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Analgesic Medications in PregnancyAka: Anesthetic Medications in Pregnancy, Rheumatologic Preparations in Pregnancy, Analgesic Medications in Lactation

See Also
1. Medications in Pregnancy
Class B: No risk in controlled animal studies
1. Acetaminophen (Tylenol)
  1. Analgesic of choice in pregnancy
2. Narcotics (Class D if prolonged use or high dose)
  1. Nalbuphine (Nubain)
  2. Meperidine (Demerol)
  3. Butorphanol (Stadol)
  4. Fentanyl (Duragesic)
  5. Hydromorphone (Dilaudid)
  6. Methadone (Dolophine)
  7. Morphine Sulfate
  8. Oxycodone (Percocet)
3. NSAIDs (first or second trimester only)
  1. Ibuprofen (Motrin)
  2. Indomethacin (Indocin)
  3. Ketoprofen (Orudis)
  4. Naproxen (Naprosyn)
  5. Piroxicam (Feldene)
  6. Sulindac (Clinoril)
Class C: Small risk in controlled animal studies
1. Narcotics (Class D if prolonged use or high dose)
  1. Codeine (Tylenol with codeine)
  2. Hydrocodone (Vicodin)
  3. Tramadol (Ultram)
  4. Propoxyphene (Darvocet)
2. Barbiturates
  1. Butalbital (Fiorinal)
    1. Class D if prolonged use or high dose
3. NSAIDs (first or second trimester only)
  1. Aspirin
  2. Etodolac (Lodine)
  3. Ketorolac (Toradol)
  4. Nabumetone (Relafen)
  5. Oxaprozin (Daypro)
Class D: Strong evidence of risk to the human fetus
1. Aspirin
  1. Used only with specific indications in pregnancy
  2. Risk of neonatal hemorrhage, IUGR, perinatal death
  3. Low dose Aspirin may be safer
    1. Hauth (1995) Obstet Gynecol 85:1055
2. All NSAIDs (Third Trimester)
3. Prolonged use or high dose of any Narcotic
4. Prolonged use or high dose Butalbital (Fiorinal)
5. General Anesthesia - not in Briggs (1998)
Lactation Safe Analgesic Medications
1. Acetaminophen (Tylenol)
2. Ibuprofen (Motrin)
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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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.