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    Pregnancy and Breastfeeding Risk Categories: Medications M

    Vaccine Injection

    From Magnesium Hydroxide to Mycophenolate, 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 M.

    MedicationPregnancy Risk CategoryBreastfeeding Risk Category
    Magnesium Hydroxide
    (Milk of Magnesia, Citro-Mag, Mylanta, Gastrobrom)
    BL1
    Magnesium SalicylateCL3
    Magnesium Sulfate
    (Epsom Salt, Magnoplasm, Salvital, Zinvit)
    DL1
    Malathion
    (Ovide, Malathion Lotion, A-Lices, Prioderm, Quellada M, Suleo-M)
    BL3
    Mangafodipir Trisodium
    (Teslacan)
    CL3
    Mannitol
    (Osmitrol)
    CL3
    Maprotiline
    (Ludiomil, Novo-Maprotilene)
    BL3
    Measles + Mumps + Rubella Vaccine
    (MMR Vaccine, M-M-R II, ProQuad, Priorix)
     CL2
    Measles + Mumps + Rubella + Varicella Vaccine
    (ProQuad, MMRV Vaccine)
    C L3
    Measle Virus Vaccine, Live
    (MMR, Attenuvax)
    CL2
    Mebendazole
    (Vernox, Sqworm)
    CL3
    Meclizine
    (Antivert, Bonine, Bonamine, Ancolan, Sea-legs)
    BL3
    Meclofenamate
    (Meclomen)
    DL2
    Medroxyprogesterone
    (Provera, Depo-Provera, Cycrin, Alti-MPA, Gen-Medroxy, Farlutal, Provelle, Divina, Ralovera, DMPA)
    XL4
    Medroxyprogesterone + Estradiol Cypionate
    (Lunelle)
    XL4
    Mefloquine
    (Lariam)
    CL2
    Megestrol
    (Megace, Megace ES)
    XL3
    MelatoninCL3
    Meloxicam
    (Mobic)
    C (first, second trimesters
    (D (third trimester)
    L3
    Melphalan
    (Alkeran)
    DL5
    Memantine
    (Namenda)
    BL3
    Meningococcal Vaccine
    (Menomune, Menveo, Menactra)
    CL1
    Menotropins
    (Pergonal, Humegon, Repronex)
    XL3
    MentholProbaly SafeL3
    Meperidine
    (Demerol, Pethidine)
    CL3
    Mepindolol Sulfate
    (Corindolan)
    C (first trimester)
    D (second, third trimesters)
    L2
    Mepivacaine
    (Carbocaine, Polocaine)
    CL3
    Meprobamate
    (Equanil, Miltown, Novo-Mepro, Apo-Meprobamate, Meprate)
    DL3
    Merbromin
    (Mercurochrome, Asceptichrome, Supercrome, Brocasept, Cinfacromin)
    HazardousL4
    Mercaptopurine
    (Purinethol, 6-MP, Puri-Nethol)
    DL3
    MercuryHazardousL5
    Meropenem
    (Merrem, Meronem)
    BL3
    Mesalamine
    (Asacol, Pentasa, Rowasa, Canasa, Colazal, Lialda, Salofalk, Mesalal, Quintasa, Mesalazine)
    BL3
    Mesoridazine
    (Serentil)
    CL4
    MestranolHazardousL3
    Mestranol + Norethynodrel
    (Enovid)
    XL3
    Metamizole
    (Dipyrone, Algosfar, Algozone, Analagin, Novalgin, Melubrin, Novalgina)
    Possibly HazardousL3
    Metaxalone
    (Skelaxin)
    CL3
    Metformin
    (Glucophage, Glucovance, Gen-Metformin, Glycon, Diabex, Diaformin, Diguanil)
    BL1
    Metformin + Sitagliptin
    (Janumet)
    BL3
    Methacholine Chloride
    (Arthralgen, Mecholyl, Provocholine)
    CL3
    Methadone
    (Dolophine, Metadon, Physeptone, Biodone Forte, Physeptone, Methex)
    CL3
    Methamphetamine
    (Desoxyephedrine, Desoxyn, Pervitin, Anadrex, Metherine)
    CL5
    Methenamine
    (Cystex, Hiprex, Urex)
    CL3
    Methicillin
    (Staphcillin, Celbenin, Metin)
    BL3
    Methimazole
    (Tapazole)
    DL2
    Methocarbamol
    (Robaxisal, Robaxin)
    CL3
    Methohexital
    (Brevital, Breital)
    BL3
    Methotrexate
    (Folex, Rheumatrex, Ledertrexate, Methoblastin, Arthitex)
    XL3
    Methscopolamine
    (Pamine, Aerohist, AlleRx, Amdry-D)
    CL3
    Methyl SalicylateProbably SafeL3
    MethylcelluloseAL1
    Methyldopa
    (Aldomet, Apo-Methyldopa, Dopamet, Nova-Medopa, Aldopren, Hydopa, Nudopa)
    BL2
    Methylene Blue
    (Dolsed, Atrosept, Prosed, Urimar-T)
    CL4
    Methylergonovine
    (Methergine, Ergometrine, Methylerometrine)
    CL2 (acute use)
    L4 (chronic use)
    MethylmethacrylateProbably SafeL3
    Methylphenidate
    (Ritalin, Concerta, Metadate CD, Metadate ER, Methylin, Dayrana, Focalin XR, PMS-Methylphenidate, Riphenidate)
    CL3
    Methylprednisolone
    (Solu-Medrol, Depo-Medrol, Medrol, Neo-Medrol, Advantan)
    CL2
    Methylsulfonylmethane
    (MSM, Crystalline DMSO, DMSO2)
     Probably SafeL3
    Metoclopramide
    (Reglan, Metozolv ODT, Apo-Metoclop, Emex, Maxeran, Maxolon, Pramin, Gastromax, Paramid)
    BL2
    Metoprolol
    (Toprol-XL, Lopressor, Apo-Metoprolol, Betaloc, Novo-Metoprol, Minax)
    CL3
    Metrizamide
    (Amipaque)
    DL2
    Metrizoate
    (Angiocontrast, Isopaque)
    DL2
    Metronidazole
    (Flagyl, Metizol, Trikacide, Protostat, Noritate, Apo-Metronidazole, NeoMetric, Novo-Nidazol, Metrozine, Rozex)
    BL2
    Metronidazole Topical Gel
    (MetroGel Topical, Metro-Gel, Metrogyl, Metrogel)
    BL2
    Metronidazole Vaginal Gel
    (Metrogel Vaginal, Metrogel)
    BL2
    Metyrapone
    (Metopyrone)
    CL2
    Mexiletine
    (Mexitil, Novo-Mexiletine, Mexiletine HCL)
    CL2
    Miconazole
    (Monistat IV, Monistat 3, Monistat 7, Micatin, Monistat, Daktarin, Daktozin, Fungo)
    CL2
    Microfibrillar Collagen Hemostat
    (Avitene, Helistat, Hemotene)
     CL3
    Midazolam
    (Versed, Hypnovel)
    DL2
    Midodrine
    (ProAmatine, Amatine, Gutron, Midon)
    CL3
    Mifepristone
    (Mifeprex, Mifegyn, Pencroftonum)
    XL3
    Miglitol
    (Glyset, Diastabol)
    BL2
    Milk Thistle
    (Holy Thistle, Lady Thistle, Marian Thistle, Silybum, Silymarin)
    Probably SafeL3
    Milnacipran
    (Savella)
    C (first trimester)
    D (second, third trimesters)
    L3
    Milrinone
    (Primacor, Corotrop)
    CL4
    Mimyx
    (MimyX)
    Probably SafeL3
    Mineral Oil
    (Paraffin)
    CL3
    Minocycline
    (Minocin, Dynacin, Arestin, Novo-Minocycline, Akamin, Minomycin, Blemix)
    DL3 (acute use)
    L4 (chronic use)
    Minoxidil
    (Loniten, Minodyl, Rogaine, Apo-Gain, Minox)
    CL3
    Mirtazapine
    (Remeron, Avanza, Zispin)
    CL3
    Misoprostol
    (Cytotec)
    XL3
    Mitomycin
    (Mutamycin, Mitomycin-C)
    DL5
    Mitoxantrone
    (Novantrone, Onkotrone)
    DL5
    Mivacurium
    (Mivacron, Mivacrom)
    CL3
    Moclobemide
    (Apo-Moclobemide, Manerix, Arima, Aurorix)
    Probably SafeL3
    Modafinil
    (Provigil, Alertec)
    CL4
    Mometasone
    (Elocon, Nasonex, Asmanex)
    CL3
    Monoethanolamine Oleate
    (Ethamolin)
    CL3
    Montelukast Sodium
    (Singulair)
    BL3
    Moringa Oleifera
    (Morgina, Mulunggay, Natalac)
    Possibly HazardousL3
    Morphine
    (Duramorph, Infumorph, Epimorph, Morphitec, M.O.S. MS Contin, Statex, Morphalgin, Ordine, Anamorph, Kapanol, Oramorph, Sevredol)
    CL3
    Moxifloxacin
    (Avelox, Vigamox)
    CL3
    Mumps Virus Vaccine, Live
    (MMR, Mumpsvax)
    XL3
    Mupirocin Ointment
    (Bactroban)
    BL1
    Mycophenolate
    (CellCept)
    CL4

     

    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. 2010. 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

    Vaccine Injection: http://commons.wikimedia.org/wiki/File:Smallpox_vaccine_injection.jpg

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