Table 1.

Blood–brain barrier ABC transporters and their major substrates relevant in pregnancy and neonatal life

Class	Substrate	ABC transporter(s)	Relevance in pregnancy and neonatal life	References
Anti-epileptic	Phenobarbital	P-gp	First-line treatment for most neonatal seizures	[39, 40]
	Lamotrigine	P-gp	Safe for use during pregnancy (26,416,395)	[39, 41]
	Phenytoin	P-gp Mrp1	Second line treatment for neonatal seizures	[39, 40, 42]
	Topiramate	P-gp	Second-generation AED, sometimes used to treat refractory neonatal seizures (Sandoval 2019)	[39, 40]
Anti-HIV	Zidovudine	P-gp BCRP Mrp4	Indicated for treatment of neonates with HIV	[43, 44]
	Ritonavir	P-gp Mrp1, Mrp2	Infants and children, combined with Lopinavir	[42, 45]
	AZT	BCRP Mrp4	Safe for use in pregnant women and their infants in combination w/Zidovudine	[42, 46]
Analgesics	Morphine	P-gp	Management for post-operative pain	[39, 47]
	Methadone	P-gp	Neonatal abstinence syndrome; therapeutic treatment for opiate abuse during pregnancy	[47, 48]
Anti-cancer	Doxorubicine	P-gp BCRP Mrp1, Mrp2, Mrp6		[42]
	Mitoxantrone	P-gp BCRP		[42]
	Daunorubicin	P-gp BCRP Mrp1, Mrp6		[42]
	Methotrexate	P-gp Mrp1, Mrp2, Mrp3, Mrp4		[42]
Anti-depresssants	Amitryptiline	P-gp	Increased rate of cardiac abnormalities when taken during pregnancy	[42, 49]
	Doxepin	P-gp	No increased incidence of neonatal cardiac abnormalities when used during pregnancy	[42, 49]
Other substrates	Verapamil	P-gp Mrp1	Calcium channel blocker; a competitive inhibitor of P-gp	[42]
	Cyclosporin A	P-gp Mrp1	Immunosuppressants; also a competitive inhibitor of P-gp	[42]