Drug use in pregnancy and lactation

When prescribing drugs for patients who are pregnant or lactating, a clinician needs to ask the following questions: (1) Is pharmacotherapy necessary? (2) What drug can be used that has the lowest potential toxicity according to current knowledge? (3) What pharmacokinetic parameters does the drug follow during pregnancy? (4) What are the major risks inherent to this particular drug treatment? (5) Do the benefits outweight the risks? and (6) How can the risks be minimized by adjusting the drug dosage and duration? It is important to inform the patient of the possible risks and have her participate in making treatment decisions. If possible, the fetus or neonate should be monitored for adverse reactions during the course of treatment, and if any serious problems occur, the medication can be discontinued. Although it is true that no drug is totally without risk when used during pregnancy or lactation, if proper precautions are taken, then treatment can be rendered with minimal risks to both mother and child.