Medications and Reported Associated Malformations

TABLE H-1

Selected Medications and Reported Associated Malformations *

Drug	Malformation(s)
Acetazolamide	Sacrococcygeal teratoma
Acyclovir	CDH, neural tube defect, cleft lip, clubfoot, transposition
Alprazolam	Umbilical hernia, clubfoot
Albuterol	Cleft palate, cranioschisis, cardiovascular defect, spina bifida, polydactyly, fetal tachycardia
Amantadine	Cardiac defects
Aminopterin	Neural tube defects, hydrocephalus, limb shortening, cleft lip/palate, clubfoot
p-Aminosalicylic acid	Ear deformity, limb deformity, hypospadias
Amiodarone	FGR, ventricular septal defect, micrognathia
Amitriptyline	Limb reduction, micrognathia, hypospadias, cleft palate, thanatophoric dysplasia
Ampicillin	Transposition of the great vessels
Amobarbital	Anencephaly, cardiac defects, limb deformity, cleft lip/palate, polydactyly, genitourinary defects, clubfoot
Amphetamine	Cerebral injury in neonates
Aspirin	Intracranial hemorrhage, FGR
Atenolol	Hypospadias, cardiovascular defects
Atropine	Polydactyly, limb reduction
Azatadine	Oral cleft, limb reduction
Baclofen	Spina bifida
Belladonna	Eye/ear malformations, hypospadias
Benztropine	Cardiovascular defects
Bromides	Polydactyly, gastrointestinal anomalies, clubfoot, FGR
Busulfan	FGR, cleft palate, neural tube defects
Captopril	Second-trimester hypocalvaria, oligohydramnios, renal dysfunction
Carbamazepine	Neural tube defects, cardiac defects
Carisoprodol	Oral clefts
Cephalexin	Cardiovascular defects, oral clefts
Cephradine	Cardiovascular defects
Chlorambucil	Renal agenesis, cardiac defects
Chlordiazepoxide	Microcephaly, duodenal atresia, cardiac defects
Chloroquine	Wilms tumor, hemihypertrophy, tetralogy of Fallot
Chlorothiazide	Fetal bradycardia
Chlorpheniramine	Polydactyly, gastrointestinal defects, hydrocephalus
Chlorpromazine	Microcephaly, syndactyly
Chlorpropamide	Microcephaly, hand anomalies
Ciprofloxacin	Hypospadias, cerebellar hypoplasia, cardiovascular defect, femoral aplasia
Clarithromycin	Craniofacial abnormalities, absent clavicles, spina bifida, cleft lip, pulmonary hypoplasia; coloboma, heart anomaly, choanal atresia, retardation (mental and somatic), genital and ear anomalies (CHARGE) association
Clomiphene	Microcephaly, neural tube defects, cleft lip/palate, cardiac defects, syndactyly, clubfoot, hypospadias
Clonazepam	Cardiovascular defects
Clorazepate	Bifid foot, absent scrotum, short femur, absent fibula, absent metacarpal bones, renal agenesis
Cloxacillin	Cardiovascular defects
Cocaine	Spontaneous abortion, placental abruption, cardiac defects, urinary tract and limb abnormalities, bowel atresias, FGR
Codeine	Pulmonary and genitourinary defects, hydrocephalus, cleft lip/palate
Colchicine	Cardiac malformation, syndactyly, cleft palate
Cortisone	Cataracts, cyclopia, VSD, coarctation of the aorta, clubfoot, cleft lip, gastroschisis
Coumarin derivatives	Spontaneous abortion, FGR, neural tube defects (open and closed) (dorsal midline dysplasia), cardiac defects, scoliosis, limb hypoplasia, cleft palate
Cyclophosphamide	Cleft palate, hand abnormalities, cardiac defects, FGR
Cyclosporine	Limb hypoplasia, agenesis of the corpus callosum, anencephaly, FGR
Cyproheptadine	Cleft lip/palate, hypospadias
Cytarabine	Hand abnormalities (lobster claw deformity), lower limb defects, neural tube defects, cardiac defects
Dacarbazine	Limb reduction defects, cleft palate, encephalocele
Danazol	Ambiguous genitalia
Daunorubicin	FGR
Dexfenfluramine	Hand malformation, anencephaly, vertebral abnormality
Diazepam	Cleft lip/palate, cardiac defects
Dicyclomine	Polydactyly
Dilantin	Microcephaly, hypertelorism, cleft lip/palate, hypoplasia of distal phalanges, short neck, broad nasal ridge
Diltiazem	Cardiovascular defects
Dimenhydrinate	Cardiovascular defects
Diphenhydramine	Cleft lip/palate, genitourinary defects, clubfoot, cardiac defects
Disulfiram	Clubfoot, vertebral defects, anal atresia, cardiac anomalies, tracheoesophageal fistula with esophageal atresia, renal anomalies, limb anomalies (VACTERL) syndrome, phocomelia
Doxepin	Oral clefts, polydactyly
Droperidol	Hydrocephalus, cerebral hypoplasia
Enalapril	Hypocalvaria, renal defects
Ephedrine	Clubfoot
Ethanol (alcohol)	FGR, microphthalmia, micrognathia, microcephaly, hypoplastic maxilla, cardiac defects, gentourinary defects, radioulnar synostosis, Klippel-Feil anomaly, diaphragmatic hernia
Ethoheptazine	Umbilical hernia, hip dislocation
Ethotoin	Cleft lip/palate, patent ductus arteriosus
Ethosuximide	Cleft lip/palate, hydrocephalus, patent ductus arteriosus, spontaneous hemorrhage in the neonate
Etretinate	Neural tube defects, facial dysmorphia, multiple synostoses, syndactylies, limb reduction
Fluconazole	Craniosynostosis, cleft palate, limb shortening
Fluorouracil	Radial aplasia, pulmonary hypoplasia, esophageal and duodenal atresia, cloacal malformation
Fluphenazine	Ocular hypertelorism, cleft lip/palate, imperforate anus
Furosemide	Hypospadias
Griseofulvin	Conjoined twins
Haloperidol	Limb reduction, aortic valve defect
Heparin	Cardiovascular defects
Heroin	FGR, multiple and varied congenital malformations
Hydroxyprogesterone	Spina bifida, anencephaly, tetralogy of Fallot, truncus arteriosus, VSD
Hydroxyzine	Oral clefts
Hyoscyamine	Polydactyly, limb reduction
Ibuprofen	Oligohydramnios, premature closure of patent ductus arteriosus
Imipramine	Diaphragmatic hernia, cleft palate, exencephaly, renal cystic dysplasia, amelia
Indomethacin	Oligohydramnios, premature closure of patent ductus arteriosus, phocomelia, penile agenesis
Isoetharine	Clubfoot
Isotretinoin	Hydrocephalus, neural tube defects, microphthalmia, microcephaly, cardiac defects, limb abnormalities, cleft palate
Itraconazole	Limb defect
Ketoconazole	Limb defect
Ketorolac	Constriction of the ductus arteriosus, fetal renal impairment
Levothyroxine	Cardiac defects, polydactyly
Lindane	Hypospadias
Lisinopril	Hypocalvaria, polydactyly, oligohydramnios
Lithium	Cardiac defects (Ebstein anomaly, VSD, coarctation, mitral atresia), neural tube defects
Lovastatin	Aortic hypoplasia, VSD, anal atresia, renal dysplasia, radial aplasia
Lysergic acid diethylamide	FGR, limb reduction, neural tube defects, cardiac defects
Marijuana	FGR, facial anomalies
Mechlorethamine	FGR, oligodactyly, malformed kidneys
Medroxyprogesterone	Cardiovascular defect
Meclizine	Eye and ear defects, hypoplastic heart, respiratory defects
Mefenamic acid	Constriction of the ductus arteriosus
Melphalan	FGR
Meprobamate	Cardiac defects, omphalocele, joint abnormalities
Mercaptopurine	Cleft palate, microphthalmia, FGR
Metaproterenol	Polydactyly
Methimazole	Patent urachus
Methotrexate	FGR, hypertelorism, dextroposition of the heart, absent digits, absence of frontal bone
Methotrimeprazine	Hydrocephalus, cardiac defects
Metronidazole	Spontaneous abortion, limb, cardiac, urinary, and facial abnormalities
Mifepristone	Sirenomelia, caudal regression syndrome
Minoxidil	Omphalocele, clinodactyly, cardiac defects (VSD and transposition)
Misoprostol	Limb defects, hypocalvaria, cleft lip, clubfoot, gastroschisis
Norethindrone	Neural tube defects, hydrocephalus
Norethynodrel	Cardiac defects, hypospadias
Nortriptyline	Limb reduction
Ofloxacin	Myelomeningocele, hydrocephalus, hypospadias
Omeprazole	Anencephaly, hydranencephaly, clubfoot
Oxazepam	Neural tube defects, FGR
Paramethadione	Spontaneous abortions, FGR, cardiac defects
Penicillamine	Hydrocephalus, flexion deformities, perforated bowel
Pentoxifylline	Cardiac defects
Phenacetin	Craniosynostosis and atresia, musculoskeletal and urinary tract defects
Phenobarbital	Cardiovascular defects
Phensuximide	Ambiguous genitalia
Phenylephrine	Eye and ear abnormalities, syndactyly, clubfoot, musculoskeletal defects
Phenylpropanolamine	Eye and ear abnormalities, polydactyly, hypospadias
Phenytoin	Microcephaly, hypertelorism, cleft lip/palate, hypoplasia of distal phalanges, short neck, broad nasal ridge
Podophyllum	Limb reduction
Procarbazine	FGR, cardiac defects, oligodactyly, malformed kidneys
Prochlorperazine	Cleft palate/micrognathia, cardiac defects, skeletal defects
Propoxyphene	Limb abnormalities, omphalocele, micrognathia, clubfoot, microcephaly
Quinacrine	Renal agenesis, neural tube defects
Quinine	Neural tube defects, hydrocephalus, limb defects, facial defects, cardiac defects, urogenital abnormalities, vertebral abnormality, gastrointestinal anomaly
Reserpine	Microcephaly, hydronephrosis
Retinoic acid	Hydrocephalus, neural tube defects, microphthalmia, microcephaly, cardiac defects, limb abnormalities, cleft palate
Rifampin	Anencephaly, hydrocephalus, limb malformation
Sodium iodide	Ablation of fetal thyroid gland
Sulfasalazine	Cleft lip/palate, hydrocephalus, cardiac defects, urinary tract abnormalities
Sulfonamides	Limb hypoplasia, urinary tract abnormalities
Sumatriptan	Phocomelia, tibial aplasia, clubfoot, cleft palate
Tamoxifen	Ambiguous genitalia
Tazarotene	Reduced skeletal ossification, hydrocephaly, spina bifida, cardiac defects
Temazepam	Oral clefts
Terfenadine	Polydactyly
Tetracycline	Hypospadias, limb hypoplasia
Thioguanine	Absent digits
Tolbutamide	Syndactyly, cardiac defects, clubfoot
Trifluoperazine	Phocomelia, transposition of the great vessels
Trimethadione	FGR, microcephaly, cleft lip/palate, cardiac defects, malformed hand, clubfoot, ambiguous genitalia, esophageal atresia, tracheoesophageal fistula
Trimethoprim	Cardiovascular defects
Valproic acid	Neural tube defects, cardiac defects, facial dysmorphism, hypertelorism, protruding eyes, micrognathia, hydrocephalus, cleft lip/palate, microcephaly, limb reduction, scoliosis, renal hypoplasia, duodenal atresia, hand deformity
Zidovudine	Renal agenesis, microphthalmus, polydactyly, cleft lip/palate, clubfoot, VSD