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Drilldown: Medicines
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Medicines (732)
Medicines
> pregnancy:
Limit to <200 mg/d (~2 cups brewed)
&
legal:
Unrestricted (food)
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Category C
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Limited data; avoid
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Limited data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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Limited human data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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Limited data
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Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)'"`UNIQ--ref-0000002B-QINU`"'
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Category B
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Chronic third-trimester exposure produces neonatal opioid withdrawal syndrome and respiratory depression at delivery.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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Generally considered safe (minimal systemic absorption).<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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Limited data; switch to insulin where feasible.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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Limited data; weigh against alternatives.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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'''Avoid in pregnancy where alternatives exist''' (animal cartilage toxicity; class-wide concern).<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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Avoid in second and third trimesters; fetal SGLT2 inhibition disrupts kidney development.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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Avoid where possible; class concerns as for other loop diuretics.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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Generally considered safe due to minimal systemic absorption.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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Generally considered safe in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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Generally considered safe.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
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Generally considered safe; minimal systemic exposure.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Other values:
'''Among the least preferred SSRIs in pregnancy.''' Observational signal for cardiac malformations (atrial and ventricular septal defects) with first-trimester exposure, and the most severe neonatal adaptation syndrome of any SSRI with third-trimester exposure'"`UNIQ--ref-0000002D-QINU`"'
'''Among the safest antihypertensives in pregnancy''', recommended for chronic hypertension during pregnancy and first-line for severe hypertension in preeclampsia and eclampsia'"`UNIQ--ref-0000001C-QINU`"'
'''Among the safest mood stabilizers in pregnancy''' with reassuring monotherapy registry data, in sharp contrast to valproate. Estrogen-containing contraceptives accelerate lamotrigine metabolism, requiring dose adjustments at start and stop of contraception'"`UNIQ--ref-00000027-QINU`"'
'''Avoid at term (38-42 weeks) and during labor''' (risk of neonatal hemolytic anemia, especially with G6PD deficiency); generally safe in earlier pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
'''Avoid in pregnancy where alternatives exist''' (animal cartilage toxicity).<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
'''Avoid in pregnancy where alternatives exist''' (animal cartilage toxicity; class-wide concern); use only when benefit clearly outweighs.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
'''Considered one of the safest anticonvulsants in pregnancy''', with reassuring monotherapy registry data comparable to lamotrigine and in sharp contrast to valproate, topiramate, and carbamazepine'"`UNIQ--ref-00000021-QINU`"'
'''Contraindicated for migraine prophylaxis in pregnancy; high teratogenic risk''' (neural tube defects, craniofacial anomalies, cardiac defects, cognitive/IQ impairment); avoid in women of childbearing potential without reliable contraception when alternatives exist'"`UNIQ--ref-0000097E-QINU`"'
'''Contraindicated in pregnancy''' (Category X); abortifacient and teratogenic. Discontinuation 3-6 months before conception is standard.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
'''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, hypocalvaria, hypotension. Stop on detection'"`UNIQ--ref-000000BE-QINU`"'
'''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, hypocalvaria, hypotension. Stop on detection'"`UNIQ--ref-000004CF-QINU`"'
'''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, hypocalvaria, hypotension. Stop on detection'"`UNIQ--ref-0000056E-QINU`"'
'''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, hypocalvaria, hypotension. Stop on detection'"`UNIQ--ref-00000844-QINU`"'
'''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, hypocalvaria, hypotension. Stop on detection'"`UNIQ--ref-00000AF0-QINU`"'
'''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, skull hypoplasia, hypotension. Stop on detection'"`UNIQ--ref-0000005B-QINU`"'
'''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, skull hypoplasia, hypotension. Stop on detection'"`UNIQ--ref-00000A24-QINU`"'
'''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, skull hypoplasia, hypotension. Stop on detection'"`UNIQ--ref-00000B86-QINU`"'
'''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, skull hypoplasia, hypotension'"`UNIQ--ref-00000C34-QINU`"'
'''Documented fetal growth restriction with chronic exposure'''; avoid in pregnancy if alternative β-blockers are appropriate. The β-blocker most consistently associated with intrauterine growth concerns'"`UNIQ--ref-00000022-QINU`"'
'''Pregnant individuals should not handle crushed/broken tablets''' (skin absorption risk); can cause hypospadias in male fetus. Not used in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
'''Pregnant individuals should not handle dutasteride capsules''' (skin absorption risk through intact capsule); can cause hypospadias in male fetus.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
'''Substantial teratogenic risk''' including cleft lip/palate, hypospadias, and growth restriction (pregnancy registry data clear); effective contraception and pre-pregnancy counseling are required in reproductive-age patients'"`UNIQ--ref-0000002A-QINU`"'
'''Substantial teratogenic risk''' including neural tube defects, craniofacial malformations, cardiac defects, and growth restriction; folic acid supplementation and effective contraception are required in reproductive-age patients'"`UNIQ--ref-0000001F-QINU`"'
Aminoglycoside-class ototoxicity in fetal cochlea is documented; use only when alternatives have failed.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Avoid after 20 weeks (NSAID-class FDA 2020 advisory on fetal renal injury and oligohydramnios with second/third-trimester use).<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Avoid after 20 weeks (NSAID-class FDA 2020 advisory).<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)'"`UNIQ--ref-00000022-QINU`"'
Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)'"`UNIQ--ref-00000028-QINU`"'
Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning; contraindicated from 30 weeks (risk of premature ductus arteriosus closure, which is paradoxically the basis of the neonatal PDA-closure indication)'"`UNIQ--ref-00000028-QINU`"'
Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning; contraindicated from 30 weeks. Specifically contraindicated in labor and delivery due to inhibition of uterine contractions'"`UNIQ--ref-00000022-QINU`"'
Avoid in pregnancy; antiandrogen effects can feminize a male fetus.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Avoid in pregnancy; switch to LMWH. Crosses placenta; warfarin-class concerns about fetal hemorrhage and teratogenicity make heparins the preferred class.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Avoid where possible; can reduce uteroplacental perfusion and produce neonatal electrolyte disturbance. Reserved for compelling indications.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Avoid. Benzodiazepines are associated with neonatal sedation, floppy-infant syndrome, and withdrawal; teratogenic signal weak but non-zero. Designer benzo with no safety data, assume worst-case.
Avoid. Discontinue at least 1 month before planned pregnancy. Animal data show embryofetal harm.'"`UNIQ--ref-0000005B-QINU`"'
Avoid. Discontinue before planned pregnancy.'"`UNIQ--ref-000000EF-QINU`"'
Avoid. Discontinue before planned pregnancy.'"`UNIQ--ref-0000018C-QINU`"'
Avoid. Discontinue ≥1 month pre-conception. May reduce oral contraceptive efficacy during titration.'"`UNIQ--ref-00000304-QINU`"'
Avoid; NSAID-class restriction after 20 weeks (FDA 2020) and limited triptan pregnancy data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Avoid; aspirin teratogenicity concerns plus opioid neonatal withdrawal.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Avoid; may cause fetal harm
Avoid; neonatal opioid withdrawal documented.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated.
Avoid; switch to insulin. Hypoglycemia in newborn reported.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Avoid; switch to insulin. Neonatal hypoglycemia reported.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Avoided where possible; same class concerns as HCTZ.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Avoided; barbiturate + aspirin teratogenicity and bleeding concerns.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Category C (buprenorphine-only formulations preferred in pregnancy)
Category C (not relevant; not used in women)
Category C (per Desoxyn label)
Category C; limited data
Category C'"`UNIQ--ref-00000045-QINU`"'
Category C'"`UNIQ--ref-0000008F-QINU`"'
Category D'"`UNIQ--ref-0000006C-QINU`"'
Category X, contraindicated; teratogenic (virilization of female fetus)
Contraindicated in known pregnancy (Aygestin); the 0.35 mg POP is not teratogenic and does not need to be discontinued before conception planning.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Contraindicated in known pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Contraindicated in pregnancy (FDA label).<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Contraindicated in pregnancy (only used in postmenopausal women); D class historically.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Contraindicated in pregnancy (use is not appropriate during gestation; class label X). Lactation considerations vary by indication.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Contraindicated in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Discontinued/withdrawn
Extensive use experience in obstetric anesthesia; broadly considered safe'"`UNIQ--ref-00000022-QINU`"'
First-line in pregnancy; dose typically increased 25-30% due to estrogen-driven rise in TBG and fetal demand. Lactation safe at physiologic doses.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally avoided in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally avoided; barbiturate exposure in late pregnancy can produce neonatal withdrawal and respiratory depression.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally avoided; fetal goiter/hypothyroidism risk (iodine load). Used only for life-threatening arrhythmia.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally avoided; not first-line.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered acceptable for short-term use.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered acceptable when needed.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered acceptable.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe (minimal systemic exposure).<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe after the first trimester; first-trimester use weighed against indication.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe at standard doses; benefits typically outweigh in active IBD.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe in pregnancy (no systemic absorption).<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe; commonly used in pregnancy when macrolide indicated.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe; commonly used in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe; loratadine and cetirizine have more pregnancy data and are typically preferred.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe; pregnancy registries do not show increased major malformation risk.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe; widely used in PCOS and gestational diabetes; placental transfer occurs.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe; widely used in obstetric reflux.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe; widely used in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe; widely used. Cetirizine and loratadine remain the more-studied alternatives.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe; widely used. Cleared in lactation at low levels.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe; widely used. Levocetirizine (the R-enantiomer) is an alternative with similar safety.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe; widely used. Loratadine and cetirizine are the most-recommended 2nd-gen H1s in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally considered safe; widely used.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally safe at replacement doses; treat the underlying cause of hypokalemia.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Generally used when influenza treatment is indicated; pregnancy is a recognized risk factor for severe influenza.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
IV sulfate is the cornerstone of eclampsia/preeclampsia management; oral replacement also safe.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Inhaled and intranasal generally considered safe; widely used in asthma in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Insulin is the preferred glucose-lowering therapy in pregnancy; aspart is widely used.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Insulin is the preferred glucose-lowering therapy in pregnancy; degludec has reassuring observational data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Insulin is the preferred glucose-lowering therapy in pregnancy; glargine has reassuring observational data, though NPH and detemir remain the traditional choices.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Insulin is the preferred glucose-lowering therapy in pregnancy; lispro is widely used.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Intranasal long considered acceptable; widely used in obstetric rhinitis.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Investigational
Limit to <200 mg/d (~2 cups brewed)
Limited data; LABA/LAMA strategies in pregnancy generally favor agents with the most reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; National Pregnancy Registry available
Limited data; National Pregnancy Registry for Atypical Antipsychotics
Limited data; alternative antihypertensives generally preferred. Crosses placenta.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; avoid in pregnancy. Lactation: present in milk; consider risks
Limited data; case series and registries suggest no major teratogenicity but other antihypertensives (labetalol, nifedipine) are typically preferred.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; fluoxetine has reassuring data but olanzapine carries metabolic-syndrome and gestational diabetes signals.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; generally avoided in pregnancy for the cosmetic indication of onychomycosis.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; generally avoided particularly in combination with statin.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; generally avoided unless triglyceride pancreatitis risk is high.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; generally considered acceptable when needed.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; labetalol/nifedipine generally preferred. Crosses placenta.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; minimal systemic absorption likely renders fetal risk low.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; not first-line in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; pitolisant may reduce hormonal contraceptive efficacy
Limited data; pregnancy exposure registry available
Limited data; quinidine has been used in pregnancy as antiarrhythmic.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; rarely indicated in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; risk-benefit case by case; pregnancy is not a strict contraindication in WHO mass drug administration programs.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; second-line to intranasal corticosteroids or PO loratadine/cetirizine.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; weigh against alternatives (aspirin) where feasible.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; weigh against alternatives, though systemic exposure is low.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited data; weigh benefits/risks
Limited human data. Animal studies show fetal effects at maternally toxic doses; use only if benefits justify the potential risk.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; animal reproductive studies not conducted<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; case reports of neonatal sedation with late-pregnancy exposure.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; endogenous hormone, but supplemental pharmacological doses are not well characterized in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; observational signals inconclusive.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; older agent with substantial use experience and no clear teratogenic signal.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; older agent with substantial use experience.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; older agent with substantial use experience; some signal for first-trimester exposure but not conclusive.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; pregnancy registry data have been broadly reassuring across the triptan class.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; pregnancy registry data have been broadly reassuring relative to baseline malformation rates.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; rarely indicated in pregnancy given the patient population.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; rarely indicated in pregnancy given the typical patient population.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; signal for neonatal extrapyramidal symptoms and withdrawal with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; some animal cardiac signal not clearly replicated in human cohort studies; observational signals inconclusive.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; some observational signals reassuring relative to other antidepressants.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; some signal for cardiac malformations and developmental delay but confounded by maternal disease and polytherapy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; some signal for cleft palate with first-trimester exposure (debated); neonatal sedation and withdrawal with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; the amphetamine class is associated with intrauterine growth restriction and neonatal withdrawal symptoms.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data; β-blocker class effects include fetal growth restriction and neonatal bradycardia/hypoglycemia.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited human data<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited safety data; weigh benefit individually.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Limited use in pregnancy; chronic third-trimester opioid exposure produces neonatal opioid withdrawal syndrome and respiratory depression at delivery.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Long the preferred ICS in pregnancy (Pulmicort) due to the most pregnancy data among the class.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Long the preferred analgesic-antipyretic in pregnancy; recent observational studies have raised speculative neurodevelopmental signals that remain under investigation.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Long-considered safe in pregnancy for lupus and other rheumatologic indications; benefits typically outweigh.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Long-term skeletal retention is a concern given the unknown effect on developing fetal bone; generally avoided.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Low-dose (81 mg) safe and indicated for preeclampsia prophylaxis after 12 weeks in high-risk patients per USPSTF; high-dose aspirin avoid third trimester due to premature ductus arteriosus closure and bleeding risk
Medicine is structurally identical to endogenous allopregnanolone; pregnancy considerations relate to breastfeeding during/after infusion. Limited data; brief interruption of breastfeeding considered
Not absorbed; generally considered acceptable when bowel prep is required<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Not applicable (male indication); historical Category B if used in unrelated female cases.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Not established
Not indicated; pregnancy effects unknown
Not relevant (geriatric problem)
Not studied in human pregnancy; no approved clinical use in any population
Observational signal for neonatal adaptation syndrome with late-pregnancy exposure (SNRI class effect).<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Observational signal for neonatal adaptation syndrome with late-pregnancy exposure; weigh against the risks of untreated maternal depression.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Observational signal for neonatal adaptation syndrome with third-trimester exposure (SSRI class effect).<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Observational signal for persistent pulmonary hypertension of the newborn (small absolute risk) and neonatal adaptation syndrome with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Older agent with substantial use experience but limited controlled data; case reports of neonatal sedation and transient hypertension with maternal use near term.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Older agent with substantial use experience, including in hyperemesis gravidarum; broadly reassuring observational data'"`UNIQ--ref-00000024-QINU`"'
Older agent with substantial use experience; broadly considered safe in pregnancy'"`UNIQ--ref-00000028-QINU`"'
Older agent with substantial use experience; observational signals not clearly causal.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Older agent with substantial use experience; observational signals reassuring for first-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
One of the better-studied basal insulin analogs in pregnancy; reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
One of the historically preferred IV agents for severe hypertension in pregnancy alongside labetalol and nifedipine.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Oral nifedipine is one of the preferred agents for severe hypertension in pregnancy and for tocolysis in preterm labor.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Penicillin G is the only fully effective syphilis treatment in pregnancy; penicillin-allergic pregnant patients require desensitization.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Pharmacologic doses generally avoided in pregnancy; vitamin doses fine.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Preferred SABA in pregnancy; benefits of asthma control outweigh limited risks.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Pregnancy categories were retired by FDA in 2015. Limited reproductive data with small observational signal for cardiac malformations; risk-benefit decision, with many patients deferring ADHD treatment during pregnancy. See pregnancy_details for the full discussion.
Pregnancy categories were retired by FDA in 2015. Quetiapine has reassuring active-comparator cohort data without consistent teratogenic signal; among the preferred neuroleptics when treatment is clinically necessary in pregnancy. See pregnancy_details for the full citation set.
Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021. Use individualized.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021. Use individualized; lactation generally avoided.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Routine antacid and acidosis correction acceptable
Routinely supplemented in pregnancy and preconception to prevent neural tube defects.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Routinely supplemented in pregnancy; needs higher in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Routinely supplemented in vegan pregnancies and pernicious anemia.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Routinely used; iron requirements rise substantially in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Safe at replacement and supplement doses.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Safe at replacement doses; deficiency is itself a risk in pregnancy and lactation.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Safe at replacement doses; high-dose use generally avoided.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Safe at routine doses; routinely supplemented in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Safe at routine fluoride levels.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Signal for gestational diabetes and metabolic syndrome with maternal exposure; the metabolic load can be substantial during pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Signal for neonatal extrapyramidal symptoms and withdrawal with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Some controversial signal for first-trimester gastroschisis association in observational studies; limited use is generally considered acceptable after the first trimester.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Some signal for cleft lip/palate with first-trimester exposure (debated); neonatal sedation and withdrawal with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Some signal for cleft palate with first-trimester exposure (debated); neonatal sedation and withdrawal with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Some signal for major congenital malformations; limited human data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Standard fluid and electrolyte management
Standard resuscitation fluid in pregnancy
Substantial teratogenic signal (barbiturate class effects including neonatal withdrawal and hemorrhagic disease of newborn).<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Synthetic levothyroxine is the standard-of-care in pregnancy; desiccated thyroid use in pregnancy is not well studied<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
T4 (levothyroxine) is the first-line in pregnancy; T3 is rarely needed.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
TCA class signal; limited human data specific to doxepin.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
TCA class signal; limited human data specific to nortriptyline.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Teratogenic signal less than carbamazepine but present; folate supplementation and effective contraception are appropriate in reproductive-age patients'"`UNIQ--ref-0000001C-QINU`"'
Topical and vaginal generally considered safe; widely used.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Topical corticosteroids in pregnancy: use lowest potency and smallest area; super-potent agents like clobetasol are reserved for compelling indications.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Topical generally safe; oral avoided.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Topical/intranasal generally low-risk; intra-articular and high-dose injection: weigh risk individually.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Topical: avoid; systemic: contraindicated in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Use in fetal SVT (transplacental antiarrhythmic therapy) is established; otherwise weigh against alternatives.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Use when benefits outweigh; small association with oral clefts debated.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Use when benefits outweigh; small association with oral clefts in first trimester debated.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Use when benefits outweigh; widely used at physiologic doses for adrenal insufficiency.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Used in FMF in pregnancy; otherwise weigh against alternatives.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Used in antenatal lung maturation (24-34 weeks gestation; 6 mg IM q12h × 4 doses); broader use weighs benefits against fetal HPA suppression.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Used in life-threatening obstetric anaphylaxis without hesitation; benefits clearly outweigh.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Used in obstetric emergencies (uterine relaxation, severe hypertension) when needed; otherwise limited routine use.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Used in transplant pregnancy when continued immunosuppression is required; reassuring data overall but careful monitoring needed.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Used when benefits outweigh risk; oral cleft signal in first-trimester exposure is debated and small in absolute terms.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Used when needed for hypoparathyroidism or renal osteodystrophy in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Widely used for hyperemesis gravidarum; reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Widely used in obstetric reflux; reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Widely used in pregnancy for HSV/VZV indications; reassuring registry data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Widely used in pregnancy when antiviral indicated; reassuring registry data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Widely used in pregnancy; meta-analyses do not show increased malformation risk.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup>
Search
legal:
(Click arrow to add another value)
None
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[[USLegal:Prescription only|Rx-only]] in US
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OTC in US
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Rx
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Rx-only in US
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Rx, Schedule IV (US)
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Schedule II
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[[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000028-QINU`"'
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Rx-only
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[[USLegal:DEA Schedule I|Schedule I]] (United States)
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[[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000022-QINU`"'
·
[[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000025-QINU`"'
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[[USLegal:Schedule IV|Schedule IV controlled substance]] in US. Carries the benzodiazepine class '''Boxed Warning''' for risk of fatal respiratory depression, coma, and death when combined with opioids'"`UNIQ--ref-00000028-QINU`"'
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'''[[USLegal:Behind-the-counter|Behind-the-counter]] in US''' under the Combat Methamphetamine Epidemic Act 2005: purchase restricted to ≤3.6 g/day and ≤9 g/30 days, with photo ID, logbook signature, and quantity logging required. Several states schedule higher than federal
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'''[[USLegal:Schedule V|Schedule V controlled substance]] in US (federally)''', distinct from gabapentin which remains federally unscheduled'"`UNIQ--ref-00000028-QINU`"'
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5-MeO-DMT is Schedule I in US (since 2011); the toad itself is protected in several southwestern states
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Currently legal in most jurisdictions with thujone limits
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Investigational
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Leaves legal in Bolivia, Peru, Colombia; cocaine internationally controlled
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OTC (1% shampoo) and [[USLegal:Prescription only|Rx-only]] (higher strengths, oral) in US. Oral form carries a '''Boxed Warning''' for hepatotoxicity and is restricted by FDA to refractory fungal infections where no alternatives are available
Other values:
OTC (10-20 mg) and [[USLegal:Prescription only|Rx-only]] (higher doses) in US
OTC (20 mg) and [[USLegal:Prescription only|Rx-only]] (higher doses) in US
OTC (20 mg, 14-day course) and [[USLegal:Prescription only|Rx-only]] (higher and longer durations) in US
OTC (Astepro 0.15%) and [[USLegal:Prescription only|Rx-only]] (other intranasal, ophthalmic, Dymista) in US
OTC (MiraLAX) and [[USLegal:Prescription only|Rx-only]] (electrolyte solutions for bowel prep) in US
OTC (Nasonex 24HR) and [[USLegal:Prescription only|Rx-only]] (other forms) in US
OTC (Pataday ophthalmic) and [[USLegal:Prescription only|Rx-only]] (Patanase intranasal) in US
OTC (intranasal Flonase) and [[USLegal:Prescription only|Rx-only]] (inhaled, topical) in US
OTC (intranasal Rhinocort Allergy) and [[USLegal:Prescription only|Rx-only]] (other forms) in US
OTC (low-dose topicals) and [[USLegal:Prescription only|Rx-only]] (other forms) in US
OTC (low-dose) and [[USLegal:Prescription only|Rx-only]] (1 mg, injectable) in US
OTC (low-dose) and [[USLegal:Prescription only|Rx-only]] (50,000 IU and concentrated solutions) in US
OTC (low-dose, dietary supplement) and [[USLegal:Prescription only|Rx-only]] (Niaspan ER) in US
OTC (low/mid-dose oral) and [[USLegal:Prescription only|Rx-only]] (injection, intranasal) in US
OTC (lower doses) and [[USLegal:Prescription only|Rx-only]] (higher doses) in US
OTC (lower strengths) and [[USLegal:Prescription only|Rx-only]] (combination with betamethasone) in US
OTC (lower-concentration washes) and [[USLegal:Prescription only|Rx-only]] (Peridex oral rinse, ChloraPrep) in US
OTC (lowest-strength topicals) and [[USLegal:Prescription only|Rx-only]] (higher strengths, injectable) in US
OTC (most dentifrice and rinse) and [[USLegal:Prescription only|Rx-only]] (high-concentration paste/gel, supplements) in US
OTC (most) and [[USLegal:Prescription only|Rx-only]] (50,000 IU) in US
OTC (ophthalmic ointment) and [[USLegal:Prescription only|Rx-only]] (other forms) in US
OTC (oral salts) and [[USLegal:Prescription only|Rx-only]] (IV) in US
OTC (oral supplements) and [[USLegal:Prescription only|Rx-only]] (IV) in US
OTC (topical) and [[USLegal:Prescription only|Rx-only]] (oral) in US
OTC (transdermal patch in women) and [[USLegal:Prescription only|Rx-only]] (other forms) in US
OTC and [[USLegal:Prescription only|Rx-only]] (IV, combination products) in US
Plant unrestricted; pharmaceutical atropine Rx-only
Rx, '''not a controlled substance''' (no DEA scheduling)
Rx, '''not a controlled substance''' (unique among wake-promoting agents)
Rx, Schedule III (US). REMS program required.
Rx-only in US (REMS program)
Rx-only;'"`UNIQ--ref-0000005C-QINU`"' not a controlled substance
Rx-only;'"`UNIQ--ref-000000F0-QINU`"' not a controlled substance
Rx-only;'"`UNIQ--ref-0000018D-QINU`"' not a controlled substance
Rx-only;'"`UNIQ--ref-00000256-QINU`"' not a controlled substance
Rx-only;'"`UNIQ--ref-00000305-QINU`"' not a controlled substance
Rx. FDA black-box warning for increased mortality in elderly patients with dementia-related psychosis (class warning shared with all antipsychotics)
Rx; ARIA monitoring required
Rx; REMS program required (excessive sedation/loss of consciousness during infusion)
Rx; REMS-like program for ARIA monitoring
Rx; black-box warning for distant spread of toxin effect
Schedule I (United States)
Schedule I in US since 1993 (despite traditional use elsewhere); legal in Ethiopia, Kenya, Yemen, Somalia, Djibouti
Schedule III (DEA, US)
Schedule III in US; X-waiver no longer required (as of 2023)
Schedule III; REMS-restricted (Schedule I if outside the pharmaceutical channel, same molecule as illicit GHB)
Schedule IV (US)
US Schedule II (single-entity); Schedule III–V (combination products by content).
Unrestricted (food)
Withdrawn from US market January 2024
[[USLegal:DEA Schedule II|Schedule II]] controlled substance in US (rescheduled from Schedule III in 1978). No accepted medical use. UN Convention on Psychotropic Substances Schedule II internationally.'"`UNIQ--ref-00000067-QINU`"'
[[USLegal:Over-the-counter|OTC]] as Bonine and Dramamine Less Drowsy; [[USLegal:Prescription only|Rx-only]] as Antivert
[[USLegal:Over-the-counter|OTC]] dietary supplement in the US ('''not FDA-regulated as a medicine'''; multiple studies show OTC products contain 50-470% of labeled melatonin content); [[USLegal:Prescription only|Rx-only]] in the EU and UK
[[USLegal:Over-the-counter|OTC]] for most oral and topical formulations; [[USLegal:Prescription only|Rx-only]] for injectable
[[USLegal:Over-the-counter|OTC]] in US at all standard strengths
[[USLegal:Over-the-counter|OTC]] in US at ≤220 mg/tablet and ≤660 mg/day; [[USLegal:Prescription only|Rx-only]] at higher strengths
[[USLegal:Over-the-counter|OTC]] in the US at ≤200 mg per tablet / ≤1200 mg/day; [[USLegal:Prescription only|Rx-only]] at higher strengths and indications
[[USLegal:Prescription only|Prescription only]]; not a controlled substance
[[USLegal:Prescription only|Rx-only]] (higher concentrations and IV) and OTC (low-dose supplements) in US
[[USLegal:Prescription only|Rx-only]] for IV formulations; OTC for oral
[[USLegal:Prescription only|Rx-only]] for most formulations; some low-concentration topical formulations are [[USLegal:Over-the-counter|OTC]] (4% cream)
[[USLegal:Prescription only|Rx-only]] for oral and most topical formulations in US; Voltaren Arthritis Pain 1% gel switched to [[USLegal:Over-the-counter|OTC]] in 2020
[[USLegal:Prescription only|Rx-only]] for parenteral formulations; OTC for oral, nasal, and many nebulizer products
[[USLegal:Prescription only|Rx-only]] in US (most products; some low-volume packs OTC)
[[USLegal:Prescription only|Rx-only]] in US (note: norgestrel 0.075 mg POP is now OTC as Opill since 2023, but norethindrone POP remains Rx)
[[USLegal:Prescription only|Rx-only]] in US (some OTC formulations exist)
[[USLegal:Prescription only|Rx-only]] in US (the veterinary preparations are not for human use)
[[USLegal:Prescription only|Rx-only]] in US since 2020 (OTC 2% formulations withdrawn under CARES Act due to safety concerns)
[[USLegal:Prescription only|Rx-only]] in US. '''Contraindicated in structural heart disease''' — CAST trial (1989) showed increased mortality from class IC agents in patients with prior MI; modern use is limited to structurally normal hearts'"`UNIQ--ref-00001141-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. '''FDA Boxed Warning (2020):''' neuropsychiatric events including agitation, depression, sleep disturbance, and suicidal thoughts; benefit-risk should be reassessed regularly'"`UNIQ--ref-00000160-QINU`"'.
[[USLegal:Prescription only|Rx-only]] in US. '''Federally non-controlled despite being a barbiturate''', a paradoxical situation given that its primary active metabolite phenobarbital is Schedule IV'"`UNIQ--ref-00000019-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. '''Not a controlled substance''', the principal clinical selling point versus psychostimulant ADHD options. Carries the antidepressant-class '''Boxed Warning''' for suicidal ideation in pediatric patients'"`UNIQ--ref-00000016-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries '''Boxed Warning''' for risk of malignancy and serious infection; nephrotoxicity, hypertension, and immunosuppression-associated complications'"`UNIQ--ref-00000A93-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries '''Boxed Warnings''' for hepatotoxicity (especially children <2 with metabolic disorders), teratogenicity, and pancreatitis'"`UNIQ--ref-0000097F-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries '''Boxed Warnings''' for pulmonary toxicity (interstitial pneumonitis, fibrosis), hepatotoxicity, and proarrhythmia'"`UNIQ--ref-00000CB5-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries a '''Boxed Warning''' contraindicating use in children <2 years (lethal dehydration in animal studies)'"`UNIQ--ref-0000119E-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries a '''Boxed Warning''' for '''tardive dyskinesia''' (irreversible movement disorder), driving the 12-week chronic-use limit'"`UNIQ--ref-00000EFB-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries a '''Boxed Warning''' for Clostridioides difficile colitis (one of the most C. difficile-inducing antibiotic classes)'"`UNIQ--ref-00001444-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries a '''Boxed Warning''' for bleeding risk and against aspirin maintenance doses above 100 mg/d (reduces ticagrelor efficacy, per PLATO subgroup analysis)'"`UNIQ--ref-00000C94-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries a '''Boxed Warning''' for bone mineral density loss with prolonged use (≥2 years; partially reversible after discontinuation)'"`UNIQ--ref-00000F22-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries a '''Boxed Warning''' for heart failure (do not initiate in NYHA III/IV; can precipitate or worsen HF in any patient)'"`UNIQ--ref-00000826-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries the '''antidepressant Boxed Warning''' for suicidality in children/adolescents/young adults and the atypical-neuroleptic '''Boxed Warning''' for increased mortality in elderly dementia patients'"`UNIQ--ref-0000154F-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries the FDA '''Boxed Warning for serious skin reactions''' including Stevens-Johnson syndrome and toxic epidermal necrolysis, with the risk concentrated in the first 2-8 weeks of therapy and elevated by rapid titration'"`UNIQ--ref-00000028-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries the NSAID-class '''Boxed Warning''' for cardiovascular thrombotic events and serious GI bleeding'"`UNIQ--ref-000011FB-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults. Not controlled'"`UNIQ--ref-00000025-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-0000001C-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-0000001F-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-0000002E-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries the atypical-neuroleptic '''Boxed Warning''' for increased mortality in elderly patients with dementia-related psychosis'"`UNIQ--ref-00000023-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries the same fluoroquinolone-class '''Boxed Warnings''' as ciprofloxacin/levofloxacin'"`UNIQ--ref-00000D84-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries the same fluoroquinolone-class '''Boxed Warnings''' as ciprofloxacin/levofloxacin'"`UNIQ--ref-000014C5-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Carries the same fluoroquinolone-class '''Boxed Warnings''' as ciprofloxacin: tendinitis/tendon rupture (especially elderly, corticosteroid co-use), peripheral neuropathy, CNS effects, worsening of myasthenia gravis'"`UNIQ--ref-00000CF7-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Caution with QT-prolonging medicines (quinidine itself is class IA antiarrhythmic, and the dose here, though sub-antiarrhythmic, still contributes to QT)'"`UNIQ--ref-00001585-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. NSAID-class '''Boxed Warning''' for CV thrombotic events and GI bleeding; triptans contraindicated in coronary artery disease, peripheral vascular disease, uncontrolled hypertension, and recent ergot or MAOI use'"`UNIQ--ref-000015D3-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. NSAID-class '''Boxed Warning''' for CV thrombotic events and GI bleeding'"`UNIQ--ref-00001270-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance, distinguishing it from carisoprodol among muscle-spasm options'"`UNIQ--ref-0000001F-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance, distinguishing it from carisoprodol which is Schedule IV'"`UNIQ--ref-00000019-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance, distinguishing it from the carisoprodol alternative for muscle spasm'"`UNIQ--ref-0000001C-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance, like guanfacine and unlike the psychostimulant alternatives for ADHD'"`UNIQ--ref-00000028-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance, which is a meaningful clinical advantage over benzodiazepine alternatives for chronic anxiety'"`UNIQ--ref-0000001F-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance, which is a meaningful clinical advantage over the benzodiazepine alternatives for short-term anxiety'"`UNIQ--ref-00000028-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance, which is a meaningful contrast to the psychostimulant alternatives for ADHD'"`UNIQ--ref-00000022-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance'"`UNIQ--ref-00000022-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance'"`UNIQ--ref-00000028-QINU`"'
[[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance'"`UNIQ--ref-0000002B-QINU`"'
[[USLegal:Schedule III|Schedule III controlled substance]] in US (Fiorinal is scheduled federally; Fioricet with acetaminophen is unscheduled federally despite identical butalbital content, a regulatory quirk)
[[USLegal:Schedule III|Schedule III controlled substance]] in US. '''Contraindicated in children <12''' for any indication and in any age post-tonsillectomy/adenoidectomy (FDA 2017 black-box advisory)'"`UNIQ--ref-00001519-QINU`"'
[[USLegal:Schedule II|Schedule II controlled substance]] in US
[[USLegal:Schedule II|Schedule II controlled substance]] in US. Acetaminophen content limited to ≤325 mg per dosage unit (FDA 2014)
[[USLegal:Schedule II|Schedule II controlled substance]] in US; WHO essential medicine'"`UNIQ--ref-00000022-QINU`"'
[[USLegal:Schedule II|Schedule II controlled substance]] in US'"`UNIQ--ref-00000019-QINU`"'
[[USLegal:Schedule II|Schedule II controlled substance]] in US'"`UNIQ--ref-0000001F-QINU`"'
[[USLegal:Schedule IV|Schedule IV controlled substance]] in US (federally scheduled 2014); some states schedule higher'"`UNIQ--ref-0000001F-QINU`"'
[[USLegal:Schedule IV|Schedule IV controlled substance]] in US (tramadol was reclassified from non-controlled to Schedule IV in 2014 after recognition of dependence risk)
[[USLegal:Schedule IV|Schedule IV controlled substance]] in US. Carries the FDA '''Boxed Warning''' for '''complex sleep behaviors''' (sleep-driving, sleep-walking, sleep-eating, other parasomnias) added in 2019'"`UNIQ--ref-0000001C-QINU`"'
[[USLegal:Schedule IV|Schedule IV controlled substance]] in US. Carries the benzodiazepine class '''Boxed Warning''' for risk of fatal respiratory depression, coma, and death when combined with opioids'"`UNIQ--ref-00000025-QINU`"'
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