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Re: vermoxFrom: ainsron (ainsron@sbcglobal.net)Thu Feb 19 09:40:57 2004
It is Category "C", as are many of the common drugs we use. Per Briggs, Drugs in Pregnancy and Lactation: Mebendazole is a synthetic anthelmintic agent. Although embryotoxic and teratogenic in rats at single oral doses as low as 10 mg/kg (1), this effect has not been observed in multiple other animal species (2). No reports of human teratogenicity caused by mebendazole have been located. One manufacturer has reports of 1st trimester mebendazole exposure in 170 pregnancies going to term without an identifiable teratogenic risk (1). There was also no increased risk of spontaneous abortion following 1st trimester exposure (1). An earlier manufacturer knew of only one malformation, a digital reduction of one hand, in 112 infants exposed in utero to the drug (3). In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 64 newborns had been exposed to mebendazole during the 1st trimester (F. Rosa, personal communication, FDA, 1993). Four (6.3%) major birth defects were observed (three expected), one of which was a limb reduction defect (none expected). No anomalies were observed in five other defect categories (cardiovascular defects, oral clefts, spina bifida, polydactyly, and hypospadias) for which specific data were available. During a 1984 outbreak of trichinosis (Trichinella spiralis) in Lebanon, four pregnant patients were treated with mebendazole and corticosteroids (4). Two women, both in the 1st trimester, had miscarriages. The authors did not comment if this was caused by the disease or the drug. Neither fetus was examined. The remaining two patients, both in the 3rd trimester, delivered healthy infants. In a separate case, a pregnant patient, also with trichinosis, was treated with mebendazole and delivered a normal infant (5). The period of pregnancy when the infection and treatment occurred was not specified. A 1985 review of intestinal parasites and pregnancy concluded that treatment of the pregnant patient should only be considered if the "parasite is causing clinical disease or may cause public health problems" (6). When indicated, mebendazole was recommended for the treatment of Trichuris trichiura (whipworm) occurring during pregnancy (6). A 1986 review recommended mebendazole therapy, when indicated, for the treatment of Ascaris lumbricoides (roundworm) and Enterobius vermicularis (threadworm, seatworm, or pinworm) (7), although another review recommended piperazine for this purpose, in spite of the known poor absorption of mebendazole (8). Ronald E. Ainsworth -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of S Banovic Sent: Thursday, February 19, 2004 12:04 AM To: Multiple recipients of list OB-GYN-L Subject: vermox I have G2 P1 14 wks GA. Can I give herVermox antihelmintic? S Banovic
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