Medikamentöse Therapie in Schwangerschaft und Stillzeit – Aktueller Kenntnisstand und Empfehlungen

Zusammenfassung

Für die meisten akuten und chronischen Erkrankungen gibt es hinreichend erprobte Medikamente, die ohne erhebliche Risiken auch in Schwangerschaft und Stillzeit eingenommen werden können. Allerdings ist ein Off-label-Use in der Schwangerschaft nicht ungewöhnlich. Dieser Artikel skizziert den aktuellen Kenntnisstand zu Analgetika, Antibiotika, Antihypertensiva, Cumarin-Antikoagulanzien, immunmodulatorischen Substanzen / Rheumatherapeutika, Retinoiden, Antiepileptika und Psychopharmaka und gibt Empfehlungen zu akzeptablen Medikamenten. Da viele Schwangerschaften ungeplant entstehen, sollte jede Therapie bei Frauen im reproduktionsfähigen Alter von einer möglichen Gravidität ausgehen und Arzneimittel mit ausreichender Dokumentation ihrer Verträglichkeit für das Ungeborene bevorzugen.

Summary

For most acute and chronic diseases there are drug treatment options without substantial risks for the unborn or breastfed child. However, off-label use is common in pregnancy. This article provides an update on the risk and safety of drugs among analgesics, antibiotics, antihypertensives, coumarin derivatives, immuno-modulatory drugs, retinoids, antiepileptics, and psychopharmaceuticals. As many pregnancies are unplanned any drug treatment during reproductive age should consider a possible pregnancy. Medicinal drugs with sufficient experience in pregnant women not indicating developmental toxicity should be prefered.

Key words

Pregnancy - teratogen - fetotoxicity - breastfeeding - drug therapy - risk assessment

• Literatur

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