Skip to main content

Pain and Pregnancy, Part Three

The FDA has clearly established guidelines for safe usage of medications during pregnancy.
Generally speaking, there are five categories of drugs: 

Pregnancy category A
Adequate research has been done with the conclusion that drugs in this category are not likely to cause any harm to the fetus in the first trimester as well as later in pregnancy.

Pregnancy Category B
Studies carried out on animals have shown no adverse effects on the fetus; however, there is a lack of controlled studies on human pregnancy.

Pregnancy category C
Animal studies have shown evidence of harmful effects on the fetus; however, no controlled study has been done on a human pregnancy. The medicines may be prescribed in cases where the potential benefits outweigh the possible adverse effects.

Pregnancy category D
Studies done on human pregnancy have shown positive risks to the fetus. However, doctors might prescribe them in certain cases where the potential benefits outweigh the risks.

Pregnancy category X

Both human and animal studies have shown positive risks to the fetus, with the adverse effects extending to serious birth defects, miscarriage and fetal death. The possible risks of using these medicines outweigh any potential benefits.

The ONLY drug the FDA has deemed possibly safe for pain management in pregnant women is Tylenol/acetaminophen.  But, as previously mentioned in this blog, there is risk of hyperactivity/ADHD in children born to women who have used this drug during pregnancy.

Other drugs commonly used for pain management include 4 basic categories:

NSAIDs--These include aspirin, ibuprofen and some other commonly used pain relievers. Some are available over the counter.  They are rated in category B or D depending on which trimester they are used. They have been associated with increased risk of perinatal mortality, teratogenicity, and other fetal abnormalities. For more information, you can read in detail here.

Antidepressants --SSRIs are pregnancy category C.  There is risk of birth defects in a developing fetus, but each agent has its own specific issues.

Opioids--are also classified as pregnancy category C. The main reason for this is the risk of addiction in a developing fetus. Sometimes they are used on a risk/benefit basis, but it is not generally done. The British Medical Journal published an article about this in 2016.

Anticonvulsants are another class of agents that are used in pain management, usually for neuropathic pain. Pregabalin is one example of these drugs, it is classified as pregnancy category C due to the risk of fetal birth defects. Another drug in this category is gabapentin; it is also category C due to the risk of fetal toxicity. These drugs should only be used when the benefits outweigh the risks; contraception is advised if used in women of childbearing age.

The best advice here is to avoid ALL medications if possible during pregnancy. If you are a women of childbearing age, it is best to take precautions against pregnancy when using medications of any kind.  Take the time to know the risks and benefits of medications before using them for your sake, and your child's sake too!

Sources:;; AAFP; 


Popular posts from this blog

Living with Chronic pain hits the big screen!

Been to the movies lately?  Jennifer Aniston is on the big screen in a recent release titled "Cake."
Her character, Claire is a victim of chronic pain...she belongs to a support group, where all of the members are coming to terms with the suicide of one of their members.  Of course, she also takes pain medication and addiction is another of her problems...and of course there's more!

I guess I am writing this post just to bring readers' attention to the fact that Hollywood has become aware of the crisis that is chronic pain.  This movie is a testament to that. People that don't have to live with this kind of pain don't fully understand the whole story.  Maybe this movie will shed some light on the issues.

Here is the official trailer for the movie:

Sources: prweb;;YouTube

Herpes As A Helper?

If you've ever had shingles, or known anyone that has experienced it, you probably know that chronic pain can persist following the initial attack (post herpetic neuralgia).  This is because the herpes virus seems to have an affinity for nerve cells.  And while it's not fun to have shingles or post herpetic neuralgia, the herpes virus may be a key in future development of delivery systems for pain management treatments.

Here's the deal--since Herpes simplex has an affinity for nerve cells, researchers are looking a genetically modified, safer version of the virus to deliver genetic material to damaged nerves.  In simple terms, once the genetic material reaches these nerve cells, it will hopefully encode these nerves to ultimately inhibit pain signals.  Animal studies and clinical trials in cancer patients have been encouraging thus far.

This is one of those developments that makes me believe that there is hope for those in chronic pain. Along with so many other exciting d…

The Knee Bone's Connected To The Leg Bone....

Two recent studies have brought a not-so-novel concept into the limelight-the concept being that people who present with knee pain often develop pain in other parts of their bodies.  These studies, known as the Multicenter Osteoarthritis Study (MOST) and the Osteoarthritis Initiative (OAI), were assessed by a Clinical Epidemiology Team as Boston University School of Medicine in an effort to find preventive strategies to combat this trend.

The authors suggest that knee pain may cause individuals to alter their gait in an effort to compensate for their discomfort. In doing so, the alignment of other body joints is altered, and this may be the cause of secondary joint pain, especially hips and ankles. The authors go on to say that the pain in these secondary sites is not necessarily osteoarthritis--perhaps bursitis or some other injury.

Osteoarthritis is a result of wear and tear in the joints.  We may not be able to completely eliminate osteoarthritis from occurring, but some common se…