Hydroxyzine (Vistaril®, Atarax®)

Selected References:

  • Bryant Ranch Prepack. 2024. Hydroxyzine Hydrochloride Product Label. Available at: https://www.accessdata.fda.gov/spl/data/897a39b6-65b1-4e52-85e9-2650d23a4dc0/897a39b6-65b1-4e52-85e9-2650d23a4dc0.xml. Accessed 14 April 2025.
  • Calderon-Margalit, R., Qiu, C., Ornoy, A., Siscovick, D. S., & Williams, M. A. 2009. Risk of preterm delivery and other adverse perinatal outcomes in relation to maternal use of psychotropic medications during pregnancy. American journal of obstetrics and gynecology, 201(6), 579.e1–579.e5798.
  • Diav-Citrin O, et al. 2003. Pregnancy outcome after gestational exposure to loratidine or antihistamines: a prospective controlled cohort study. J Allergy Clin Immunol 111:1239-1243.
  • Earl FL, et al. 1973. Teratogenic research in beagle dogs and miniature swine. Lab Anim Drug Test Symp Int Comm Lab Anim, 5th Fischer, Stuttgart pp. 233-247.
  • Einarson A, et al. 1997. Prospective controlled study of hydroxyzine and cetirizine in pregnancy. Ann Allergy Asthma Immunol 78:183-186.
  • Erez S, et al. 1971. Double-blind evaluation of hydroxyzine as an antiemetic in pregnancy. J Reprod Med 7:57-59.
  • Ito S, et al. 1993. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol 168:1393-1399.

Hydroxyzine (Vistaril®, Atarax®)

Selected References:

  • Andersen JT, et al. 2016. Diclofenac/misoprostol during early pregnancy and the risk of miscarriage: a Danish nationwide cohort study. Arch Gynecol Obstet 294(2): 245-250.
  • Cassina M, et al. 2010. First trimester diclofenac exposure and pregnancy outcome. Reprod Toxicol 30:401-404.
  • Choi E-Y, et al. 2023. Neonatal and maternal adverse outcomes and exposure to nonsteroidal anti-inflammatory drugs during early pregnancy in South Korea: a nationwide cohort study. PLoS Med, 20(2):e1004183.
  • Dawood MY. 1993. Nonsteroidal anti-inflammatory drugs and reproduction. Am J Obstet Gynecol, 169(5):1255-1265.
  • Daniel S, et al. 2012. Major malformations following exposure to Nonsteroidal anti-inflammatory drugs during the first trimester of pregnancy. J Rheumatol 39(11): 2163-2169.
  • Daniel S, et al. 2014. Fetal exposure to nonsteroidal anti-inflammatory drugs and spontaneous abortion. Can Med Assoc J 186(5):E177-E182.
  • Daniel S, et al. 2015. NSAIDs and spontaneous abortions – true effect or an indication bias? Br J Clin Pharmacol, 80(4):750-754.
  • Dathe K, et al. 2018. No evidence of adverse pregnancy outcome after exposure to ibuprofen in the first trimester—Evaluation of the national Embryotox cohort. Reproductive Toxicology, 79: 32-38.
  • Ericson A and Kallen BA. 2001. Nonsteroidal anti-inflammatory drugs in early pregnancy. Reprod Toxicol, 15:371-
  • Janssen NM and Genta MS. 2000. The effects of immunosuppressive and anti-inflammatory medication on fertility, pregnancy, and lactation. Arch Intern Med, 160:610-619.
  • Nakhai-Pour HR, et al. 2011. Use of nonaspirin nonsteroidal anti-inflammatory drugs during pregnancy and the risk of spontaneous abortion. CMAJ. 183(15):1713-1720.
  • Nezvalova-Henriksen K et al. 2013. Effects of ibuprofen, diclofenac, naproxen, and piroxicam on the course of pregnancy and pregnancy outcome: a prospective study. BJOG, 120(8):948-959.
  • Nielsen GL, et al. 2001. Risk of adverse birth outcome and miscarriage in pregnant users of non-steroidal anti-inflammatory drugs: population based observational study and case-control study. BMJ, 322(7281):266-270.
  • Nielsen GL, et al. 2004. Danish group reanalyses miscarriage in NSAID users. BMJ, 328(7431):109.
  • Ofori B, et al. 2006. Risk of congenital anomalies in pregnant users of non-steroidal anti-inflammatory drugs: a nested case-control study. Birth Defects Res B Dev Reprod Toxicol 77:268-279.
  • Padberg S, et al. 2018. Safety of diclofenac use during early pregnancy: A prospective observational cohort study. Reprod Toxicol. 77:122-129.
  • Phadke V, et al. 2012. Maternal ingestion of diclofenac leading to renal failure in newborns. Pediatr Nephrol. 27(6):1033-1036.
  • S. Food and Drug Administration. 2020. FDA Warns that Using a Type of Pain and Fever Medication in Second Half of Pregnancy Could Lead to Complications.Available at: https://www.fda.gov/news-events/press-announcements/fda-warns-using-type-pain-and-fever-medication-second-half-pregnancy-could-lead-complications?utm_medium=email&utm_source=govdelivery Accessed 2 Dec 2024.
  • Scherneck S, et al. 2015. Reversible oligohydramnios in the second trimester of pregnancy in two patients with long-term diclofenac exposure. Reprod Toxicol. 58:61-64.

Hydroxyzine (Vistaril®, Atarax®)

Selected References:

  • Andersen HJ. 1983. Excretion of verapamil in human milk. Eur J Clin Pharmacol, 25:279-80.
  • Anderson P, et al. 1987. Verapamil and norverapamil in plasma and breast milk during breast feeding. Eur J Clin Pharmacol, 31:625-627.
  • Belfort MA, et al. 1990. Hemodynamic changes associated with intravenous infusion of the calcium antagonist verapamil in the treatment of severe gestational proteinuric hypertension. Obstet Gynecol, 75:970-974.
  • Benoff S, et al. 1994. The effect of calcium ion channel blockers on sperm fertilization potential. Fertil Steril, 62:606-617.
  • Byerly WG, et al. 1991. Verapamil in the treatment of maternal paroxysmal supraventricular tachycardia. Ann Emerg Med, 20(5):552-554.
  • Czeizel AE, Rockenbauer M. 1997. Population-based case-control study of teratogenic potential of corticosteroids. Teratology, 56:335-340.
  • Czeizel AE, Toth M. 1998. Birth weight, gestational age and medications during pregnancy. Int J Gynaecol Obstet, 60:245-249.
  • Fearrington EL, et al. 1983. Hyperprolactinemia-galactorrhea induced by verapamil. Am J Cardiol, 51:1466-1467.
  • Gluskin LE, et al. 1981. Verapamil-induced hyperprolactinemia and galactorrhea. Ann Intern Med, 95:66-67.
  • Inoue H. 1984. Excretion of verapamil in human milk. Br Med J, 288:645-646.
  • Joglar JA, et al. 2023. HRS expert consensus statement on the management of arrhythmias during pregnancy. Heart Rhythm. 20: e175–264.
  • Katsoff D, Check JH. 1997. A challenge to the concept that the use of calcium channel blockers causes reversible male infertility. Hum Reprod, 12(7):1480-482.
  • King BD, et al. 1983. Impotence during therapy with verapamil. Arch Intern Med, 143:1248-1249.
  • Magee LA, et al. 1996. The safety of calcium channel blockers in human pregnancy: a prospective, multicenter cohort study. Am J Obstet Gynecol, 174(3):823-828.
  • Miller MR, et al. 1986. Verapamil and breast-feeding. Eur J Clin Pharmacol, 30:125-126.
  • Murad SHN, et al. 1985. Effects of verapamil on uterine blood flow and maternal cardiovascular function in the awake pregnant ewe. Anesth Analg, 64:7-10.
  • Spelger G, et al. 1980. Kardiale Parameter beim Neugeborenen nach Tokolyse [Cardiac parameters of the newborn after tocolysis (author’s transl)]. Klin Padiatr, 192(4):319-324. German.
  • Tamirisa KP, 2022. Arrhythmias and Heart Failure in Pregnancy: A Dialogue on Multidisciplinary Collaboration. J Cardiovasc Dev Dis, 9:199.
  • Tektemur A, et al. 2020. Verapamil-induced ion channel and miRNA expression changes in rat testis and/or spermatozoa may be associated with male infertility. Andrologia, 52(10):e13778.
  • Weber-Schoendorfer C, et al. 2008. The safety of calcium channel blockers during pregnancy: a prospective, multicenter, observational study. Reprod Toxicol, 2008;26:24-30.
  • 2025. Product labeling. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3283bba6-05dd-3766-e063-6394a90ada69

 

Hydroxyzine (Vistaril®, Atarax®)

Selected References:  

  • An Y, et al. 2014. The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment. Clin Endocrinol (Oxf), 80(3):425-431.  
  • Chan E. 1993. Displacement of bilirubin from albumin by berberine. Biol Neonate, 63:201-208. 
  • Di Pierro F, et al. 2023. Effect of Berberine Phytosome on reproductive, dermatologic, and metabolic characteristics in women with polycystic ovary syndrome: a controlled, randomized, multi-centric, open-label clinical trial. Frontiers in pharmacology, 14:1269605. 
  • Ha S & Song X. 2024. Berberine as adjuvant therapy for treating reduced fertility potential in women with polycystic ovary syndrome: A meta-analysis of randomized controlled trials. Explore (New York, N.Y.), 20(6):103040 
  • Imanshahidi M, et al. 2008. Pharmacological and therapeutic effects of Berberis vulgaris and its active constituent, berberine. Phytother Res, 22:999–1012. 
  • Lampe KF. 1999. Berberine. In DeSmet PAGM, Keller K, Hnsel R, Chandler RF. Adverse effects of herbal drugs, vol 1: 97-103. Springer-Verlag, Berlin. 
  • Zhao S, et al. 2021. Effect and mechanism of berberine against polycystic ovary syndrome. Biomedicine & Pharmacotherapy, 138:111468. 

Hydroxyzine (Vistaril®, Atarax®)

Selected References:

Hydroxyzine (Vistaril®, Atarax®)
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