Any agent that can disturb the
development of an embryo or fetus. Teratogens may cause a birth defect in the child. Or a teratogen may halt the
pregnancy outright. The classes of teratogens include radiation,
maternal infections, chemicals, and drugs.
Drugs known to be capable of acting as teratogens include, but are by no means limited to, ACE inhibitors like benazepril (brand
name: Lotensin), captopril (Capoten), enalapril (Vasotec),
fosinopril sodium (Monopril), lisinopril (Zestril,
Prinivil), lisinopril and hydrochlorothiazide (Zestoretic,
Prinzide), quinapril (Accupril), and ramipril (Altace); the
acne medication isotretinoin (Accutane, Retin-A); alcohol,
whether ingested chronically or in binges; androgens (male
hormones); the antibiotics tetracycline (Achromycin),
doxycycline (Vibramycin), and streptomycin; blood-thinners,
such as warfarin (Coumadin); seizure medications, including
phenytoin (Dilantin), valproic acid (Depakene, Depakote,
Valprotate), trimethadione (Tridione), paramethadione
(Paradione), and carbamazepine (Tegretol); the anti-
depressant/anti-manic drug lithium (Eskalith, Lithotab);
antimetabolite/anticancer drugs methotrexate (Rheumatrex)
and aminopterin; the antirheumatic agent and chelator
penicillamine (Ciprimene, Depen); antithyroid drugs, such
as thiouracil/propylthiouracil and carbimazole/methimazole;
cocaine; DES (diethylstilbestrol), a hormone; and
thalidomide (Thalomid). Obviously, alcohol and illegal or
unnecessary drugs should never be used by women who are
pregnant, or who plan to get pregnant. However, sometimes a
medication necessary for health is also a teratogen:
thyroid medication, blood thinners, and lithium are just a
few examples. In these cases, female patients should work
carefully with their doctors to determine if an alternative
treatment is possible before and during pregnancy. In some
cases the danger of birth defects is limited to a certain
part of the pregnancy, and medication can be started again
after that period has passed. Other medications can be
safely restarted with the baby's birth. Some medications
also pass through breast milk, however, and if they cannot
be avoided the mother may need to choose formula feeding
instead.
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