High-Risk Medications Evaluated, Pregnancy Category, and Potential Complications of Use16
| Medication Class | Medication Name | Pregnancy Category | Possible Side Effects of Use during Pregnancy |
|---|---|---|---|
| HMG-CoA reductase inhibitor | atorvastatin simvastatin pravastatin | X | Studies of several HMG-CoA reductase inhibitors have shown congenital abnormalities in infants and skeletal malformations in rats and mice. |
| Anticonvulsant | topiramate | X | Increased risk for cleft lip and/or cleft palate (oral cleft), hypospadias. Abortions, premature births, low birth weights, and a reduction in live births have also been observed in prospective studies. |
| Anticonvulsant/mood stabilizer | valproic acid | X and D* | Valproic acid syndrome in infants (facial dysmorphology, congenital heart defects, spina bifida, cleft lip and palate, and developmental delays). |
| Antiemetic | ondansetron | Fetal risk cannot be ruled out | Inconsistent findings, possible increased risk of cardiac malformations |
| Selective serotonin reuptake inhibitor | paroxetine | Fetal risk has been demonstrated | Increased risk of major congenital and cardiac malformations and an increased risk of pulmonary hypertension of the newborn, especially with use during the first trimester of pregnancy. |
| Angiotensin converting enzyme inhibitor | lisinopril | Fetal risk has been demonstrated | Increased risk of spontaneous abortion, oligohydramnios, and newborn renal dysfunction. |
HMG-CoA, 3-hydroxy-3-methyl-glutaryl-coenzyme A.
↵* X for migraine prophylaxis, valproate products; D for epilepsy and bipolar disorder.