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Hematology Medications in Pregnancy

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Hematology Medications in Pregnancy, Oncology Medications in Pregnancy

  • Background
  1. Pregnancy Categories will be replaced on medication bottles with specific warnings and precautions by 2020 in U.S.
    1. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm425317.htm
    2. Although FDA Pregnancy Categories are no longer FDA designated, they are included here
      1. As of 2018, succinct guidance (to replace ABCDX) on specific drugs in pregnancy is lacking
  • Class B
  • No risk in controlled animal studies
  • Class C
  • Small risk in controlled animal studies
  1. Antiplatelet Medications
    1. Clopidogrel (Plavix) - not in Briggs (1998)
    2. Dipyridamole (Persantine)
    3. Ticlopidine (Ticlid) - not in Briggs (1998)
  2. Chemotherapeutics
    1. Asparaginase
    2. Dacarbazine
    3. Dactinomycin
    4. Interferon alfa
  • Class D
  • Strong evidence of risk to the human fetus
  1. Chemotherapeutics
    1. Bleomycin
    2. Cisplatin
    3. Cyclophosphamide
    4. Cytarabine
    5. Daunorubicin
    6. Doxorubicin
    7. Etoposide
    8. Fluorouracil
    9. Hydroxyurea
    10. Melphalan
    11. Mercaptopurine
    12. Methotrexate
    13. Plicamycin
    14. Tamoxifen
    15. Vinblastine
    16. Vincristine
  2. Miscellaneous Agents
    1. EDTA - Not in Briggs (1998)
    2. Penicillamine
  3. Anticoagulants
    1. Coumadin (Warfarin)
    2. Dicumarol
  • Class X
  • Very high risk to the human fetus
  1. Leuprolide (Lupron)
  2. Aminopterin
  • References
  1. Briggs (1998) Drugs in Pregnancy and Lactation, 5th ed
  2. Larimore (2000) Prim Care 27(1):35-53 [PubMed]