List of medicines to avoid during pregnancy along with their safer alternatives available.


Medicines to avoid during pregnancy


Pregnancy is a miraculous journey that typically lasts around 40 weeks.The duration of pregnancy, which is separated into three trimesters, is usually around 40 weeks. For both the mother and the developing baby, each trimester brings its own distinct set of changes and developments.

First trimester(1-12 weeks):

The fertilised egg lodges itself in the uterus during the first trimester and starts to develop into an embryo.
It is possible to experience early pregnancy symptoms like morning sickness, exhaustion, breast soreness, and frequent urination.
Major limbs, organs, and facial features of the unborn child begin to develop.
The baby’s heart begins to beat towards the end of the first trimester, and the gender is typically known

Second trimester (13-18 weeks):

Because many women receive respite from the early pregnancy symptoms at this time, the second trimester is frequently referred to as the “golden period” of pregnancy.
While the baby’s organs continue to develop, it also begins to move and kick.
The mother’s belly starts to clearly enlarge, and she might feel the baby’s “quickening” movements.
The baby’s sex organs grow, and ultrasonography can usually determine the baby’s gender.

Third trimester (29-40 weeks):

The baby acquires weight and grows quickly in the third trimester.
Inconveniences including back pain, more frequent Braxton Hicks contractions, and shortness of breath could affect the mother.
In preparation for birth, the baby’s lungs develop and its head normally descends into the pelvis.
The woman may start to have regular contractions, her water may break, and her cervical dilation towards the end of the third trimester.
It is crucial to protect the health and wellbeing of both the mother and the growing foetus throughout pregnancy because it is a special moment in a woman’s life. And during this time,it is extremely important to know which medicine is safe and which is toxic as even a slight mistake can have dire consequences on mother aswell as the unborn child.Knowing which medications to avoid while being pregnant is an important part of prenatal care. While many medications are thought to be safe to use during pregnancy, there are several that are known to provide dangers to the fetus’s development and should be avoided in order to avoid potential harm. The medications that should be avoided during pregnancy and the reasons why will be thoroughly discussed in this article.

Categories of drugs:

The study of the safety of drugs during pregnancy is a difficult and dynamic subject.Based on their possible dangers to the growing foetus, the U.S. Food and Drug Administration (FDA) divides drugs into many categories. These categories consist of:
Category A: Appropriate and carefully monitored trials in pregnant women have not revealed any foetal risk.
Category B: Pregnancy-related concerns have not been demonstrated in tests on animals, although such research is inadequate.
Category C: Although there aren’t enough well-controlled trials on pregnant women, animal studies have revealed negative consequences, though it’s possible that the potential advantages outweigh the dangers.
Category D: Based on human data, there is evidence that the foetus is at danger, although in some cases, the benefits may outweigh the risks.
Category X: Research on both humans and animals has revealed serious hazards to the foetus, and these risks outweigh any potential advantages. Using these drugs while pregnant is not advised.

Medicines to avoid during pregnancy:


Several different medical issues require the usage of medications, however not all medications are safe to take while pregnant. There is evidence that some medicines can harm the developing foetus and result in birth abnormalities, developmental delays, or other problems. It is crucial that pregnant women understand which medications are safe to take and which ones they should avoid, and that they speak with their healthcare professional before taking any prescriptions.

Here is the list of medicines to avoid during pregnancy and their brand names in Pakistan along with their alternative :

Accutane (isotretinoin): Accutane is a potent drug used to treat severe acne, it belongs to category X and is strictly forbidden to take it while you are pregnant due to the possibility that it can result in birth defects. It has been linked to a significant chance of severe birth malformations, such as heart, head, and facial abnormalities, as well as abnormalities of the central nervous system. Topical medications like benzoyl peroxide, glycolic acid, or azelaic acid, which are typically regarded as safe for use during pregnant, may be another option for treating acne during pregnancy. But, it’s crucial to speak with a doctor before using any acne medications while pregnant.
ACE inhibitors: These drugs are used to treat high blood pressure, however there is a possibility that they could be harmful to an unborn child thus are placed in category C and D . It has been established that ACE inhibitors have harmful effects on embryonic development, including birth abnormalities, kidney damage, and other issues. If a pregnant woman has high blood pressure, she should discuss alternate choices with her doctor, such as lifestyle modifications, other drugs that are thought to be safe to take while pregnant, or close monitoring of blood pressure.
Warfarin: A common blood thinner and anticoagulant used to prevent blood clots is warfarin.It belongs to pregnancy category D , it has been linked to birth malformations include skeletal deformities and developmental delays, as well as an increased risk of bleeding during pregnancy. Working together with their healthcare practitioner, pregnant women who need anticoagulant therapy should identify the pregnancy’s safest alternative possibilities. Warfarin may be substituted with heparin, a different type of anticoagulant that is frequently regarded as safer for usage during pregnancy.
Methotrexate is a drug that is used to treat various cancers as well as autoimmune conditions like psoriasis and rheumatoid arthritis. However, it belongs to pregnancy category X and should be avoided during pregnancy as it is known to cause birth malformations, such as limb anomalies and developmental delays. Together with their healthcare provider, pregnant women with these diseases should investigate other treatment modalities that are deemed safer to use while pregnant, such as corticosteroids or other immunosuppressive drugs.
Nonsteroidal anti-inflammatory medicines, or NSAIDs, are frequently used to treat pain, lessen inflammation, and lower fever. Examples of NSAIDs include ibuprofen, aspirin, and naproxen. However,they are avoided in pregnancy as they belongs to category B and D depending on pregnancy trimesters especially when used during the third trimester of pregnancy, they have been linked to an increased risk of miscarriage and injury to the growing foetus. Acetaminophen, which is typically regarded as safe for use during pregnancy when used according to the authorised dosage, should be considered as an alternative to NSAIDs for pain relief or fever reduction in pregnant women.
Tetracycline: Bacterial infections are treated with tetracycline, an antibiotic. Nonetheless, it should be avoided during pregnancy as it is known to discolour a baby’s developing teeth and is a categoryD medicine. Women who are pregnant and have bacterial infections should discuss alternate antibiotics, such as penicillin or erythromycin, with their healthcare physician.
Retinoids: A class of drugs that include tretinoin, adapalene, and tazarotene are known to cause birth abnormalities thats why categorized in category D and should be avoided during pregnancy. They are used to treat skin problems like acne and psoriasis.
Lithium: Used for bipolar disorder. Alternative: Other mood stabilizers such as lamotrigine or olanzapine.
Carbamazepine: Used for epilepsy and mood disorders and belongs to categoryD . Alternative: Other antiepileptic drugs like lamotrigine or levetiracetam.
Misoprostol: Used for ulcers and to induce labor belongs to categoryD . Alternative: None, as misoprostol can cause uterine contractions and should be avoided during pregnancy.
Ergotamine: Used for migraines and isplaced in categoryC and is only used when benifits outweighs the risks. Alternative: Acetaminophen (paracetamol) or sumatriptan (under close medical supervision).
Fluconazole: Used for fungal infections and belongs to categoryD . Alternative: Topical antifungal creams or nystatin.
Diuretics (e.g., furosemide): Used for high blood pressure and edema. Alternative: Lifestyle changes, such as a low-sodium diet and increased physical activity.

Foods to avoid during pregnancy:

To promote the healthy growth of your unborn child during pregnancy, it’s crucial to pay attention to the meals you eat. These are a few foods to avoid during pregnancy:
  • Seafood, eggs, and meat that are raw or undercooked may contain dangerous bacteria including salmonella, listeria, and toxoplasma that could be hazardous to the health of your unborn child.
  • Species that are known to have high levels of mercury, such as shark, swordfish, king mackerel, and tilefish, can affect your baby’s growing neurological system.
  • Processed foods and foods high in sugar: They can promote weight gain that is excessive and raise the risk of gestational diabetes.
  • Supplementing with too many vitamins and minerals can be hazardous to the development of your unborn child. One such vitamin and mineral is vitamin A. Before ingesting any supplements while pregnant, it’s crucial to speak with your doctor about your diabetes.
  • Caffeine intake that is excessive: Consuming excessive amounts of caffeine during pregnancy has been linked to a higher risk of miscarriage and low birth weight. It’s ideal to keep your daily caffeine consumption to 200 mg, or roughly one 12-ounce cup of coffee.
  • Alcohol: Because it can increase the risk of birth abnormalities and developmental delays, there is no safe level of alcohol use during pregnancy.
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