TABLE H-1
Selected Medications and Reported Associated Malformations *
Modified from Briggs GG, Freeman RK, Yaffe SJ: Drugs in Pregnancy and Lactation, 7th ed. Philadelphia, Lippincott Williams & Wilkins, 2005.
| Drug | Malformation(s) |
|---|---|
| Acetazolamide | Sacrococcygeal teratoma |
| Acyclovir | CDH, neural tube defect, cleft lip, clubfoot, transposition |
| Alprazolam | Umbilical hernia, clubfoot |
| Albuterol | Cleft palate, cranioschisis, cardiovascular defect, spina bifida, polydactyly, fetal tachycardia |
| Amantadine | Cardiac defects |
| Aminopterin | Neural tube defects, hydrocephalus, limb shortening, cleft lip/palate, clubfoot |
| p-Aminosalicylic acid | Ear deformity, limb deformity, hypospadias |
| Amiodarone | FGR, ventricular septal defect, micrognathia |
| Amitriptyline | Limb reduction, micrognathia, hypospadias, cleft palate, thanatophoric dysplasia |
| Ampicillin | Transposition of the great vessels |
| Amobarbital | Anencephaly, cardiac defects, limb deformity, cleft lip/palate, polydactyly, genitourinary defects, clubfoot |
| Amphetamine | Cerebral injury in neonates |
| Aspirin | Intracranial hemorrhage, FGR |
| Atenolol | Hypospadias, cardiovascular defects |
| Atropine | Polydactyly, limb reduction |
| Azatadine | Oral cleft, limb reduction |
| Baclofen | Spina bifida |
| Belladonna | Eye/ear malformations, hypospadias |
| Benztropine | Cardiovascular defects |
| Bromides | Polydactyly, gastrointestinal anomalies, clubfoot, FGR |
| Busulfan | FGR, cleft palate, neural tube defects |
| Captopril | Second-trimester hypocalvaria, oligohydramnios, renal dysfunction |
| Carbamazepine | Neural tube defects, cardiac defects |
| Carisoprodol | Oral clefts |
| Cephalexin | Cardiovascular defects, oral clefts |
| Cephradine | Cardiovascular defects |
| Chlorambucil | Renal agenesis, cardiac defects |
| Chlordiazepoxide | Microcephaly, duodenal atresia, cardiac defects |
| Chloroquine | Wilms tumor, hemihypertrophy, tetralogy of Fallot |
| Chlorothiazide | Fetal bradycardia |
| Chlorpheniramine | Polydactyly, gastrointestinal defects, hydrocephalus |
| Chlorpromazine | Microcephaly, syndactyly |
| Chlorpropamide | Microcephaly, hand anomalies |
| Ciprofloxacin | Hypospadias, cerebellar hypoplasia, cardiovascular defect, femoral aplasia |
| Clarithromycin | Craniofacial abnormalities, absent clavicles, spina bifida, cleft lip, pulmonary hypoplasia; coloboma, heart anomaly, choanal atresia, retardation (mental and somatic), genital and ear anomalies (CHARGE) association |
| Clomiphene | Microcephaly, neural tube defects, cleft lip/palate, cardiac defects, syndactyly, clubfoot, hypospadias |
| Clonazepam | Cardiovascular defects |
| Clorazepate | Bifid foot, absent scrotum, short femur, absent fibula, absent metacarpal bones, renal agenesis |
| Cloxacillin | Cardiovascular defects |
| Cocaine | Spontaneous abortion, placental abruption, cardiac defects, urinary tract and limb abnormalities, bowel atresias, FGR |
| Codeine | Pulmonary and genitourinary defects, hydrocephalus, cleft lip/palate |
| Colchicine | Cardiac malformation, syndactyly, cleft palate |
| Cortisone | Cataracts, cyclopia, VSD, coarctation of the aorta, clubfoot, cleft lip, gastroschisis |
| Coumarin derivatives | Spontaneous abortion, FGR, neural tube defects (open and closed) (dorsal midline dysplasia), cardiac defects, scoliosis, limb hypoplasia, cleft palate |
| Cyclophosphamide | Cleft palate, hand abnormalities, cardiac defects, FGR |
| Cyclosporine | Limb hypoplasia, agenesis of the corpus callosum, anencephaly, FGR |
| Cyproheptadine | Cleft lip/palate, hypospadias |
| Cytarabine | Hand abnormalities (lobster claw deformity), lower limb defects, neural tube defects, cardiac defects |
| Dacarbazine | Limb reduction defects, cleft palate, encephalocele |
| Danazol | Ambiguous genitalia |
| Daunorubicin | FGR |
| Dexfenfluramine | Hand malformation, anencephaly, vertebral abnormality |
| Diazepam | Cleft lip/palate, cardiac defects |
| Dicyclomine | Polydactyly |
| Dilantin | Microcephaly, hypertelorism, cleft lip/palate, hypoplasia of distal phalanges, short neck, broad nasal ridge |
| Diltiazem | Cardiovascular defects |
| Dimenhydrinate | Cardiovascular defects |
| Diphenhydramine | Cleft lip/palate, genitourinary defects, clubfoot, cardiac defects |
| Disulfiram | Clubfoot, vertebral defects, anal atresia, cardiac anomalies, tracheoesophageal fistula with esophageal atresia, renal anomalies, limb anomalies (VACTERL) syndrome, phocomelia |
| Doxepin | Oral clefts, polydactyly |
| Droperidol | Hydrocephalus, cerebral hypoplasia |
| Enalapril | Hypocalvaria, renal defects |
| Ephedrine | Clubfoot |
| Ethanol (alcohol) | FGR, microphthalmia, micrognathia, microcephaly, hypoplastic maxilla, cardiac defects, gentourinary defects, radioulnar synostosis, Klippel-Feil anomaly, diaphragmatic hernia |
| Ethoheptazine | Umbilical hernia, hip dislocation |
| Ethotoin | Cleft lip/palate, patent ductus arteriosus |
| Ethosuximide | Cleft lip/palate, hydrocephalus, patent ductus arteriosus, spontaneous hemorrhage in the neonate |
| Etretinate | Neural tube defects, facial dysmorphia, multiple synostoses, syndactylies, limb reduction |
| Fluconazole | Craniosynostosis, cleft palate, limb shortening |
| Fluorouracil | Radial aplasia, pulmonary hypoplasia, esophageal and duodenal atresia, cloacal malformation |
| Fluphenazine | Ocular hypertelorism, cleft lip/palate, imperforate anus |
| Furosemide | Hypospadias |
| Griseofulvin | Conjoined twins |
| Haloperidol | Limb reduction, aortic valve defect |
| Heparin | Cardiovascular defects |
| Heroin | FGR, multiple and varied congenital malformations |
| Hydroxyprogesterone | Spina bifida, anencephaly, tetralogy of Fallot, truncus arteriosus, VSD |
| Hydroxyzine | Oral clefts |
| Hyoscyamine | Polydactyly, limb reduction |
| Ibuprofen | Oligohydramnios, premature closure of patent ductus arteriosus |
| Imipramine | Diaphragmatic hernia, cleft palate, exencephaly, renal cystic dysplasia, amelia |
| Indomethacin | Oligohydramnios, premature closure of patent ductus arteriosus, phocomelia, penile agenesis |
| Isoetharine | Clubfoot |
| Isotretinoin | Hydrocephalus, neural tube defects, microphthalmia, microcephaly, cardiac defects, limb abnormalities, cleft palate |
| Itraconazole | Limb defect |
| Ketoconazole | Limb defect |
| Ketorolac | Constriction of the ductus arteriosus, fetal renal impairment |
| Levothyroxine | Cardiac defects, polydactyly |
| Lindane | Hypospadias |
| Lisinopril | Hypocalvaria, polydactyly, oligohydramnios |
| Lithium | Cardiac defects (Ebstein anomaly, VSD, coarctation, mitral atresia), neural tube defects |
| Lovastatin | Aortic hypoplasia, VSD, anal atresia, renal dysplasia, radial aplasia |
| Lysergic acid diethylamide | FGR, limb reduction, neural tube defects, cardiac defects |
| Marijuana | FGR, facial anomalies |
| Mechlorethamine | FGR, oligodactyly, malformed kidneys |
| Medroxyprogesterone | Cardiovascular defect |
| Meclizine | Eye and ear defects, hypoplastic heart, respiratory defects |
| Mefenamic acid | Constriction of the ductus arteriosus |
| Melphalan | FGR |
| Meprobamate | Cardiac defects, omphalocele, joint abnormalities |
| Mercaptopurine | Cleft palate, microphthalmia, FGR |
| Metaproterenol | Polydactyly |
| Methimazole | Patent urachus |
| Methotrexate | FGR, hypertelorism, dextroposition of the heart, absent digits, absence of frontal bone |
| Methotrimeprazine | Hydrocephalus, cardiac defects |
| Metronidazole | Spontaneous abortion, limb, cardiac, urinary, and facial abnormalities |
| Mifepristone | Sirenomelia, caudal regression syndrome |
| Minoxidil | Omphalocele, clinodactyly, cardiac defects (VSD and transposition) |
| Misoprostol | Limb defects, hypocalvaria, cleft lip, clubfoot, gastroschisis |
| Norethindrone | Neural tube defects, hydrocephalus |
| Norethynodrel | Cardiac defects, hypospadias |
| Nortriptyline | Limb reduction |
| Ofloxacin | Myelomeningocele, hydrocephalus, hypospadias |
| Omeprazole | Anencephaly, hydranencephaly, clubfoot |
| Oxazepam | Neural tube defects, FGR |
| Paramethadione | Spontaneous abortions, FGR, cardiac defects |
| Penicillamine | Hydrocephalus, flexion deformities, perforated bowel |
| Pentoxifylline | Cardiac defects |
| Phenacetin | Craniosynostosis and atresia, musculoskeletal and urinary tract defects |
| Phenobarbital | Cardiovascular defects |
| Phensuximide | Ambiguous genitalia |
| Phenylephrine | Eye and ear abnormalities, syndactyly, clubfoot, musculoskeletal defects |
| Phenylpropanolamine | Eye and ear abnormalities, polydactyly, hypospadias |
| Phenytoin | Microcephaly, hypertelorism, cleft lip/palate, hypoplasia of distal phalanges, short neck, broad nasal ridge |
| Podophyllum | Limb reduction |
| Procarbazine | FGR, cardiac defects, oligodactyly, malformed kidneys |
| Prochlorperazine | Cleft palate/micrognathia, cardiac defects, skeletal defects |
| Propoxyphene | Limb abnormalities, omphalocele, micrognathia, clubfoot, microcephaly |
| Quinacrine | Renal agenesis, neural tube defects |
| Quinine | Neural tube defects, hydrocephalus, limb defects, facial defects, cardiac defects, urogenital abnormalities, vertebral abnormality, gastrointestinal anomaly |
| Reserpine | Microcephaly, hydronephrosis |
| Retinoic acid | Hydrocephalus, neural tube defects, microphthalmia, microcephaly, cardiac defects, limb abnormalities, cleft palate |
| Rifampin | Anencephaly, hydrocephalus, limb malformation |
| Sodium iodide | Ablation of fetal thyroid gland |
| Sulfasalazine | Cleft lip/palate, hydrocephalus, cardiac defects, urinary tract abnormalities |
| Sulfonamides | Limb hypoplasia, urinary tract abnormalities |
| Sumatriptan | Phocomelia, tibial aplasia, clubfoot, cleft palate |
| Tamoxifen | Ambiguous genitalia |
| Tazarotene | Reduced skeletal ossification, hydrocephaly, spina bifida, cardiac defects |
| Temazepam | Oral clefts |
| Terfenadine | Polydactyly |
| Tetracycline | Hypospadias, limb hypoplasia |
| Thioguanine | Absent digits |
| Tolbutamide | Syndactyly, cardiac defects, clubfoot |
| Trifluoperazine | Phocomelia, transposition of the great vessels |
| Trimethadione | FGR, microcephaly, cleft lip/palate, cardiac defects, malformed hand, clubfoot, ambiguous genitalia, esophageal atresia, tracheoesophageal fistula |
| Trimethoprim | Cardiovascular defects |
| Valproic acid | Neural tube defects, cardiac defects, facial dysmorphism, hypertelorism, protruding eyes, micrognathia, hydrocephalus, cleft lip/palate, microcephaly, limb reduction, scoliosis, renal hypoplasia, duodenal atresia, hand deformity |
| Zidovudine | Renal agenesis, microphthalmus, polydactyly, cleft lip/palate, clubfoot, VSD |
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