Prescription Drugs of Choice During Pregnancy

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Condition Medication Reference(s)
Asthma Albuterol is rescue therapy of choice
Budesonide is the preferred inhaled corticosteroid
Long-acting b2-agonists salmeterol  is the preferred add-on controller therapy
Bacterial Vaginosis Treatment is recommended for all pregnant women with symptoms.
Metronidazole OR
Chlamydia Azithromycin 2
Cholestasis of pregnancy Ursodeoxycholic acid (UDCA) 14
Chronic hypertension Labetalol OR / AND
Nifedipine slow-release preparation
Depression , mild Psychotherapy such as cognitive-behavioral therapy (CBT) OR interpersonal therapy 18
Depression , severe Psychotherapy AND fluoxetine.
Alternative medications: sertraline or  tricyclic antidepressant
Depression with psychosis Electroconvulsive therapy OR
Haloperidol AND antidepressant as above
Depression mild, postpartum while breast-feeding Psychotherapy with or without antidepressant (sertraline or paroxetine) 18
Depression severe, postpartum while breast-feeding Supportive services AND sertraline
Alternative medication: Paroxetine
18, 19
Diabetes Insulin 4
Gonorrhea; uncomplicated genital

Ceftriaxone 250 mg as a single intramuscular dose, plus  azithromycin 1 g orally in a single dose
Patients with severe penicillin or cephalosporin allergy  gentamicin 250 mg IM  and 2-g oral azithromycin.

5, 29
Hepatitis B Tenovir 27,28
Herpes Acyclovir OR
Hypothyroidism Levothyroxine 7,15
Hyperthyroidism Propylthiouracil (PTU). in the first trimester of pregnancy.
Methimazole  after first trimester
Beta adrenergic blocking agents, such as propranolol  may be used for controlling hypermetabolic symptoms.


Idiopathic thrombocytopenic purpura (ITP) Prednisone.
IVIg may be used with corticosteroids when a more rapid increase in platelet count is required, or corticosteroids are contraindicated [
Malaria Chloroquine , hydroxychloroquine
For chloroquine-resistant P. falciparum infection, treat with either mefloquine or a combination of quinine sulfate and clindamycin
Nausea and vomiting of pregnancy Diclegis (doxylamine succinate and pyridoxine hydrochloride)
Refractory cases add promethazine or dimenhydrate . If still no response add metoclopromide .
Pediculosis Pubis Permethrin 1% cream  OR
Pyrethrins with piperonyl butoxide
Preeclampsia prevention Low-dose aspirin (81 mg/d) after 12 weeks of gestation in women who are at high risk for preeclampsia. 20-26
  • Cefriaxone  OR
  • Ampicillin AND  genatmicin OR
  • Cefazolin  OR
  • Cefotetan  OR
  • Aztreonam
    (Several other regimens are also acceptable )
  • 10,11


    Seizure , eclamptic Magnesium 21
    Scabies Permethrin cream 5% 2
    Syphilis Benzathine penicillin 2
    Trichomoniasis Metronidazole 2
    Ulcer Sucralfate
    Urinary tract infection Nitrofurantoin ( Avoid in first trimester)
    Venous thromboembolism (VTE) Low Molecular Weight Heparin
    Enoxaparin  OR
    Dalteparin   OR
    Vulvovaginal Candidiasis  Only topical azole therapies, applied for 7 days, are recommended
    Terconazole 0.4% cream


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    CDC Sexually Transmitted Diseases Treatment Guidelines , 2010 December 17, 2010 / Vol. 59 / No. RR-12 Morbidity and Mortality Weekly Report PMID: 21160459
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    Update to CDC's Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections. Centers for Disease Control and Prevention (CDC).MMWR Morb Mortal Wkly Rep. 2012 Aug 10;61(31):590-4.PMID: 22874837
    Management of Herpes in Pregnancy. ACOG Practice Bulletin No. 82. American College of Obstetricians and Gynecologists. Obstet Gynecol 2007; 109:123348.
    Stagnaro-Green A, ert al. American Thyroid Association Taskforce on Thyroid Disease During Pregnancy and Postpartum.Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011 Oct;21(10):1081-125. doi: 10.1089/thy.2011.0087. PMID: 21787128
    Neunert C, et al., The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood. 2011 Apr 21;117(16):4190-207. Epub 2011 Feb 16. PMID: 21325604
    Nausea and vomiting of pregnancy. ACOG Practice Bulletin No. 52. American College of Obstetricians and Gynecologists. Obstet Gynecol 2004;103:80315
    Jolley JA, Wing DA.Pyelonephritis in pregnancy: an update on treatment options for optimal outcomes.
    Drugs. 2010 Sep 10;70(13):1643-55. PMID: 20731473
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     Inherited thrombophilias in pregnancy. Practice Bulletin No. 124 American College of Obstetricians and Gynecologists. Obstet Gynecol 2011;118:730-40.
    13. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Renal and Urinary Tract Disorders. In: Williams obstetrics. 23rd ed. New York: McGraw-Hill, 2010:7 1053
    14. Bacq Y, Efficacy of Ursodeoxycholic Acid in Treating Intrahepatic Cholestasis of Pregnancy: A Meta-analysis.Gastroenterology. 2012 Aug 11. doi:pii: S0016-5085(12)01187-0. 10.1053/j.gastro.2012.08.004. PMID: 22892336
    15. Thyroid disease in pregnancy. ACOG Practice Bulletin No. 37. American College of Obstetricians and Gynecologists. Obstet Gynecol 2002;100:387396
    16. Griffith KS, et al. Treatment of malaria in the United States: a systematic review. JAMA. 2007 May 23;297(20):2264-77. PMID: 17519416
    17. Centers for Disease Control and Prevention. Treatment of Malaria: Guidelines For Clinicians (United States) .Part 3: Alternatives for Pregnant Women and Treatment of Severe Malaria Accessed 10/27/20
    18. Altshuler LL, et al., Treatment of depression in women: a summary of the expert consensus guidelines.
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    19. Berle JO, Spigset O.Antidepressant Use During Breastfeeding. Curr Womens Health Rev. 2011 Feb;7(1):28-34. PMID: 22299006
    20.Final Recommendation Statement: Low-Dose Aspirin Use for the Prevention of Morbidity and Mortality From Preeclampsia: Preventive Medication . U.S. Preventive Services Task Force. December 2014.
    21. Hypertension in pregnancy: executive summary. Obstet Gynecol. 2013 Nov;122(5):1122-31. doi:10.1097/01.AOG.0000437382.03963.88.PMID:24150027
    22. Duley L, et al., Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD004659. PMID: PMID:17443552 
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    Available at : Accessed 7/12/2010
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    hypertensive disorders during pregnancy
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    Available at : Accessed 7/12/2012
    27.Hepatitis B (chronic) : diagnosis and management NICE guidelines [CG165] Published date: June 2013
    National Institute for Health and Care Excellence.
    28. European Association For The Study Of The Liver.EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. J Hepatol. 2012 Jul;57(1):167-85. doi: 10.1016/j.jhep.2012.02.010. Epub 2012 Mar 20,
    PMID: 22436845
    29. Dual therapy for gonococcal infections. Committee Opinion No. 645. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015;126:e959.PMID: 26488526

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