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    Pregnancy and Breastfeeding Risk Categories: Medications C

    Black Pills

    From Cabergoline to Cytarabine, learn about the safety of the most common medications during pregnancy and breastfeeding with the following general overview of drugs that begin with the letter C.

    MedicationPregnancy Risk CategoryBreastfeeding Risk Category
    C-1 Esterase InhibitorCL3
    Cabergoline
    (Dostinex)
    BL4
    Caffeine
    (Vivarin, Nodoz)
    CL2
    Calcipotriene
    (Dovonex, Talconex Scalp, Sorilux Foam)
    CL3
    Calcitonin
    (Calcimar, Salmonine, Osteocalcin, Miacalcin, Calcitare, Calsynar, Miacalcic, Caltine)
    CL3
    Calcitriol
    (Rocaltrol)
    CL3
    Calcium SaltProbably SafeL3
    Calendula
    (Marigold)
    XL3
    CamphorCL3
    Candesartan
    (Atacand, Amias)
    C (first trimester)
    D (second, third trimester)
    L3
    CandinCL3
    Cannabis
    (Marijuana, Pot, Weed, Tetrahydrocannabinol)
    CL5
    Capecitabine
    (Xeloda)
    DL5
    Capsaicin
    (Zostric, Axsain, Capsin, Capzasin-P, No-Pain, Absorbine Jr. Arthritis, ArthriCare, Capsig, Natraflex, Pepper Spray)
    CL3
    Captopril
    (Capoten, Apo-Capto, Novo-Captpril, Acenorm, Enzace, Acepril)
    C (first trimester)
    D (second, third trimester)
    L2
    Carbamazepine
    (Tegretol, Epitol, Carbatrol, Apo-Carbamazepine, Mazepine, Teril)
    DL2
    Carbamide Peroxide
    (Gly-Oxide, Debrox, Auro Otic, Peroxide, Exterol, Urea Peroxide)
    CL1
    Carbenicillin
    (Geopen, Geocillin, Carindacillin, Carbapen)
    BL1
    CarbetapentaneCL5
    Carbidopa
    (Lodosyn, Sinemet, Kinson, Sinacarb)
    CL3
    Carbimazole
    Neo-Mercazole, NeoMercazole)
    DL3
    Carbinoxamine
    (Palgic, Arbinoxa)
    CL2
    Carbon MonoxideHazardousL3
    Carboplatin
    (Carboplat, Carbosin, Emorzin, Novoplat, Paraplatin, Paraplatin-AQ)
    DL5
    Carboprost
    (Hemabate, Carboprost Tromethamine)
    CL3
    Carboxymethyl CelluloseProbably SafeL2
    Carisoprodol
    (Soma Compound, Solol, Soma, Carisoma, Vanadom)
    CL3
    Carmustine
    (BCNU, Bicnu, Carmubris, Nitrumon, Gliadel)
    DL5
    Carnitine
    (Carnitor, L-Carnitine)
    BL2
    Carteolol
    (Cartrol, Teoptic)
    CL3
    Carvedilol
    (Coreg, Eucardic, Proreg, Dilatrend)
    CL3
    Cascara SagradaCL3
    Caspofungin Acetate
    (Cancidas)
    CL3
    Castor Oil
    (Alphamul, Neoloaid, Emulsoil, Catrol Oil, Seda-rash, Exzem Oil)
    XL3
    Cefaclor
    (Ceclor, Apo-Cefaclor, Keflor, Distaclor)
    BL1
    Cefadroxil
    (Ultracef, Duricef, Baxan)
    BL1
    Cefazolin
    (Ancef, Kefzol, Cefamezin)
    BL1
    Cefdinir
    (Omnicef)
    BL1
    Cefditoren
    (Spectracef)
    BL2
    Cefepime
    (Maxipime)
    BL2
    Cefixime
    (Suprax)
    BL2
    Cefoperazone
    (Cefobid, Dicapen, Cefoperazone Sodium)
    BL2
    Cefotaxime
    (Claforan)
    BL2
    Cefotetan
    (Cefotan, Apatef)
    BL2
    Cefoxitin
    (Mefoxin)
    BL1
    Cefpodoxime Proxetil
    (Vantin, Orelox)
    BL2
    Cefprozil
    (Cefzil)
    BL1
    Ceftaroline
    (Teflara)
    BL3
    Ceftazidime
    (Fortaz, Tazidime, Ceptaz, Fortum)
    BL1
    Ceftibuten
    (Cedax)
    BL2
    Ceftizoxime
    (Cefizox, Baxam)
    BL1
    Ceftriaxone
    (Rocephin)
    BL1
    Cefuroxime
    (Ceftin, Zinacef, Kefurox, Zinnar)
    BL2
    Celecoxib
    (Celebrex)
    CL2
    Cephalexin
    (Keflex, Ibilex, Apo-Cephalex, Ceporex, Novo-Lexin)
    BL1
    Cephalothin
    (Keflin, Ceporacin)
    BL1
    Cephapirin
    (Cefadyl)
    BL1
    Cephradine
    (Velosef, Anspor, Nicef)
    BL1
    Certolizumab Pegol
    (Cimzia)
    BL3
    Cetirizine
    (Zyrtec, Reactine, Zirtek)
    BL2
    Cetuximab
    (Erbitux)
    CL4
    Cevimeline
    (Evoxac)
    CL3
    ChamomilePossibly HazardousL3
    Chloral Hydrate
    (Aquachloral, Noctec, Novo-Chlorhydrate, Dormel, Elix-Noctec)
    CL3
    Chlorambucil
    (Leukeran, Linfolysin, Alti-Chlorambucil)
    DL5
    Chloramphenicol
    (Chloromycetin, Ak-Chlor, Chloroptic, Sopamycetin, Chlorsig, Biocetin)
    CL4
    Chlordiazepoxide
    (Apo-Chlordiazepoxide, Librium, Libritabs, Solium, Medilium, Amitrol)
    DL3
    Chlordiazepoxide + Clidinium
    (Librax, Clinoxide, Apo-Chlorax, Pro-Chlorax, Corium)
    DL3
    Chlorhexidine
    (Peridex, BactoShield, Betasept, Dyna-Hex, Hibiclens, Hibitane, Hexol, Savlon, Bactigras)
    BL4
    Chloroquine
    (Aralen, Novo-Chloroquine, Chlorquin, Avloclor)
    CL2
    Chlorothiazide
    (HydroDIURIL, Chlortride, Saluric, Diuril)
    CL3
    Chlorpheniramine
    (Aller Chlor, Chlor-Tripolon, Chlor-Trimeton, Demazin, Alunex, Piridon)
    BL3
    Chlorpromazine
    (Thorazine, Ormazine, Chlorpromanyl, Largactil, Novo-Chlorpromazine, Chloractil)
    CL3
    Chlorpropamide
    (Diabinese, Apo-Chlorpropamide, Novopropamide, Melitase)
    CL3
    Chlorprothixene
    (Tarctan, Tarasan)
    CL3
    Chlorthalidone
    (Thalitone, Hydone, Hygroton)
    BL4
    Chlorzoxazone
    (Paraflex, Parafon Forte DSC, Relaxazone, Remular-S, Lorzone)
    cL4
    Cholera Vaccine
    (Dukoral)
    CL3
    Cholestyramine
    (Questran, Cholybar)
    CL1
    Chondroitin Sulfate
    (Viscoat)
    CL3
    Chorionic Gonadotropin
    (A.P.L., Chorex-5, Profasi, Gonic, Pregnyl, Novarel)
    XL3
    Chromium
    (Chromium Picrolinate)
    CL3
    Ciclesonide
    (Omnaris)
    CL3
    Ciclopirox Olamine
    (Loprox)
    BL3
    CilastatinProbably SafeL3
    Cilastatin + Imipenem
    (Primaxin IM, Primaxin IV)
    CL2
    Cimetidine
    (Tagamet, Apo-Cimetidine, Novo-Cimetine, Peptol, Magicul, Peptimax, Zita)
    BL1
    Cinacalcet
    (Sensipar)
    CL3
    Cinnarizine
    (Arlevert, Stugeron)
    CL3
    Ciprofloxacin
    (Cipro, Ciloxan, Ciproxin)
    CL3
    Cisapride
    (Propulsid, Prepulsid)
    CL2
    Cisplatin
    (Abiplatin, Bioplatino, Cis-Gry, C-Platin, Placis)
    DL5
    Citalopram
    (Celexa, Cipramilk, Talam, Talohexal)
    CL2
    Cladribine
    (Leustatin, Leustar, Litak)
    DL5
    Clarithromycin
    (Biaxin, Klacid, Klaricid)
    CL1
    ClavulanateCL3
    Clemastine
    (Tavist, Tavegyl, Dayhist Allergy)
    BL4
    Clidinium BromideCL3
    Clindamycin
    (Cleocin, Cleocin T, Dalacin, Clindatech)
    BL2
    Clindamycin + Tretinoin
    (Veltin, Ziana)
    BL2
    Clindamycin Topical
    (Cleocin T, ClindaDerm, ClindaMax, Clindagel, Clindatech, Dalacin T)
    BL2
    Clindamycin Vaginal
    (Cleocin Vaginal, Dalacin Vaginal Cream, Dalacin T)
    BL2
    Clobazam
    (Frisium)
    CL3
    Clobetasol
    (Clebevate, Clobex, Cormax, Olux-E, Olux, Temovate E, Temovate, Clobetasol Propionate)
    CL5
    Clofazimine
    (Lamprene)
    CL3
    Clofedanol/Chlophedianol
    (Ulone)
    Probably SafeL3
    Clomiphene
    (Clomid, Serophene, Milophene)
    XL4
    Clomipramine
    (Anafranil, Apo-Chlomipramine, Placil)
    CL2
    Clonazepam
    (Klonopin, Rivotril, Apo-Clonazepam, PMS-Clonazepam, Paxam)
    DL3
    Clonidine
    (Catapres, Dixarit, Apo-Clonidine, Novo-Clonidine)
    CL3
    Clopidogrel
    (Plavix)
    BL3
    Clorazepate
    (Tranxene, Tranxene-SD, Apo-Clorazepate, Novo-Clopate)
    DL3
    Clotrimazole
    (Gyne-Lotrimin, Mycelex, Lotrimin, FemCare, Trivagizole, Canesten, Clotrimaderm, Myclo, Hiderm, Clonea)
    B (topical/vaginal)
    C (oral)
    L1
    Cloxacillin
    (Tegopen, Cloxapen, Apo-Cloxi, Novo-Cloxin, Orbenin, Alclox, Kloxerate-DC)
    BL2
    Clozapine
    (Clozaril)
    BL3
    Co-Trimoxazole
    (TMP-SMZ, Bactrim, Cotrim, Septra, Novo-Trimel, Spetrin, Respax, Trimogal)
    C
    D (at term)
    L3
    Coagulation Factor VIIa
    (NovoSeven)
    CL2
    Coal Tar
    (Neutrogena T/Gel, Neutrogena T/Derm, Betatar Gel, Cutar Emulsion, DHS Tar, Denorex, Doak Tar, Duplex T)
    CL2
    Cobalt-57 + Vitamin B12
    (Vitamin B12-radiolabelled, Cyanocobalamin-radiolabelled, Schilling test, Vitamin B12 Absorption Test)
    HazardousL4
    Cocaine
    (Crack)
    C (first, second trimester)
    X (third trimester)
    L5
    Codeine
    (Empirin #3 #4, Tylenol #3 #4, Actacode, Codalgin, Codral, Pandeine, Veganin, Paveral, Penntuss, Kaodene, Teropin)
    CL3
    L5 (in rapid metabolizers)
    Coenzyme Q10
    (Ubiquinone, CoQ10, Ubidecarenone)
    Probably SafeL3
    Colchicine
    (Colcrys, Colgout)
    CL4
    Colesevelam
    (WelChol, Colesevelam HCL)
    BL1
    Colestipol
    (Colestid)
    CL3
    Comfrey
    (Bruisewort, Blackwort, Slippery Root, Russian Comfrey, Knitbone)
    XL5
    Conjugated Estrogens
    (Estratab, Premarin, Menext, Elestrin, Estrace, Estraderm, Delestrogen, Estinyl, Estring, Evorel)
    XL3
    Corticotropin
    (ACT, Acthar, ACTH)
    CL3
    Cranberry ExtractProbably SafeL3
    Cromolyn Sodium
    (Nasalcrom, Gastrocrom, Intal, Nalcrom, Opticrom, Rhynacrom, Vistacrom, Cromese)
    BL1
    11C-Way 100635 or 11C-Raclopride
    (C-Way 100635, C-Raclopride)
    Possibly HazardousL2 (after brief delay)
    Cyclizine
    (Cyclivert)
    BL3
    Cyclobenzaprine
    (Flexeril, Cycoflex, Novo-Cyclprine, Fexmid)
    BL3
    Cyclopentolate
    (AK-Pentolate, Cyclogyl, Cylate, Ocu-Pentolate, Pentolair, Diopentolate, Minims Cyclpentolate)
    CL3 (after 6 hours)
    Cyclophosphamide
    (Neosar, Cytoxan, Procytox, Cycloblastin, Endoxan, Endoxana)
    DL5
    Cycloserine
    (Seromycin, Closina, Cycloserine)
    CL3
    Cyclosporine
    (Sandimmune, Neoral, Restasis)
    CL3
    Cyproheptadine
    (Periactin, PMS-Cyproheptadine)
    BL3
    Cytarabine
    (Cytosar)
    DL5

     

    Pregnancy Risk Categories

    A. Controlled Studies Show No Risk

    Adequate, well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester of pregnancy.

    B. No Evidence of Risk in Humans

    Adequate, well-controlled studies in pregnant women have not shown increased risk of fetal abnormalities despite adverse findings in animals, or, in the absence of adequate human studies, animal studies show no fetal risk. The chance of fetal harm is remote but remains a possibility.

    C. Risk Cannot Be Ruled Out

    Adequate,well-controlled human studies are lacking, and animal studies have shown a risk to the fetus or are lacking as well. There is a chance of fetal harm if the drug is administered during pregnancy, but the potential benefits may outweigh the potential risks.

    D. Positive Evidence of Risk

    Studies in humans, or investigational or post-marketing data, have demonstrated fetal risk. Nevertheless, potential benefits from the use of the drug may outweigh the potential risk. For example, the drug may be acceptable if needed in a life-threatening situation or serious disease for which safer drugs cannot be used or are ineffective.

    X. Contraindicated in Pregnancy

    Studies in animals or humans, or investigational or post-marketing reports, have demonstrated positive evidence of fetal abnormalities or risks which clearly outweighs any possible benefit to the patient.

    Breastfeeding Risk Categories

    L1. Safest

    Drug which has been taken by a large number of breastfeeding mothers without any observed increase in adverse effects in the infant. Controlled studies in breastfeeding women fail to demonstrate a risk to the infant and the possibility of harm to the breastfeeding infant is remote, or the product is not orally bioavailable in an infant.

    L2. Safer

    Drug which has been studied in a limited number of breastfeeding women without an increase in adverse effects in the infant; and/or, the evidence of a demonstrated risk which is likely to follow use of this medication in a breastfeeding woman is remote.

    L3. Moderately Safe

    There are no controlled studies in breastfeeding women; however, the risk of untoward effects to a breastfed infant is possible; or, controlled studies show only minimal non-threatening adverse effects. Drugs should be given only if the potential benefit justifies the potential risk to the infant.

    L4. Possibly Hazardous

    There is positive evidence of risk to a breastfed infant or to breastmilk production, but the benefits of use in breastfeeding mothers may be acceptable despite the risk to the infant (e.g. if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

    L5. Contraindicated

    Studies in breastfeeding mothers have demonstrated that there is significant and documented risk to the infant based on human experience, or it is a medication that has a high risk of causing significant damage to an infant. The risk of using the drug in breastfeeding women clearly outweighs any possible benefit from breastfeeding. The drug is contraindicated in women who are breastfeeding an infant.

    Disclaimer: The information provided in this article is not meant to replace the professional medical advice from your health care provider. For detailed information on specific medications or for information on medications not listed, please consult your health care provider.

    References

    Hale, Thomas W. 2008. Medications and mothers’ milk, 13th edn. Amarillo, Texas: Hale Publishing.
    Hale, Thomas W. 2010. Medications and mothers’ milk, 14th edn. Amarillo, Texas: Hale Publishing.
    Hale, Thomas W. 2012. Medications and mothers’ milk, 15th edn. Amarillo, Texas: Hale Publishing.
    Safe Fetus: http://safefetus.com/index.php
    Search Medica RX: http://www.mims.com/USA

    Image Credits

    Black Pills: http://commons.wikimedia.org/wiki/File:Pills_014.jpg

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