Medication Safety in Pregnancy: Concerns & Options

Question
I am 20 wks pregnant I am currently taking ambien 10mg, Tylenol pm and smoke 4-7 cigarettes a day. The last 2 weeks I have been taking percocet as needed for pain. I stopped taking the percocet because I found out it was a category c medication. My pregnancy was going ok but now my un born baby seems to have slight heart problems and my amnio fluid is really low. I was told the ambien and Tylenol is a cat.. b drug. Do you think the medication is causing the newly develope problems in my pregnancy? Is it too late to correct it? Is there anything I can do at this point? I want to have a healthy baby, is it too late. Please advice

Answer
Dear lb,

Actually, Ambien is a FDA Pregnancy Risk Category C drug. This means that there have been no adequate and well controlled studies done on pregnant women, but studies on animals show adverse effect and toxicity on fetus. Drugs in this category should be given only if the potential benefit outweighs the potential risk to the fetus.

Tylenol PM contains diphenhydramine. Diphenhydramine, as you said, is a Category B drug. However, for this drug specifically, the information is as follows:
- No fetal adverse effects in animals.
- No well controlled human data but suggested possible association with congenital defects in first trimester exposure including: genitourinary, eye, ear, cardiac defects, cleft palate, hypospadias, inguinal hernia, polydactyly, malformations of the diaphragm and hypoplasia of cerebral hemisphere.
- Chronic maternal ingestion of the drug can cause neonatal withdrawal.
- Exposure during the last two weeks of pregnancy to antihistamines in general is associated with retrolental fibroplasia in premature infants.
- Has oxytocic effect on uterus.

Now, anything that has been already diagnosed with your baby is already there and will simply need to be dealt with medically. However, if it were me, I would seriously consider discontinuing (gradually so as to not cause any withdrawal symptoms) these medications. Of course, you always need to consult your doctor about this first to make him/her aware of your thoughts/plans.

I hope this has helped you and answered your question. I wish you well.

Brenda