[Developmental toxicity of the over-the-counter analgetics and antypiretics]

Over-the-counter antipyretics (acetaminophen, aspirin, ibuprofen) and/or analgesics (acetaminophen, aspirin, diclofenac, ibuprofen, naproxen) are relatively safe for adults. However, data on their developmental toxicity is sparse. Moreover, experimental and clinical findings are commonly incompatible. The highest developmental toxicity was found for aspirin. However, unlike full-dose of aspirin, its low doses are compatible during pregnancy. Over-the-counter nonselective cyclooxygenase inhibitors (non-steroidal anti-inflammatory drugs, NSAID) may induce miscarriage, stillbirth, intrauterine growth retardation, preterm constriction of the ductus arteriosus with a secondary persistent pulmonary hypertension, reduced fetal renal perfusion that led to oligohydramion, prolonged pregnancy as well as an increase prevalence of intracranial bleeding in newborns. For acetaminophen and ibuprofen an increased risk of cryptorchidism was also pointed. Prenatal exposure to acetaminophen may also induce bronchial asthma during childhood, preeclampsia, preterm birth, maternal phlebothrombosis and pulmonary embolism. Furthermore, epidemiological data suggest higher risk of cardiac, abdominal wall and orofacial defects of evaluated drugs.