Table 3.131.
Known risks to fetus of some drugs used systemically in dentistry
| Categorya | B | C | D and X |
|---|---|---|---|
| Either safe to fetus in animal models without human data, or risk in animal models but safe in human studies | Risk to fetus in animal models but no human studies available, or no human studies support safety | Definitive human data demonstrating risk to fetus | |
| Use in dentistry | Where necessary | Only if really essential and after consulting physician | Do not use |
| Local anaesthetics | Lidocaine |
Articaineb |
|
| Prilocainec | Bupivacaine |
||
| Mepivacaine | |||
| Sedative agents | Promethazine | Benzodiazepines |
|
| Nitrous oxided | |||
| Analgesics | Meperidine |
Codeine |
Aspirin |
| Paracetamol/acetaminophen | Diflunisal | NSAIDse | |
| Antimicrobials | Azithromycin |
Aciclovir |
Doxycycline |
| Cefadroxil |
Ciprofloxacin |
Minocycline |
|
| Cefuroxime |
Clarithromycin |
Tetracyclines |
|
| Cephalexin | Fluconazole | Co-trimoxazolef | |
| Clindamycin | |||
| Antimicrobials | Erythromycin |
||
| Loracarbef |
|||
| Metronidazole |
|||
| Penciclovir (cream) | |||
| Penicillins | |||
| Others | Corticosteroids (even topical) |
Antidepressants |
|
| Carbamazepine |
|||
| Colchicine |
|||
| Danazol |
|||
| Phenytoin |
|||
| Povidone-iodine applications |
|||
| Retinoids |
|||
| Thalidomide |
|||
| Warfarin | |||
a
US Federal Drug Agency (FDA) pregnancy categories; category A has not been included as this represents drugs with no risk to the fetus.
b
Sometimes categorised as B.
c
Prilocaine, at least in theory, can cause methaemoglobinaemia.
d
Nitrous oxide, though able to interfere with vitamin B12 and folate metabolism, does not appear to be teratogenic in normal use though it is advisable to restrict use to the second or third trimester.
e
May be safer in first and second trimesters.
f
Co-trimoxazole may cause neonatal haemolysis.