A Practical Guide to Dermatological Drug Use in Pregnancy

C. Zip, MD, FRCPC

Disclosures

Skin Therapy Letter. 2006;11(4):1-4. 

In This Article

Fungal Infections

The use of topical antifungals is considered safe in pregnancy because of negligible percutaneous absorption. Animal reproduction studies involving oral terbinafine (category B) have shown no abnormalities, but human pregnancy data are lacking.[5] Oral fluconazole (category C) taken during the first trimester at a continuous daily dose of 400mg/day or more appears to be teratogenic and associated with a pattern of abnormalities involving the head and face, bones, and heart.[26]

Smaller doses of fluconazole, as used for treatment of vaginal candidiasis, have been associated with minimal or no risk of fetal abnormalities. The available data pertaining to human use of itraconazole (category C) indicates no significant risk for major abnormalities. However, because of concern regarding the use of fluconazole, a structurally related triazole antifungal, avoidance of itraconazole is suggested in the first trimester.

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