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In another study of more than 225 infants exposed during the first trimester, no such a.s.sociation was found (Aselton et al et al., 1985; Jick et al et al., 1981). No adverse effects were found among offspring in animal studies regarding the teratogenicity of these two agents. Phenylephrine may also be used for the treatment of acute hypotension.

208.

Antihistamines, decongestants, and expectorants during pregnancy Oxymetazoline, xylometazoline, and naphazoline Oxymetazoline, xylometazoline, and naphazoline Oxymetazoline, xylometazoline, and naphazoline are sympathomimetic agents used as decongestants in long-acting nasal sprays (Afrin, Allerest, Dristan, 4-Way). The frequency of congenital anomalies was not increased among more than 250 infants whose mothers took oxymetazoline during the first trimester (Aselton et al et al., 1985; Jick et al et al., 1981). Similarly, among 432 infants whose mothers took xylometazoline in the first trimester, the frequency of congenital anomalies was not increased (Aselton et al et al., 1985; Jick et al et al., 1981). No studies have been published regarding naphazoline use during pregnancy.

Table 11.2 Antihistamines Antihistamines Generation FDA cla.s.s First generation Azatadine (Optimine) C.

Bromodiphenhydramine (Ambenyl) C.

Brompheniramine C.

Buclizine (Bucladin) C.

Carbinoxamine (Clistin) C.

Chlorpheniramine B.

Clemastine (Tavist) B.

Cyclizine (Marezine) C.

Cyproheptadine (Periactin) B.

Dexchlorpheniramine (Polaramine) B.

Dimenhydrinate C.

Diphenhydramine B.

Diphenylpyraline (Hispril) C.

Doxylamine (Unisom) B.

Meclizine (Antivert, Bonine) C.

Methdilazine B.

Phenindamine (Nolahist) C.

Promethazine C Pyrilamine (Dormarex, Sommicaps, Sominex) C.

Terfenadine (Seldane) C.

Trimeprazine C.

Tripelennamine (PBZ) B.

Triprolidine (Actidil, Bayidy) C.

Second generation Astemizole C.

Cetirizine B.

Cromolyn sodium B.

Desloratadine

Ebastine

Fexofenadine C.

Ipratropium B.

Loratadine B.

Antihistamines 209.

Table 11.3 Congenital anomalies and first-trimester antihistamine exposure Antihistamine Congenital anomalies and first-trimester antihistamine exposure Antihistamine Percent congenital n/N anomalies (%) First generation Azatadine 4.7.

6/127.

Brompheniramine 5.9.

16/271.

Chlorphenamine (chlorpheniramine) 6.9.

96/1388.

Clemastine 3.7.

110/2847.

Cyproheptadine 4.2.

12/285.

Dexchlorpheniramine 4.6.

50/1080.

Diphenhydramine 4.7.

154/3286.

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