardiac malformations in the fetus.
  9. Retinoids: Topical or oral retinoids, often used for acne treatment, are known to cause birth defects and should be avoided during pregnancy.

10. Antibiotics contraindicated in pregnancy

  1. Tetracyclines: Tetracycline, doxycycline, and minocycline are associated with the risk of discoloration of fetal teeth and impairment of bone growth.
  2. Fluoroquinolones: Ciprofloxacin, levofloxacin, and other fluoroquinolones have been associated with potential adverse effects on fetal cartilage development and have generally been avoided during pregnancy.
  3. Sulfonamides: Trimethoprim-sulfamethoxazole, also known as Bactrim or Septra, is associated with an increased risk of certain birth defects, such as neural tube defects.
  4. Aminoglycosides: Gentamicin, tobramycin, and other aminoglycoside antibiotics are typically used in specific situations, such as severe infections, but are generally avoided during pregnancy due to concerns about potential toxicity.
  5. Nitrofurantoin: While nitrofurantoin (Macrobid, Macrodantin) is commonly used for urinary tract infections, it is generally contraindicated near term (at 38-42 weeks of pregnancy) due to the risk of hemolytic anemia in newborns.
  6. Metronidazole: Although there is limited evidence of adverse effects, metronidazole is generally avoided during the first trimester of pregnancy. It may be used in certain situations when the benefits outweigh the risks.

11. Antifungals contraindicated in pregnancy

  1. Fluconazole: Although it is commonly used for fungal infections, high-dose or long-term use of fluconazole during pregnancy has been associated with an increased risk of certain birth defects.
  2. Ketoconazole: Limited data suggests potential fetal harm with the use of oral ketoconazole during pregnancy, and it is generally not recommended.
  3. Itraconazole: This antifungal medication is associated with a risk of birth defects, and its use during pregnancy is generally contraindicated.
  4. Voriconazole: There is limited information on the safety of voriconazole during pregnancy, and it is generally avoided unless the potential benefits outweigh the risks.
  5. Griseofulvin: It is known to have teratogenic effects and can cause birth defects. It is generally contraindicated during pregnancy, particularly during the first trimester.
  6. Terbinafine: Although terbinafine is generally considered safe for topical use, there is limited information on its safety when taken orally during pregnancy. It is best to consult with a healthcare professional before using oral terbinafine.


These are just a few examples of drugs that are contraindicated in pregnancy. It is important for pregnant individuals to discuss their medications with healthcare professionals to ensure the safe use of medications during pregnancy. Healthcare providers can provide guidance on alternative treatments or safe alternatives for managing conditions during pregnancy to protect the health of both the mother and the developing baby.

Author: Dr. Rabia
Dr Rabia Akhtar, MBBS(Bachelor of Medicine and Bachelor of Surgery), has perceived her graduation from India. Special Interest: Surgery, Chronic disease, Emergency Medicine, Paediatrics, Women's Health.
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