analgesics during pregnancy
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Introduction
- acetaminophen (A)
- NSAIDs
- avoid NSAIDs[1]
- linked to miscarriage & rare birth defects in 1st trimester
- linked to premature closure of the ductus arteriosus in 3rd trimester[1]
- ibuprofen (B)
- naproxen (B)
- ketoprofen (B)
- diclofenac (B)
- flurbiprofen (B)
- avoid NSAIDs[1]
- phenazopyridine (B)
- pentosan polysulfate (B)
- opiates
- pregnancy category generally = C
- pregnancy category D (prolonged use or high doses at term)
- avoid opiates if possible
- use opiate if no other options
- small risk of heart defects & spina bifida in 1st trimester
- risk of fetal exposure, fetal dependence
- infants born to women who used opioids during pregnancy should be monitored for neonatal abstinence syndrome[2]
- breast feeding encouraged in women on stable opiate doses[2]
* pregnancy category in parentheses
More general terms
References
- ↑ 1.0 1.1 1.2 Prescriber's Letter 19(2): 2012 Analgesics in Pregnancy and Lactation Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=280211&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 2.0 2.1 2.2 Anello J, Feinberg B, Heinegg J et al Opioid Use and Pregnancy Guidelines on opioid use during pregnancy by the American College of Obstetricians and Gynecologists. Medscape: New Guidelines and Recommendations, August 2017. http://reference.medscape.com/viewarticle/884517
American College of Obstetricians and Gynecologists (ACOG) Opioid Use and Opioid Use Disorder in Pregnancy. Committee Opinion Number 711, August 2017 https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Opioid-Use-and-Opioid-Use-Disorder-in-Pregnancy