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  • Gastrointestinal Medications in Pregnancy

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Gastrointestinal Medications in Pregnancy

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  1. See Also
    1. Inflammatory Bowel Disease in Pregnancy
    2. Constipation in Pregnancy
    3. Diarrhea in Pregnancy
    4. Dyspepsia in Pregnancy
    5. Vomiting in Pregnancy
    6. Medications in Pregnancy
  2. Class A: No risk in controlled human studies
    1. Pyridoxine (Vitamin B6)
  3. Class B: No risk in controlled animal studies
    1. Milk of Magnesia
    2. Doxylamine
    3. Metoclopramide
    4. Antacids (e.g. Maalox, Mylanta, Tums)
      1. May interfere with iron absorption
      2. High dose aluminum associated with fetal malformation
    5. Kaolin-pectin (Kaopectate)
      1. Considered antidiarrheal of choice in pregnancy
      2. Not absorbed but risk of Iron Deficiency Anemia
    6. Loperamide (Imodium)
      1. Possibly associated with fetal cardiac malformation
      2. Avoid in first trimester
    7. Sucralfate
    8. Meclizine (Antivert)
    9. Mesalamine
    10. Ranitidine
      1. Crosses placenta but considered safe
      2. Used as second line after maalox, mylanta or tums
    11. Cimetidine
      1. Crosses placenta but considered safe
      2. Used as second line after maalox, mylanta or tums
    12. Lansoprazole
    13. Lactulose
  4. Class C: Small risk in controlled animal studies
    1. Hydroxyzine (Vistaril)
    2. Prochlorperazine (Compazine)
    3. Droperidol (Inapsine)
    4. Metamucil
    5. Bismuth Subsalicylate (Pepto Bismol) in trimester 1-2
      1. Risk of Salicylate absorption
      2. Not recommended in pregnancy
    6. Atropine-Diphenoxylate (Lomotil)
      1. Class D in third trimester
      2. Not recommended in pregnancy
    7. Nizatidine (Axid)
      1. Avoid in pregnancy
      2. IUGR, fetal death and abortion seen in rabbit studies
    8. Docusate sodium (Colace)
    9. Promethazine (Phenergan)
    10. Senna
  5. Class X: Very high risk to the human fetus
    1. Misoprostol
    2. Bismuth Subsalicylate (Pepto Bismol) in trimester 3
  6. References
    1. Briggs (1998) Drugs in Pregnancy and Lactation, 5th ed
    2. Black (2003) Am Fam Physician 67(12):2517
    3. Larimore (2000) Prim Care 27(1):35

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