Prescribing in Pregnancy

Key points

• Generally safe: penicillins, cephalosporins, erythromycin (avoid estolate), most antihypertensives (labetalol, methyldopa, nifedipine).
• Avoid: tetracyclines (teeth/bone), aminoglycosides (ototoxicity), ACE inhibitors/ARBs (renal dysgenesis), warfarin (fetal bleeding/teratogenic), statins.
• Antiepileptics: valproate most teratogenic (neural tube defects); lamotrigine relatively safest.
• Methimazole/carbimazole: risk of aplasia cutis; PTU preferred in first trimester.
• Folate supplementation (400 µg; 5 mg if on antiepileptics) periconceptually.

Decision points in this pathway

• Which class?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.