Table 1.
Food and Drug Administration’s classification of selected anti-glaucoma medications and potential side effects in pregnancy
| FDA’s classification | Reported effect in animal studies | Reports of side effects in human studies | |
|---|---|---|---|
| Preservative of medications, BAK | C* | Doserelated increase in fetal resorption and death and minor sternal defects14 | |
| Betablockers | C | A case with cardiac conduction disorder. Arrhythmia and bradycardia (resolved after stopping the drug)15 Systemic use: Intrauterine growth restriction and persistent betablockade in the newborn Impairment of respiratory control in the neonate, lethargy and confusion16,17 | |
| Carbonic anhydrase Inhibitors | |||
| Oral | C | Forelimb anomalies18 | Single case of sacrococcygealteratoma (has not been substantiated by others)19 |
| Topical | C | Fetal vertebral body malformations and decrease fetal weights (dose 31 times)20,21 | |
| Prostaglandin analogs | |||
| Latanoprost | C | Dead fetus (dose 80 times)22 | A case of miscarriage in a 46 yearold woman that seems to be due to her reproductive risk related to her advance age, not the drug23 |
| Travoprost | C | Teratogen (dose 250 times)24 | |
| Bimatoprost | C | Reduced duration of gestation and increased incidence of dead fetus (dose 41 times)25 | |
| Parasympathomimetics | |||
| Pilocarpine | C | Teratogen26 | Signs mimicking meningitis in the newborn27 |
| Echothiophate iodide | Suppression of the infant’s pseudocholinesterase | ||
| Sympathomimetic | |||
| Nonselective | B** | Congenital cataract2 | Systemic: Delays the second stage of labor or cause a prolonged period of uterine atony with hemorrhage Topical: Local side effects and a high rate of systemic side effects28 |
| Brimonidine | B | No fetal damage29 | In infants has central nervous system effects30 |
| Fixedcombination Antiglaucoma Medications | C | ||
| FixedCombination Timolol/dorzolamide | C31 | As each component of the drug | |
| FixedCombination Timolol/brimonidine | C32 | As each component of the drug |
*
Uncertain safety, with no human studies and animal studies showing adverse effect;
**
Presumed safety based on animal studies