A Practical Guide to Dermatological Drug Use in Pregnancy



Skin Therapy Letter. 2006;11(4):1-4. 

In This Article


In some studies first trimester exposure to systemic corticosteroids (category C) has been associated with intrauterine growth retardation and a small increase in the incidence of cleft lip with or without cleft palate.[17,18] However, when needed, the maternal benefits of short courses of oral corticosteroids appear to outweigh the fetal risks, especially when given beyond the first trimester.

The topical calcineurin inhibitors, tacrolimus and pimecrolimus, are in pregnancy category C. Use of oral tacrolimus in pregnant organ transplant recipients has not been associated with fetal loss or teratogenicity thus far.[5] Pimecrolimus has shown no evidence of teratogenicity in animal studies.[19] To date, there have been no reports of adverse effects on pregnancy with topical use of either tacrolimus or pimecrolimus.

Chlorpheniramine and diphenhydramine (both category B) have been considered the antihistamines of choice for oral and parenteral use, respectively, in pregnancy,[20] although one case-control study showed an association between the use of diphenhydramine in the first trimester and cleft palate.[21] Antihistamines in general have been linked to retrolental fibroplasia in premature infants when taken in the last 2 weeks of pregnancy.


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